- The Senate the Veterans Affairs Committee held a hearing
on Dec. 5, 2007, to consider the nomination of Dr. James Peake to be Secretary of
Veterans Affairs. Dr. Peake answered committee members’ questions regarding the
needs of veterans suffering from traumatic brain injuries (TBI) and PTSD, disability
ratings, provision for care in rural areas and the transition of veterans between
DoD and VA .
Military Health Care News
- The Office of the Assistant Secretary of Defense for
Health Affairs published a notice in the Federal Register on Dec. 4, 2007, to advise interested parties of a
Military Health System (MHS) demonstration project entitled Enhanced Access to Autism
Services Demonstration Project. This demonstration project will begin
60 days after publication in the Federal Register (Feb. 2, 2008) and will
remain in effect for two years from the start date of the demonstration.
The Department of Defense (DoD) proposes the program under
DoD’s demonstration authority under 10 United States Code (U.S.C.) 1092 to expand
the availability of Intensive Behavioral Intervention (IBI) services (defined as
an intensive application of certain behavior modification interventions) to Extended
Care Health Option (ECHO) program beneficiaries with autism. The demonstration program
will permit TRICARE cost-sharing of services by IBI tutors under a modified corporate
services model. This demonstration will determine whether military families are
able to make more effective use of the special education benefit in the ECHO program.
Additionally, the demonstration will help determine the effectiveness of expanding
the provider base in improving the access to services for TRICARE and attendant
improvement in functional outcome for those military dependent children receiving
services.
For purposes of this demonstration, provider qualifications
will be established by DoD pending development of national standards by a nationally
recognized certifying body for ABA providers, which standards DoD determines appropriate
for acceptance in the delivery of quality care under the program. DoD intends
to retain the ECHO benefit as currently outlined in 32 Code of Federal Regulations
(CFR) 199.5, except for the changes that will be implemented in the demonstration
program noted above.
- The US Family Health Plan, a managed care (TRICARE Prime)
option within the government's military health benefits system, has achieved 2007
national member satisfaction ratings among the highest of all managed care organizations
(MCOs) in America. It was evaluated against a protocol known as the Health
Plan Employer Data & Information Set (HEDIS(R)) through a methodology called
the Consumer Assessment of Healthcare Providers and Systems (CAHPS(R)) 4.0H Survey.
The CAHPS Survey methodology—the most comprehensive tool
for measuring consumer satisfaction with health plans—was developed jointly by the
Agency for Healthcare Research (AHRQ) and The National Committee for Quality Assurance
(NCQA). Designed to produce standardized results, the CAHPS Survey measures the
members' experience with health plan care and service over the preceding 12 months.
A random sample of 4,372 US Family Health Plan members,
representing all six hospital and physician networks contracted with the Department
of Defense (DoD) to deliver care through the Plan, rated their overall satisfaction
with the Plan, its customer service and their utilization of its healthcare services.
On a scale of 0 to 10 (with 10 as the best possible rating), 87.9 percent of the
US Family Health Plan members rated their overall satisfaction with the Plan as
an 8, 9 or 10. The national average for member satisfaction with health plans, based
on the 251 plans documented by the NCQA in its Quality Compass 2007 Public Report,
is 63.2 percent.
The US Family Health Plan members' satisfaction rating for
claims processing also significantly surpasses the Quality Compass benchmark. Further,
members continue to report strong satisfaction with the Plan's customer service.
- Health Net Federal Services, LLC,
the contractor administering the TRICARE program, which
provides health care support and services to more than 3 million active duty and
retired military personnel and their eligible family members in the North Region, announced it recently received multiple awards
for its health education materials by the Health Information Resource Center (HIRC).
HIRC is a national clearinghouse for consumer health programs, recognizing the best
materials and resources through its National Health Information and World Wide Web
Health Awards.
Health Net's Preventive Care Services division
provides extensive health information programs and resources for TRICARE beneficiaries
and military treatment facilities in order to promote health and reduce the risk
of disease among military families in the TRICARE North Region.
