FEDERAL HEALTH UPDATE
July 25, 2008Produced 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
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Congressional Schedule
As the Military Health System (MHS) approaches a recent deadline from Congress, and documents its strategy for working on the AHLTA system and the VA’s VISTA electronic health record, several options have surfaced. While no decision has been made, our senior experts and consultants have weighed in. There is a strong feeling here and at the VA that the best approach is a convergent evolution of the two systems. This approach optimizes the strengths of both systems while creating interoperability that will drive more universal information exchange. The Department of Defense and the MHS still believe in the power of harnessing our existing financial and intellectual investment without pulling the plug on either system. We look forward to examining these issues with our leadership, our consultants, and the congress in the coming days, months and years and will work together to ensure the seamless transition of patients and their records in both our great health systems. On a similar note, many participated in the recent June 20th AHLTA Webhall. The Office of the Chief Information Officer greatly appreciates your enthusiastic participation. Your thoughts, concerns, and suggestions are very important to us and we are absolutely committed to making AHLTA work for you. The Defense Health Information Management System (DHIMS) have provided responses to all the questions posed during and after the Webhall. Please click here to view those responses. Thank you for your interest and the valuable feedback you provided, and we hope you continue to provide your input to make the MHS a better place.
Vangent's four-year contract will support FHP&R systems integration, operations, maintenance and management and administration of Sensitive but Unclassified (SBU), Secret and Top Secret Sensitive Compartmented Information (TS SCI) networks. Vangent will also provide 24x7 help desk support for deployed DoD Medical Surveillance Systems and information assurance services including DoD Information Assurance Certification and Accreditation Process (DIACAP). Vangent will serve as the prime contractor, with subcontractors Akimeka, LLC, DefenseWeb Technologies, Inc. and Seidcon, Inc. FHP&R is responsible for deployment-related health policy, doctrine, theater information systems, system rightsizing, and international agreements.
The 20th annual APEX Awards were given in 11 main categories including newspapers, magazines, journals and annual reports. Entries were judged based on their performance in areas such as graphic design, editorial content and the ability to achieve overall communications excellence. Contest winners were announced in early July. TMA develops the MHS Stakeholders’ Report every year in the belief that all MHS stakeholders—wounded warriors, health care providers and TRICARE beneficiaries—deserve an annual accounting of performance within the MHS, and its vision for the future. The report serves as an overall annual benchmark for teamwork, commitment and innovation. This is not the first time TMA has won accolades for its work on this publication; in 2002, the League of American Communications Professionals (LACP) bestowed TMA with its Vision Award for the report. Since then, TMA has won the award every year. The MHS annual report has also won the Apex award once before, in 2005. With the acceptance of this year’s APEX award, TMA puts itself among the ranks of some of the top organizations in the country. Other 2008 APEX award winners include AARP, the National Football League, the Walt Disney Company, Charles Schwab and Co., Inc., and Ogilvy PR Worldwide. http://www.health.mil/Press/Release.aspx?ID=290
To read his remarks, please visit http://www.health.mil/MHSBlog/Article.aspx?ID=306
Granger began his academic career at Arkansas State University, in Jonesboro. Graduating in 1976 with a Bachelor of Science degree in zoology and a minor in military science, this was the starting point of a career dedicated to medicine and service. Granger’s undergraduate alma mater also awarded him the honor of distinguished alumnus for 2008 on July 10. Granger also participates in the Chancellor’s Cabinet and is a founding member of the Beck PRIDE Center for America’s Wounded Veterans National Advisory Council. Located within the College of Nursing and Health Professions, the center assists combat veterans with a centralized site for coordination of resources helping families achieve a successful post-war adjustment. http://www.health.mil/Press/Release.aspx?ID=285
The top story highlights the Atlanta VA Medical Center Restoration Clinic, where art and medicine come together to create amazing prosthetics for veterans. A second feature looks at one group of veterans at VA’s Medical Center in Loma Linda, Calif., who have found an unusual – and effective – way of dealing with their pain. These combat veterans have turned to the healing powers of the arts in a unique poetry therapy workshop. In another story, “The American Veteran” travels with Project Healing Waters, a partnering organization that takes veterans and active duty service members facing mental and physical difficulties on a fly fishing trip to the Yellow Breeches River in Pennsylvania, where veterans can develop new skills and experience the restorative power of nature. The series is designed to inform active-duty members, veterans, their families and communities about the services and benefits they have earned and to honor them. For more information, please visit http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1535
