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New Year Potpourri or 20ll Potpourri I

By December 31, 2010Commentary

An article in the Journal of General Internal Medicine reports on physicians’ use of results from patient experience surveys in the State of Massachusetts, which collects and reports the data.  Most physician groups are aware of the results and use them for some form of patient experience improvement programs and a number of the groups can actually collect incentives for doing so.  Larger group practices tend to use the data for improvement most intensively.  Few improvement activities, however, focus on physician/patient interpersonal communication skills, which may be the area needing the most improvement and one that is most important to patients.   (JGIM Abstract)

A Wall Street Journal article reports on prescription drug use by children.  According to figures from Medco, a large pharmacy benefit manager, 25% of children are on at least one chronic medicine and 7% are on two or more.  This is a staggering, if not shocking, number, particularly since most drugs have had very little, if any, testing in children.  The potential side effects are therefore not well-researched.  What research has been done suggests that often there are different adverse consequences than those found in adults.  In some cases, this prescribing just may be occurring for parents’ or others convenience, as is the case with many ADHD prescriptions.   (WSJ Article)

CMS put out a preliminary notice of the quality measures it recommends states adopt for fee-for-service and managed care Medicaid, seeking comments on those proposed standards.  The measures were developed by an AHRQ subcommittee and mirror many existing standards from the National Quality Forum.  Topics covered include prevention and health promotion; acute condition management; chronic condition management; family experience of care and availability.   (CMS Notice)

A Wall Street Journal article notes that many new reform law-related provisions take effect on January 1.  Many of these are the result of rules issued under the law.  Several of the changes relate to pharmaceuticals, for example manufacturers will pay a new tax, Medicare Part D enrollees in the doughnut hole will get a larger discount on prices and higher income beneficiaries will get less of a subsidy for their Part D premiums.  Other changes include limits on administrative spending on by health plans.   (WSJ Article)

Another Wall Street Journal article highlighted the low number of drug approvals by the FDA this year.  The agency approved 21 drugs in 2010, and delayed many others, largely out of enhanced safety scrutiny.  Since government now pays for half of all drugs, it is not hard to suspect that one reason for the delays actually is cost control.  In regard to both new drugs and devices, limiting or delaying access to the market can save significant sums, as they tend to be relatively expensive.   May not be the best way to improve patient care.   (WSJ Article)

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