Health Net Federal Services received five
distinguished awards in the Health Promotion/Disease and Injury Prevention category.
Health Net's Healthy Living Newsletter series, Take Charge of Your Health Online
poster series and Breast Health Self-Exam card each won a National Health Information
Award. Health Net's Web-based resources, the Healthy Living page and Healthy Living
with Health Net Weight Management Program, each received a World Wide Web Health
Award.
Health Net's Healthy Living page provides
comprehensive resources on a variety of health issues including children's health,
disease management, self-care, stress management, tobacco cessation, weight management
and women's health.
The online Healthy Living with Health Net
Weight Management Program promotes lifestyle habits to maintain a healthy weight
for life. The program is often used as a supplemental resource by Military Treatment
Facilities in the TRICARE North Region when educating and counseling patients who
want to reach or maintain a healthy weight. http://www.pr-inside.com/print333465.htm
- TRICARE Management Activity (TMA) published a news release
announcing that a limited amount of TRICARE beneficiary data had been placed at
risk through unauthorized access to claims information. Proactive measures
are being taken to ensure that affected TRICARE beneficiaries are informed.
Analysis thus far has not produced indications of the beneficiary data being misused.
Patient data were found to be accessible in a manner that
did not meet stringent security specifications for the Department of Defense or
TRICARE’s information technology services provider Electronic Data Systems (EDS).
The data included personal information, such as the full or partial Social Security
number of the primary beneficiary and, for a dependent, name, birth date and limited
health information. The data were held on a Web application server that allowed
external entities an unauthorized level of access without going through the required
authentication process if the Web address was known. That situation has since
been remedied.
EDS has sent out approximately 4,700 notification letters
informing affected beneficiaries of the risk. The envelopes contain a cover
letter from Army Maj. Gen. Elder Granger, deputy director, TMA. They also
contain an informational letter about the incident from EDS, including identity
protection information.
EDS has established a specific “help line” to handle questions
and concerns. The beneficiary notification letters contain a toll-free number—(800)
556–3195—that can be used in the U.S. and from overseas. Those located outside the
United States must dial the country’s AT&T USADirect access number first.
EDS is offering beneficiaries put at risk a free, one-year
subscription to a credit monitoring and protection service. Through this service,
beneficiaries will have access to specialists with a leading identity theft and
mitigation firm. These specialists will be able to respond to concerns about
any actual identity theft as well as provide more detailed information on credit,
fraud and identity theft matters. Additionally, those affected will receive
up to $20,000 identity theft protection coverage with no deductible as it relates
to this matter. http://www.tricare.mil/pressroom/news.aspx?fid=350
- Army Maj. Gen. George Weightman took command of the
U.S. Army Medical Research and Materiel Command (MRMC) in a ceremony Nov. 28, 2007.
In his new role, Weightman is responsible for improving the readiness and materiel
of the U.S. armed forces. The MRMC’s mission is to advance research, development,
and acquisition of knowledge and medical products; deliver, maintain, and dispose
medical equipment and supplies; provide health facility capital investment and life
cycle management expertise; and develop, deploy, operate, and sustain medical IM/IT
systems.
- The Defense Center of Excellence (DCoE) for Psychological
Health (PH) and Traumatic Brain Injury (TBI) began initial operations. The DCoE
will be fully functional by October 2009. It is currently operating in temporary
office spaces in Rosslyn, Va., as part of its initial phase.
The Department of Defense (DoD), with support from the Department
of Veterans Affairs (VA), is leading a national collaborative network to advance
and disseminate PH/TBI knowledge, enhance clinical and management approaches, and
facilitate other vital services to best serve the urgent and enduring needs of warrior
families with PH and/or TBI.
The center will integrate quality programs and advanced
medical technology to give expertise in dealing with psychological health and traumatic
brain injuries. The DCoE will coordinate existing medical, academic, research,
and advocacy assets within the services with those of the VA and the Health and
Human Services Department, other federal, state and local agencies, as well as academic
institutions.
