|
FEDERAL HEALTH UPDATE
*Click to print newsletter in pdf format Mar 12, 2010Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
Additional sponsorship by  www.fedhealthinst.org |
|||
Executive and Congressional News
This legislation extends through 2010 federal jobless benefits and subsidies to help some unemployed people afford health insurance — two programs that were expanded in last year's economic recovery plan. In addition, the federal government
would transfer $25 billion to states to help them afford rising Medicaid
costs. The legislation would also avert a 21 percent increase in payments
to doctors who treat Medicare patients.
Military Health Care News
MyPHRSC, a Medicare pilot project, has been extended through Sept. 30, 2010. MyPHRSC gives enrolled TRICARE For Life (TFL) beneficiaries online access to their Medicare claims records for the preceding 24 months. TFL beneficiaries in South Carolina can register and create their free MyPHRSC health record by going to www.myphrsc.com. A new MyPHRSC feature, the Health Tracker, allows beneficiaries to track some of their own health information so they can better manage their health, allowing them to monitor blood pressure, blood sugar, cholesterol, peak flow and weight, and print out the information and bring it to their doctor. MyPHRSC is available only to TFL
beneficiaries living in South Carolina. Beneficiaries with questions
can email questions@myphrsc.com or call (888) 697-4772.
The former Commandant of the United States Marine Corps, Krulak currently serves as an executive consultant and member of the board of directors for the Union Pacific Corporation in Omaha, Neb., and the Freeport-McMoRan Copper and Gold Corporation in Phoenix, Ariz. Krulak was vice chairman, head of corporate development and acquisitions, and chief administrative officer of the MBNA America Bank, and chairman and chief executive officer of the MBNA Europe Bank, Ltd. Lewin is an elected member of the Institute of Medicine of the National Academies of Sciences and an executive consultant for a number of health care organizations across the United States. Founder of The Lewin Group, a health care management and consulting firm, he was the firm’s president and chief executive officer from 1970 through 1999. Lewin serves on a number of corporate boards, including H&Q Healthcare and Life Sciences funds and Intermountain Healthcare. Mr. Lewis previously served on the Department of Defense Task Force on the Future of Military Health Care. Located on the grounds of Bethesda’s National Naval Medical Center and across from the National Institutes of Health, USU is the nation’s federal school of medicine and graduate school of nursing. The University educates health care professionals dedicated to career service in the Department of Defense and the U.S. Public Health Service. Medical students are active-duty uniformed officers in the Army, Navy, Air Force and Public Health Service who are being educated to deal with wartime casualties, natural disasters, emerging infectious diseases, and other public health emergencies. For more information about USU and
its programs, visit www.usuhs.mil.
The council released its statement despite finding several problems in an environmental impact statement prepared by the U.S. Army for its expansion of bio-containment laboratories at Fort Detrick in Frederick, Md. The committee held public meetings to gather information from officials of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) and contractors involved in the development of the environmental impact statement, as well as from Fort Detrick emergency personnel, the Frederick County Board of Commissioners, and members of the local community. The committee also met with officials from Frederick Memorial Hospital and Frederick County’s emergency management and health departments. The environmental impact statement estimates the effects of potential mishaps at the new USAMRIID facilities, including “maximum credible event” scenarios where Ebola virus and the bacteria causing Q fever are released from an exhaust stack. The committee, however, could not verify the estimate that such an event would lead to insignificant ground concentrations in the surrounding environment and would not pose a hazard to the nearby community. The data to support this estimate were lacking, missing or not transparent in the statement, according to the committee, whose own calculations indicated the potential for significantly higher exposure to those in the surrounding area. An exceptionally large aerosol release of a pathogen might pose a health risk, but the committee said this is an inappropriate maximum credible event because there are no reasonably foreseeable scenarios where such a release could occur. In addition, the environmental impact statement did not adequately document or characterize individual risk of exposure or infection, nor did it consider potential exposures to workers and others on the base itself or how the spread of a pathogen would be affected by population size and density. Although Congress mandated the new labs be located at Fort Detrick as part of a larger bio-defense campus, it would have been appropriate for the statement also to consider risks at an alternative location, such as in a less populated area, which would have provided a comparison helpful for evaluating risk-management strategies. The committee determined that it
would not be useful to propose specific revisions to the environmental
impact statement, given that construction of the new facilities has
begun. Rather, the Army should develop new guidelines for conducting
hazard assessments of bio-containment facilities. Currently there is
no specific guidance for such assessments.