Part of VA’s mission is to assist veterans gain employment. Monster, in partnership with VA’s Center for Veterans Enterprise, provides veteran-owned small businesses the opportunity to post job openings for veterans, including service-disabled veterans, at a large price discount. Monster will post the job openings for 60 days, twice as long as for other employers. To participate in Monster job listings, veteran business owners must be listed in VA’s online Vendor Information Pages (VIP) maintained by the Department’s Center for Veterans Enterprise at http://www.VetBiz.gov. In addition to helping veteran owners get business from other companies and prospective veteran employees find jobs, VA’s VIP pages will give Monster a source for purchasing services itself and VA will refer appropriate, listed suppliers to Monster. The VA-Monster agreement is initially for two years and provides for extensions. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1537
In addition to the sponsorship, Health Net is contributing to the PVA Rehabilitation Fund to assist recently disabled veterans returning from Iraq or Afghanistan to participate in the Wheelchair Games. Two of these athletes will be sponsored directly from Health Net’s contributions to the fund. During the five-day multi-event sports and rehabilitation program, veterans compete in games such as swimming, table tennis, archery, bowling, basketball, power soccer, wheelchair slalom, and quad rugby. The National Veterans Wheelchair Games event is presented by the Department of Veterans Affairs (VA) and Paralyzed Veterans of America (PVA) and supported by corporate, civic, and veterans service organizations (VSOs). http://www.businesswire.com/portal/site/google/?ndmViewId=news_view&newsId=20080724005306&newsLang=en
The study led by Schnurr for the Department of Veterans Affairs (VA) was the largest clinical trial of individual psychotherapy for PTSD ever conducted. The findings led to VA supporting a national training program in “prolonged-exposure therapy,” which had not previously been widely used. Schnurr has worked at VA for 19 years and is responsible for program development, consultation on research projects, and strategic direction of the activities at the seven sites that make up the National Center for PTSD. She is also a research professor of psychiatry at Dartmouth Medical School, as well as the editor of the Journal of Traumatic Stress. Schnurr is one of four doctors and researchers who is featured in the August 2008 issue of the Ladies Home Journal, the fifth largest magazine in the country, with more than 13 million subscribers. They were chosen following a search of more than 80 medical organizations, medical schools, teaching hospitals, universities and government agencies. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1536
Expenditures hit $82 billion in 2007 because of the rising cost of health care, the expense of caring for an aging population of mostly Vietnam War veterans and a new crop of severely wounded troops from the wars in Iraq and Afghanistan. This sum exceeds the $80 billion in inflation-adjusted dollars spent in 1947 after most of the 16.1 million Americans serving in World War II left the service, according to a Congressional Research Service report submitted to Congress last month. An 11 percent hike in spending to $91 billion is slated for this fiscal year, and the Department of Veterans Affairs has proposed $94 billion for 2009. U.S. Sen. Patty Murray, D-Wash. has stated that more is needed and is seeking another $3.3 billion for the 2009 budget proposal. About 1.6 million Americans have served in Iraq and Afghanistan. About 325,000 of those veterans use VA health care, records show. There are 5.5 million veterans of all ages now receiving VA health care and 2.9 million receiving compensation. Those populations overlap, and the VA does not have a current figure on total number of veterans served. Costs soared in 1947 because of a massive exodus of troops from the military, all entitled to education, training and loan guarantee benefits under the then-new G.I. Bill, the report says. Actual dollars spent in 1947 were $8.4 billion, the report says. Then, health care was only 12 percent of the veterans’ budget, says Dan Tucker, deputy assistant secretary for budget at the Department of Veterans Affairs. Now, health care costs make up 44 percent of the budget. Costs fell precipitously after 1947, surging slightly in 1975-76 because of Vietnam-era veterans, the report says. Roughly a third of the nation's 23.5 million veterans served in Vietnam. http://www.usatoday.com/news/washington/2008-07-22-vabudget_N.htm?POE=click-refer
