Hospitals and insurance companies said that President Obama had substantially overstated their promise to reduce the growth of health spending. Obama invited health industry leaders to the White House to trumpet their cost-control commitments. But three days later, confusion swirled as the companies' trade associations raced to tamp down angst among members around the country. After meeting with six major healthcare organizations Obama hailed their cost-cutting promise as historic, but healthcare leaders who attended the meeting have a different interpretation. They say they agreed to slow health spending in a more gradual way and did not pledge specific year-by-year cuts.
The Federal Coordinating Council for Comparative Effectiveness Research took its second listening session on the road from Washington on Wednesday.
At the session in Chicago, the council, authorized under the American Recovery and Reinvestment Act (ARRA) to assist federal agencies in coordinating and comparing the effectiveness of health services research, heard requests for addressing disparities and creating better transparency for research.
The goal of comparative effectiveness research (CER) is to provide information on the relative strengths and weakness of various medical interventions. Like the previous session last month, individuals participating in the listening session—representing provider, patient, research, medical education, and other healthcare organizations—suggested new ideas to consider.
Neva Lubin-Johnson, MD, a general internist on the National Medical Association's board of trustees, told the council that African-Americans have rarely been represented in clinical trials in numbers that are reflective of the general population as a whole.
Since much of comparative effectiveness data is retrospective, current and future data will continue to be "flawed"—to the detriment of African-Americans—if data issues are not addressed now, she said. "Evidence-based research has led to conclusions that are not necessarily relevant."
This can be problematic when examining conditions, such as prostate cancer, which occurs four times more often in African-American men, she said. In situations such as this, an oversampling of the population might be appropriate when it comes to comparative effectiveness research, she suggested.
Thomas Wilson, PhD, an epidemiologist speaking on behalf of the American Board of Quality Assurance and Utilization Review Physicians and the Population Health Impact Institute, called for more transparency when it came to comparative effectiveness research. This includes disclosure of a researcher's potential conflict of interest—especially in peer-reviewed journals.
"Our concern is that the traditional reliance on expert and anonymous peer review to ferret out these problems in not working," Wilson said. "The tried and true way forward is to provide detailed, timely, and clearly written disclosures of the methods used. This will enable the users of comparative effectiveness research findings to trust but verify."
He suggested that those researching comparative effectiveness should pledge "to reduce bias that will rarely—if ever be totally eliminated—and to prominently state in clear language the usefulness and the limitations of their findings." Also, researchers should show results prior to adjustments, as well as adjusted results, and research papers should disclose in details the methods and metrics used.
Naomi Aronson, PhD, executive director of the Technology Evaluation Center of the Blue Cross Blue Shield Association, said it will be important to translate knowledge of what works with the care that will work. Healthcare must find out what interventions can "improve clinician and patient adoption" and should use evidence-based care at multiple levels, she said. "We want to know—must know—how knowledge of what works can be translated to healthcare that does work."
California health regulators fined Kaiser Permanente's Bellflower hospital $250,000 for failing to keep employees from snooping in the medical records of Nadya Suleman, the mother who set off a media frenzy after giving birth to octuplets in January. The fine is the first monetary penalty imposed and largest allowed under a new state law enacted last year after widely publicized violations of privacy at UCLA Medical Center involving Farrah Fawcett, Britney Spears, Maria Shriver, and other celebrities.
Massachusetts-based Partners HealthCare narrowed its loss in the second quarter, but still reported a $151 million deficit through the first half of its 2009 fiscal year, largely because of investment declines. The slumping investments, which are used to support expansion, have forced the healthcare system to scale back on a five-year building program across Eastern Massachusetts.
U.S. HealthWorks Medical Group has acquired five Medero Medical centers in Florida. The California-based company acquired two centers in Orlando, one in Leesburg, and two in Tampa. The medical centers focus on providing injury and illness diagnosis and treatment, preventive services, and other occupational health programs. Terms of the transaction were not disclosed.
The waits to see Boston dermatologists, obstetrician-gynecologists, and orthopedic surgeons for routine care have grown longer—to as much as a year for the busiest doctors. A study of five specialties shows that the wait for a nonurgent appointment in the Boston area has increased in the past five years, and now averages 50 days. Patients in Boston and other areas of Massachusetts for years have faced notoriously long delays, according to earlier surveys of physicians' offices. A number of factors contribute, doctors said, but the 2006 health insurance law which has required hundreds of thousands of state residents to obtain coverage probably has worsened the waits.
U.S. House Democrats are weighing an expansion of the government's role in healthcare that would include a mandate that employers provide coverage to all full-time workers or pay a percentage of their payroll to the Treasury. Also being considered is a new government-run program to provide health coverage to some of the estimated 46 million uninsured Americans. This "public option" competing with private insurers would likely be run by the Department of Health and Human Services.
Though health officials say the swine flu outbreak appears relatively mild, some medical experts say the United States is unprepared in many ways to handle a severe pandemic. Hundreds of ERs have shut down over the past 15 years, largely because of financial pressures, and even hospital equipment could be in short supply.
Michigan residents without health insurance would have a chance to buy an affordable health policy under measures introduced by Sen. Tom George. The legislation sets the stage for a debate about what to do about rising health insurance costs and Michigan's growing number of uninsured people. One in 11 state residents has no health coverage.
The Massachusetts Senate's plan to cut 28,000 legal immigrant residents from Commonwealth Care coverage is discriminatory and shortsighted, advocates for the immigrant community say. The proposed cuts are included in the Senate Ways and Means committee budget. Commonwealth Care, created as part of the 2006 health law, aimed to make insurance coverage nearly universal in Massachusetts. It extended state-subsidized insurance on a sliding price scale to working-class residents who did not previously qualify.