The Defense and Veterans Brain Injury Center (DVBIC) is
now integrated into the center. DVBIC has DoD’s primary subject matter expertise
on TBI and many of its functions are transitioning to the DCoE. The DoD Center for
Deployment Psychology, currently at the Uniformed Services University of the Health
Sciences, is also integrated into the training and education functions of the DCoE.
http://media-newswire.com/release_1058263.html
Veterans Health Care News
- The Department of Veterans Affairs (VA) announced it
will provide nearly $4.7 million for “caregiver assistance pilot programs” to expand
and improve health care education and provide needed training and resources for
caregivers who assist disabled and aging veterans in their homes.
The pilot programs will support eight caregiver projects
across the country. In addition, VA provides support and assistance through
a variety of programs such as care management, social work service, care coordination,
geriatrics and extended care and through its nationwide volunteer programs.
Among the key services provided to caregivers are transportation,
respite care, case management and service coordination, assistance with personal
care (bathing and grooming), social and emotional support, and home safety evaluations.
Education programs teach caregivers how to obtain community
resources such as legal assistance, financial support, housing assistance, home
delivered meals and spiritual support. In addition, caregivers are taught
skills such as time management techniques, medication management, communication
skills with the medical staff and the veteran and ways to take better care of themselves.
Many of the projects use technology, including computers,
Web-based training, video conferencing and teleconferencing to support the needs
of caregivers who often cannot leave their homes to participate in support activities.
- At the Memphis (Tenn.) and Palo Alto (Calif.) VA medical
centers, a project will provide education, support and skills-building to help caregivers
manage both patient behaviors and their own stress. This intervention will
be provided in 14 Home-Based Primary Care (HBPC) programs across the country and
also to caregivers in non-HBPC settings at the Palo Alto VAMC.
- At the VA medical center in Gainesville, Fla., caregivers
will take part in a Transition Assistance Program to provide skills training, education
and supportive problem solving using videophone technology.
- At the VA Healthcare System of Ohio, headquartered in
Cincinnati, caregiver advocates will be available around the clock to coordinate
between VA and community services.
- At the VA Desert Pacific Network and the VA Sierra Nevada
Healthcare System, VA will work with a community coalition to provide education,
skills training and resources for caregivers of veterans with traumatic brain injury
using computer-based telehealth, including Web, telephone and videoconferencing.
- At the VA medical center in Albany, N.Y., a pilot project
will convert a three-hour workshop developed by the National Family Caregivers Association
called “Communicating Effectively with Health Care Professionals” into a cost-effective
multimedia format.
- At the Atlanta VA Medical Center, use of computer-based
technology will provide instrumental help and emotional support to caregivers who
live in remote areas or to those who cannot leave a patient alone.
- The Tampa VA Medical Center and the Miami VA Healthcare
System are working on a collaborative project. In the Tampa area, the current
program will be expanded to provide 24-hour in-home respite care to temporarily
relieve caregivers up to 14 days a year. In Miami, the program will coordinate
comprehensive community-based care services, including respite, home companions,
adult day care and use of emergency response system.
- The VA Pacific Islands Health Care System will use the
“medical foster home” model of care, in which caregivers in the community take veterans
into their homes and provide 24-hour supervision. This program will take place
on the islands of Kauai, Hawaii, Maui and rural areas of Oahu.
Health Care News
- The National Heart, Lung, and Blood Institute of the
National Institutes of Health announced a new strategic plan to guide its next decade of research, training, and education
to reduce the national burden of cardiovascular, lung, blood, and sleep disorders.
The plan sets forth three major goals that cover the
scientific continuum from bench to bedside and address basic, clinical, and translational
research. Realizing the future envisioned in the plan will require collaboration
with other organizations, both public and private, and with other agencies of the
federal government.