While the site’s essential mission to offer Web-based tools targeting behavioral health issues remains the same, the newly revamped site, focused on the needs of the entire military community, showcases expanded content, easily accessed connections to real-time support, quick health tips, a “geolocator” to find local providers, and updated graphics with banner links to core resources such as the Real Warriors Campaign. In addition to topics on post-traumatic stress, depression, anger, sleep, relationships, substance abuse, physical injury, work adjustment, life stress, health and wellness, families with kids, and spirituality, the six new topics will address mild traumatic brain injury, tobacco, anxiety, military sexual trauma, stigma and resilience. New topics will be rolled out one-by-one over the coming weeks. Facebook and Twitter will be used to announce availability of new topic content. Each topic has a self-assessment, self-paced workshops, videos, and an eLibrary. All topics are easily accessed from the home page allowing users to link up to a vast matrix of expert information and other resources. In a next iteration, coming soon, users will be able to connect via forums and blogs. To fulfill its mission,
the Afterdeployment.org project team continues to work with subject
matter experts through partnerships among the Defense Centers
of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), the military services, the
Department of Veterans Affairs, the National Center for PTSD, and various
academic institutions.
The WPS Bridge65 monthly rate can be "locked" for up to five years, offering peace of mind to anyone concerned about rising health insurance costs. WPS believes this is the only product of its kind in Wisconsin. The WPS Bridge65 is designed to assist individuals who are waiting for Medicare eligibility but do not have access to group health insurance coverage. It can be customized to suit individual needs. WPS offers a range of benefit and deductible levels for the plan, as well as prescription drug coverage. People can choose a traditional copay plan similar to what one may have under a group policy, or an HSA-qualified plan that allows customers to save for current and future medical expenses in a tax-free health savings account. WPS provider networks include Wisconsin doctors and health care facilities. For those who travel extensively, WPS also offers a national network wrap. WPS Bridge65 members are also eligible for discounts on vision care, health club memberships, and other wellness resources. WPS Health Insurance is a not-for-profit
company that has been providing quality health and benefit plan administration
for businesses and individuals throughout Wisconsin for more than 60
years. The company provides claims processing services for the
TRICARE For Life contract, as well as supporting the TRICARE West Region
contract.
Thermomed, a small device that can be used to treat skin infections using heat, was developed by Dr. Naomi Aronson, the director of the infectious diseases division at the Uniformed Services University of the Health Sciences. The device uses two small tines, like a fork, to apply heat in a localized area. By applying that heat in a grid over an infected bite, Aronson found the parasite causing the infection can be killed quickly. Without treatment, the infection can take anywhere from 6 to 12 months to fully heal. The effects of Thermomed treatment on the patient’s skin are a small blister followed by a burn on the same level of pain as sunburn for a day. After that, discomfort was negligible. The treatment is also beneficial because a leishmaniasis infection can be very scarring, and Thermomed devices are used in many cases to remove scars. Cutaneous leishmaniasis major, which has affected some 1,300 American service members and civilians since the beginning of Operations Iraqi and Enduring Freedom, causes ulcer-like, non-healing sores on the skin around an infected bite. Because the more common versions of leishmaniasis can infect the whole body, the only available medication is delivered intravenously and takes more than a week to run its course. In addition, the medicine, sodium stibogluconate, isn’t approved by the U.S. Food and Drug Administration, so it has to be acquired under a research protocol. For the military, this means high costs in paying for the medicine and in transporting troops stateside for weeks at a time to receive treatment. The Thermomed treatment is simple: lidocaine is used to numb the skin around the sore and then the Thermomed is applied to make a small grid of burns over the affected skin and surrounding area. After a few days, the pain is gone and the infection is dead. To learn more, visit
the Uniformed
Services University of the Health Sciences.