Dr. Cline is currently administrator for HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA). Effective August 30, Dr. Cline will leave this post, and Rear Adm. Eric Broderick, D.D.S., SAMHSA’s Deputy Administrator, will become the agency’s acting administrator. In addition, Kana Enomoto will become SAMHSA’s acting deputy administrator. As health attaché, Dr. Cline will coordinate HHS programs in Iraq and provide advice to the U.S. ambassador, HHS Secretary and others. He will also be a liaison to Iraq’s Ministries of Health, Higher Education and Social Affairs and will work closely with international organizations, private partners and other U.S. government agencies engaged in health-related activities. Since December 2006, Dr. Cline has led SAMHSA, the $3.3 billion agency responsible for improving the accountability, capacity and effectiveness of delivery systems to prevent substance abuse, treat addiction and provide mental health services. Prior to this appointment, he served as Oklahoma’s secretary of health and commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services. He was also a provider at a community mental health center and served as an instructor in clinical psychiatry at Harvard Medical School. Dr. Cline received his Bachelor’s degree from the University of Oklahoma, and a Master’s degree and doctorate in clinical psychology from Oklahoma State University. http://www.hhs.gov/news/press/2008pres/07/20080722a.html
The grants will be used by the states to offset losses that they incurred in the operation of high-risk pools, which are typically state-created non-profit associations that offer health coverage to individuals with serious medical conditions. Grant funds also provide support for disease management for chronic conditions and premium subsidies for individuals with lower incomes. Enrollment in these pools is growing, with more than 200,000 individuals enrolled in state pools. To be eligible, a state must have a “qualified” high-risk pool that meets the criteria specified in section 2745 of the Public Health Service Act, and must follow such rules as capping premiums at no higher than 200 percent of the standard charge in the state. Funds were allocated based on the number of uninsured individuals in each state and the numbers of individuals enrolled in each pool. HHS’ Center for Medicare and Medicaid Services (CMS) administers the program. This year’s grants are in addition to approximately $286 million that states have received since 2003 to support this program. The 30 states that received grants are: Alabama, Alaska, Arkansas, Colorado, Connecticut, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming. http://www.hhs.gov/news/press/2008pres/07/20080721a.html
Incoming SACHRP member Barbara E. Bierer, M.D., senior vice president for research, Brigham and Women’s Hospital and professor of medicine and pediatrics, Harvard Medical School, will also serve as the committee chair. Incoming member David G. Forster, J.D., M.A., C.I.P., is vice president, Office of Compliance, Western Institutional Review Board. The 11-member committee, which meets three times a year, is composed of leaders in human subject protections and/or the conduct of human subject research. Its members provide recommendations to the Secretary on the responsible conduct of research involving human subjects. The members are responsible for reviewing and evaluating the activities of the Office for Human Research Protections and other offices and agencies within HHS that are responsible for human subject protection in biomedical and behavioral research. The SACHRP committee also offers advice and recommendations on policy and program development, program implementation, evaluation and other matters of significance to the human research-related mission and goals of HHS. http://www.hhs.gov/news/press/2008pres/07/20080721b.html
Beginning in 2009 and during the next four years, CMS will provide incentive payments to eligible professionals who are successful electronic prescribers. Eligible professionals will receive a two percent incentive payment in 2009 and 2010; a one percent incentive payment in 2011 and 2012; and a one half percent incentive payment in 2013. Beginning in 2012, eligible professionals who are not successful electronic prescribers will receive a reduction in payment. Eligible professionals may be exempted from the reduction in payment, on a case-by-case basis, if it is determined that compliance with requirement for being a successful prescriber would result in significant hardship. Medicare is expected to save up to $156 million over the five-year course of the program in avoided adverse drug events. It’s been estimated that Medicare beneficiaries experience as many as 530,000 adverse drug events every year, contributed to in part by negative interactions with other drugs or a prescriber’s lack of information about a patient’s medication history. In another step toward establishing a health care system based on value, the first payments under the Medicare Physicians Quality Reporting Initiative (PQRI) have been awarded. By collecting data on quality, health care providers can use the information collected to improve patient care. Through PQRI, CMS has