Powerful new research approaches in the fields of genetics,
genomics, and imaging provide unprecedented opportunities to achieve the one of
the three goals: to increase understanding of the molecular and physiological basis
of health and disease. An example of a new program to address this goal is one that
will link genetic data from long-standing groups of clinical study participants
with data about their health indicators and characteristics, and then make the data
available to researchers -- with appropriate privacy safeguards.
A second goal is to enhance knowledge of the clinical mechanisms
of disease and thereby identify better approaches to prevention, diagnosis, and
treatment. Addressing this goal will be enabled by new clinical research networks
designed to investigate innovative approaches to promote establishment of standard
treatment protocols to test new basic science discoveries and then foster rapid
dissemination of research findings to health care professionals and the public.
The final goal is to improve the translation of research
into practice for the benefit of personal and public health by seeking a better
understanding of the processes for health behavior change. Approaches to be employed
include those that will tie the development of guidelines for clinical practice
to up-do-date scientific evidence and then promote their use through appropriately
designed public education programs.
- Nearly one in five U.S. adults – more than 40 million
people – report they do not have adequate access to the health care they need, according
to the annual report on the nation’s health released today by the Centers for Disease
Control and Prevention (CDC).
The report also contains a special section focusing on access
to care, which shows that nearly 20 percent of adults reported that they needed
and did not receive one or more of these services in the past year – medical care,
prescription medicines, mental health care, dental care, or eyeglasses – because
they could not afford them.
In 2005, nearly one in 10 people between the ages of 18
and 64 said they were unable to get necessary prescription drugs during the past
12 months due to cost. Nearly 10 percent said they delayed receiving needed medical
care. This report did not study the relationship between access to health care services
and health outcomes.
- Young adults 18-24 years of age were more likely than
children or older adults to lack a usual source of care and to be uninsured. About
30 percent of these young adults did not have a usual source of health care and
an equal percentage were uninsured.
- One in 10 adults ages 45-64 years did not have a usual
source of health care, and more than 5 percent of adults in this age group who had
diagnosed high blood pressure, serious heart conditions, or diabetes reported not
having a usual source of medical care.
- In 2005, one out of five people under the age of 65
reported being uninsured for at least part of the 12 months prior to being interviewed.
The majority of this group reported being uninsured for more than 12 months.
- One in 10 women aged 45-64 years with income below the
poverty level reported delaying medical care due to lack of transportation.
- About one-third of all children living below the poverty
level did not have a recent dental visit in 2005, compared with less than one-fifth
of children with higher income.
The study, of more than 276,000 Danish children, found that
those who were overweight when they were 7 to 13 years old were much more likely
to develop heart disease between the ages of 25 and 71—even those who were just
a little chubby as kids and possibly regardless of whether they lost the weight
when they grew up.
The study was published with an analysis of U.S. health
statistics that projects teenage obesity will raise the nation's rate of heart disease
by at least 16 percent by the year 2035, causing more than 100,000 additional cases.
The risk increased with any amount of excess weight in childhood, the researchers
found.
The proportion of U.S. children who are overweight has tripled
since 1976 and now totals more than 9 million. The sharp rise has already caused
a jump in children developing Type 2 diabetes, which used to be known as adult-onset
diabetes because it occurred almost exclusively among adults. Children are also
increasingly being diagnosed with high blood pressure and cholesterol, which raised
fears they will be more likely to develop heart disease —the nation's leading cause
of death.
The risk was significantly lower for those who were overweight
at age 7 but not at age 13, indicating that a child who can lose excess weight while
still young, and remain at a normal weight, can reduce the extra risk substantially.
Because the researchers did not have data on the subjects'
adult weight, they could not definitively determine whether the increased risk was
due to the effects of being overweight when young or because overweight children
are more likely to become overweight adults.
In another study, researchers from the University of California
at San Francisco used federal statistics from the year 2000 and other data to project
that by the time today's adolescents turn 35 in 2020, up to 37 percent of men and
44 percent of women will be obese, resulting in an additional 100,000 cases of heart
disease by 2035. Researchers said the projections would have been even higher if
the analysis had included the Danish data.
