Doctors, social agencies and community groups that have long been frustrated by the inability to alleviate environmental conditions that contribute to ailments like heart disease and obesity are promoting the idea that a shift in land-use planning and design can stanch some of the harmful influences. The concept is being put to one of its earliest and biggest tests in the La Alma/Lincoln Park neighborhood near downtown Denver. That's where the city's housing authority used a relatively new decision-making tool known as a health impact assessment to draft a redevelopment plan that encourages physical activity and environmental sustainability.
Despite objections from regulators, health insurers Blue Shield of California and Aetna Inc. are proceeding with double-digit rate increases that state officials said were unreasonable. Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates.
In the Supreme Court's ruling last summer, it upheld the ACA, but gave the states the option of whether or not to participate in Medicaid expansion. For hospitals, that meant a big source of necessary funding was suddenly in jeopardy. In states like Arkansas, where many Republican lawmakers campaigned on an anti-Obama-care platform, hospitals are worried about harmful cuts in service—and even fear for their survival—if the legislature says no to expansion of coverage. Hospitals are feeling even more vulnerable after the "fiscal cliff" deal in January that slashed reimbursement rates even more, with Arkansas hospitals projected to take an additional cut of more than $400 million.
The poll of more than 2,000 medical students and residents from every medical school in the United States found that one-third of first-year students and more than half of fourth-year students and residents said they received drug-industry-sponsored gifts. Most of the students said this interaction with drug companies provided them with valuable education, but the majority also agreed that these interactions opened them up to bias, according to the findings published online in the Journal of General Internal Medicine.
Twitter users send around 500 million tweets a day, an endless fire hose of information about how people feel, what they're doing, what they know and where they are. For epidemiologists and public health officials, it's a potential gold mine of data, a possible way to track where disease is breaking out and how it spreads, as well as how best to help—but only if they can figure out how to find the useful signal amid all that noise.
Federal regulators are giving themselves an extra four months to perform a surprise do-or-die inspection of Parkland Memorial Hospital. Under the original safety oversight agreement with the public hospital, struck in late 2011, Parkland was supposed to undergo such a survey some time before April 30, 2013. It could still happen any day now. But regulators recently realized that not enough time was built into the agreement to allow for the element of surprise, said David Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services.