The current guidelines for treating troops with such injuries allow for them to come forward on their own. Troops in combat and in close contact with explosions or blasts make the decision on whether they need to be evaluated for concussions or head injuries. But under the new policy, every service member exposed to such an incident will be required to seek attention. Those troops also will be required to rest and will be excluded from their unit's mission cycle for at least 24 hours. Early detection and treatment is the cornerstone of the new policy. The guidelines are designed to help health care providers and researchers track such occurrences, as well as expand their knowledge in treatment, and to ensure unit readiness and longevity in afflicted troops. The policy is intended to addresses the culture of troops who are so dedicated to their mission that they often shrug off their symptoms and simply learn to deal with them. Since 2006, service members exposed to roadside bombs, sports injuries and other incidents that could result in head injuries have participated in the military acute concussion evaluation. The evaluation is done in theater and is flexible enough to be done in a combat environment. Line medics and Navy corpsmen can give the evaluation on the spot or at the base camp in about 10 to 15 minutes without troops having to be transported to a field hospital. Studies have shown that troops recover more quickly when close to their unit. Troops are asked a series of questions that help the medics determine the severity of the concussion. Afterward, the individual is required to rest for 24 hours, and then participate in a follow-up evaluation. If the symptoms persist, more evaluations will be done to determine if the individual needs to be evacuated to a larger medical facility. Making the evaluation mandatory for all troops in question was a request from troops on the front lines, and has drawn much attention from senior defense officials. Veterans Health Care News
Over the next two years, about 200,000 veterans are expected to file disability compensation claims under an historic expansion of three new presumptive illnesses announced last year by VA Secretary Eric Shinseki. They affect veterans who have Parkinson’s disease, ischemic heart disease and B-cell leukemias. In practical terms, veterans who served in Vietnam during the war and who have one of the illnesses covered by the "presumption of service connection" don’t have to prove an association between their medical problems and military service. This “presumption” makes it easier for Vietnam veterans to access disability compensation benefits. Vietnam veterans are encouraged to submit their claims as soon as possible to begin the process of compensation. Along with the publication of proposed regulations for the three new presumptives this spring, VA intends to publish a formal request in Federal Business Opportunities for private-sector corporations to propose automated solutions for the parts of the claims process that take the longest amount of time. VA believes these can be collected in a more streamlined and accurate way. Development involves determining what additional information is needed to adjudicate the claim, such as military and private medical records and the scheduling of medical examinations. With this new approach, VA expects to shorten the time it takes to gather evidence, which now takes on average over 90 days. Once the claim is fully developed and all pertinent information is gathered, VA will be able to more quickly decide the claim and process the award, if granted. The contract is expected to be awarded
in April, with proposed solutions offered to VA within 90 days. Implementation
of the solution is expected within 150 days.
This initiative is aimed at improving care and services to service members and veterans by sharing health information using the Nationwide Health Information Network (NHIN) developed under the leadership of the Department of Health and Human Services (HHS). DoD and VA selected the Virginia/Tidewater area of Southeastern Virginia as the next area to partner with. Based on its high concentration of veterans, military retirees, members of the guard and reserve and active duty service members and their dependents. In the Virginia/Tidewater area, VA and DoD will partner with private sector hospitals that have joined a regional health information exchange in this area. The Virginia/Tidewater pilot builds on the first pilot in San Diego with Kaiser Permanente. Service members and veterans in the Virginia/Tidewater area will be invited to participate in this health data exchange program. scheduled to launch this year. Individuals who choose to participate will authorize their public and private sector health care providers and doctors to share specific health information electronically, safely, securely and privately. The program, through policy and technology, places the highest priority on patient privacy and data security. No exchange of information will occur without the appropriate permissions of the individual patients. Access to care will not be affected by a decision not to participate. Health Care News
In the letter, Sebelius called on the executives to publicly justify proposed health insurance premium increases. Sebelius’ letter comes after a meeting last week with these executives at the White House. The letter comes shortly after a new analysis from Goldman Sachs found that competition in the insurance market is so weak, insurance companies can continue to raise rates even if it means losing customers. The analysis found that “price competition is down” and that “incumbent carriers seem more willing than ever to walk away from existing business.” To view a copy of the letter, please
visit http://www.hhs.gov/news/press/
In recent years a new type of treatment called artemisinin-based combination therapy (ACTs) has transformed the treatment of malaria, but if not used properly the medicine could become ineffective. The Guidelines for the Treatment of Malaria (second edition) provides evidence-based and current recommendations for countries on malaria diagnosis and treatment. The main changes from the first edition of the guidelines (published in 2006) are the emphasis on testing before treating and the addition of a new ACT to the list of recommended treatments. In 2008, just 22 percent of suspected malaria cases were tested in 18 of 35 African countries reporting. Until now, most clinics had to rely on microscopy, but the recent development of quality-assured Rapid Diagnostic Tests (RDTs) using a dip stick and a drop of blood means a policy change is possible. The tests can reliably demonstrate the presence or absence of malaria parasites in the blood and can be performed at all levels of the health system, including community settings. The move towards universal diagnostic testing of malaria is a critical step forward in the fight against malaria as it will allow for the targeted use of ACTs for those who actually have malaria. WHO is supporting malaria endemic countries to improve the quality of their diagnostic services using both microscopy and RDTs, and urging the manufacturers of RDTs to continue improving the accuracy and quality of these critically important diagnostic tests. WHO estimates that 80 countries have adopted ACTs for first-line treatment of uncomplicated P. falciparum malaria. In the guidelines, WHO emphasizes the importance of treating this deadliest form of the disease with artemisinin-based combination therapies. WHO has now added a fifth ACT — dihydroartemisinin plus piperaquine — to the previous list of recommended medicines. WHO recommends oral artemisinin-based monotherapy should be removed from the market because its use will hasten the development of parasite resistance. Countries need to ensure that patients are diagnosed properly and take the full dose of ACTs to prevent the development of drug resistance. The first ever guidelines on Good procurement practices for artemisinin-based antimalarial medicines are based on the newest stringent internationally agreed production and procurement quality standards. The manual aims to improve the capacities of national and international procurement officers in the understanding of key quality elements and required documentation. Half of the world's population is
at risk from malaria. Each year almost 250 million cases occur, causing
860 000 deaths. Approximately 85 percent of these deaths are among children,
and most occur in Africa.