- The Centers for Disease Control and Prevention (CDC)
released a new report, which found that the teen birth rate in the United States
rose in 2006 for the first time since 1991. In addition, the study found unmarried
childbearing rose significantly in 2006.
The statistics are featured in a new report,
“Births: Preliminary Data for 2006,” prepared by CDC’s National Center for Health Statistics, and are
based on data from over 99 percent of all births for the United States in 2006.
The report shows that between 2005 and 2006, the birth rate
for teenagers aged 15-19 rose 3 percent, from 40.5 live births per 1,000 females
aged 15-19 in 2005 to 41.9 births per 1,000 in 2006. This follows a 14-year downward
trend in which the teen birth rate fell by 34 percent from its all-time peak of
61.8 births per 1,000 in 1991.
The largest increases were reported for non-Hispanic black
teens, whose overall rate rose 5 percent in 2006. The rate rose two percent for
Hispanic teens, three percent for non-Hispanic white teens and four percent for
American Indian teens.
The birth rate for the youngest teens aged 10-14 declined
from 0.7 to 0.6 per 1,000 and the number of births to this age group fell 5 percent
to 6,405. The birth rate for older teens ages 18-19 is 73 births per 1,000 population
– more than three times higher than the rate for teens ages 15-17 (22 per 1,000).
Between 2005 and 2006 the birth rate rose 3 percent for teens aged 15-17 and 4 percent
for teens aged 18 and 19.
The study also shows unmarried childbearing reached a new
record high in 2006. The total number of births to unmarried mothers rose nearly
eight percent to 1,641,700 in 2006. This represents a 20 percent increase from 2002,
when the recent upswing in non-marital births began. The biggest jump was among
unmarried women aged 25-29, among whom there was a 10 percent increase between 2005
and 2006.
In addition, the non-marital birth rate also rose sharply,
from 47.5 births per 1,000 unmarried females in 2005 to 50.6 per 1,000 in 2006 -
a seven percent one-year increase and a 16 percent increase since 2002.
The study also revealed that the percentage of all U.S.
births to unmarried mothers increased to 38.5 percent, up from 36.9 percent in 2005.
- The preliminary estimate of total births in the U.S.
for 2006 was 4,265,996, a three percent increase -- or 127,647 more births -- than
in 2005.
- Birth rates increased for women in their twenties, thirties
and early forties between 2005 and 2006, as well as to teenagers.
- The Caesarean delivery rate rose again in 2006, to 31.1
percent of all births, a three percent increase from 2005 and a new record high.
The percentage of all births delivered by cesarean has climbed 50 percent over the
last decade.
- The preterm birth rate rose slightly between 2005 and
2006, from 12.7 percent to 12.8 percent of all births. The percentage of births
delivered before 37 weeks of gestation has risen 21 percent since 1990.
- The low birthweight rate also rose slightly in 2006,
from 8.2 percent in 2005 to 8.3 percent in 2006, a 19 percent jump since 1990.
- As a result of the increases in the birth rates for
women aged 15-44, the total fertility rate – an estimate of the average number of
births that a group of women would have over their lifetimes – increased two percent
in 2006 to 2,101 births per 1,000 women. This is the highest rate since 1971 and
the first time since then that the rate was above replacement – the level at which
a given generation can replace itself.
- A variant of a gene involved in communication among
brain cells has a direct influence on alcohol consumption in mice, according to
a new study by scientists supported by the National Institute on Alcohol Abuse and
Alcoholism (NIAAA), part of the National Institutes of Health (NIH), and the U.S.
Army.
Scientists do not know yet whether a similar gene variant,
with a similar effect on alcohol consumption, exists in humans.
Known as Grm7, the gene encodes a receptor subtype
that inhibits the release of glutamate and other neurotransmitter mole |