The new system will let members create personalized communities where they can safely share information with other users, as well as groups that will be open to the public. Medical professionals will be on hand to participate in community discussions, and experts from various medical groups and societies are expected to lead discussions with members. The WebMD Health
Exchange system will be open to third-party sponsors, who will be allowed
to create branded exchanges and host consumer discussions on a variety
of health and wellness issues.
Collins will share the honor with co-recipients Eric Lander, Ph.D., director of the Broad Institute at the Massachusetts Institute of Technology and Harvard University, and David Botstein, Ph.D., director of the Lewis-Sigler Institute for Integrative Genomics at Princeton University. The prize was announced by James J. Barba, president and chief executive officer of Albany Medical Center and chairman of the National Selection Committee. This year’s honorees will be recognized during an April 23 celebration at Albany Medical Center in Albany, N.Y. Collectively, the work of Drs. Collins, Lander, and Botstein unlocked the human genome, paving the way for easier identification and study of genes associated with common diseases such as diabetes, cancer and heart disease, and less common genetic conditions such as progeria (premature aging) and Huntington’s disease. Knowledge gleaned from the Human Genome Project, in which all three played a key role, has led to an explosion of genetic research and will in the future be a key to diagnosing, treating, and combating a myriad of human disease conditions. This is the 10th year the Albany
Medical Center Prize, often called "America’s Nobel," has
been awarded. It was established in 2000 by the late Morris "Marty"
Silverman to honor scientists whose work has translated from "the
bench to the bedside," resulting in better outcomes for patients,
and to draw positive attention to Albany Medical Center and the Capital
Region of New York as a center for biomedical research and medical education.
The study was conducted to determine if immunized children could act as a barrier to limit the spread of influenza to the wider, unvaccinated community, a concept known as herd immunity. Researchers recruited volunteers from 46 Canadian Hutterite religious colonies that have limited contact with surrounding, non-Hutterite populations. A total of 947 children between 36 months to 15 years of age participated in the trial; 502 children in 22 colonies received 2008-09 seasonal influenza vaccine, while 445 youth in the other colonies received hepatitis A vaccine. The hepatitis A vaccine served as a control vaccine for comparison. In the six months after the children were vaccinated, 119 of 2,326 unvaccinated community members (who were of all ages) developed laboratory confirmed cases of influenza. Of these, 80 of 1,055 were from colonies where children received hepatitis vaccine, while 39 of 1,271 were from colonies where children received the influenza vaccine. The researchers found that influenza vaccination was 61 percent effective at indirectly preventing illness — that is, protecting via herd immunity — in unvaccinated individuals if they lived in a colony where approximately 80 percent of the children had received flu vaccine. The findings offer experimental proof to support selective influenza immunization of school aged children to interrupt influenza transmission. Particularly, if there are constraints in quantity and delivery of vaccine, it may be advantageous to selectively immunize children in order to reduce community transmission of influenza. Mark Loeb, M.D., of McMaster University, Hamilton, Ontario, led the trial. The research was funded in part by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and by the Canadian Institutes for Health Research. An illustration showing
how vaccination generates herd immunity is available at http://www3.niaid.nih.gov/
The bad news is that obesity has increased in every five-year period since the survey started measuring it. The good news is that the proportion of adults who are obese has not changed significantly since 2006. Other good news is that the proportion of adults who smoke cigarettes declined in every five year period, however it is disappointing that the number is not significantly lower this year than it was in 2005. It is encouraging that most adults wear seatbelts in the front seat of cars, though it is unfortunate that there has been no significant improvement since 2005. These are the results of a nationwide Harris Poll survey of 1,010 adults surveyed by telephone between February 16 and 21, 2010. The main findings of this new survey are:
Harris uses two different measurers of obesity. Since 1983, it has used the Metropolitan Life tables for people over 25, based on height, weight and body frame. Since 2005, it also has computed the more widely used Body Mass Index (BMI). Reserve/Guard
Reports/Policies
Legislation
Hill Hearings
Meetings / Conferences
| |||
If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject. Back issues availiable at Federal Health Update Archives. |
|||
© Copyright 2007, IFHC 5185 MacArthur Blvd. NW, Suite 104-656, Washington, DC 20016 (202)271-5814 postmaster@fedhealthinst.org |