provided more than $36 million in bonus payments to more than 56,000 health professionals who reported quality information to Medicare. The average incentive amount for individual physicians was more than $600, and the average incentive payment for physician group practices was more than $4,700. The largest payment to a physician group practice totaled more than $200,000. Recent legislation extends the physician quality reporting system and provides for incentive payments of two percent for reporting data on quality measures in 2009 and 2010, up from 1.5 percent in 2008. In addition, CMS will post on its Web site the names of eligible professionals who satisfactorily submitted data on PQRI quality measures and establish a Physician Feedback Program in which claims and other data will be used to develop confidential reports to physicians that measure the resources involved in furnishing care to Medicare beneficiaries. http://www.hhs.gov/news/facts/eprescribing.html
The three-day trip includes visits to two Alaska Native villages and two regional tribal health consortiums to better understand the challenges of access to care; meetings with tribal leaders to discuss the health care goals of the Alaska Native people; and demonstrations of how telemedicine and telehealth are employed to increase access and quality of care to Alaska Native communities. The use of telemedicine and telehealth is having significant impact on improving access to health care in rural Alaska. Telemedicine is being used to exchange medical information from one site to another via electronic communications to improve patient health. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care. By utilizing telemedicine and telehealth, patients who live in rural Alaska have better and timely access to critical care through medical specialists, such as cardiology, pediatrics and radiology. Secretary Leavitt will also meet with health care providers, employers, and insurers to discuss the health care challenges in Alaska and the transformation of the current health system into a system that delivers high quality care at low cost. This vision for the health care system includes advancing interoperable health information technology; measuring and publishing price information to give consumers information they need to make better decisions on purchasing health care; measuring and publishing quality information to enable consumers to make better decisions about their care; and promoting incentives for quality and efficiency of care. On July 24, 2008, Secretary Leavitt presented Acting Health Commissioner Bill Hogan the National President’s Challenge Award. Alaska was one of five states which had the highest participation rates in the nation based on population. The National President’s Challenge, which kicked off March 20 and concluded May 15, was a six-week program launched by the President’s Council on Physical Fitness and Sports to encourage Americans to be more active. Participants were able to register as individuals or with a team and set goals, log their activity and track their progress. To complete the challenge, participants 18 and older needed to be active 30 minutes a day, while youth aged 6-17 needed to be active an hour a day. http://www.hhs.gov/news/press/2008pres/07/20080722b.html
As part of developing the guidance, HHS held day-long public engagement and stakeholder meetings throughout the country and received more than 200 written public comments on the goals and objectives of pandemic vaccination. In all the meetings, stakeholders and the public identified the same four vaccination program objectives as the most important:
The guidance is based on up-to-date scientific information and directly considers the values and ethical issues involved in planning a phased approach to pandemic vaccination. The ultimate goal of the pandemic vaccination program is to vaccinate every person in the United States who wants to be vaccinated. Because pandemic vaccine cannot be made fast enough for everyone to be vaccinated at once, federal, state, local and tribal governments, communities, and the private sector can use the guidance to decide who should be vaccinated during the early stage to best protect people and communities. The guidance’s vaccination structure defines four broad target groups: people who 1) maintain homeland and national security, 2) provide health care and community support services, 3) maintain critical infrastructure, and 4) are in the general population. Everyone in the United States is included in at least one vaccination target group. People who are not included in any occupational group would be vaccinated as part of the general population based on their age and health status. While vaccines are an important resource in a pandemic, vaccination will be only one of several tools to fight the spread of influenza if and when a pandemic emerges. Other tools include community public health measures, antiviral medications, facemasks and respirators, washing hands and covering coughs and sneezes. For further information, please see http://www.pandemicflu.gov/vaccine/allocationguidance.pdf.
The FDA Commissioner's Fellowship Program is not meant to replace the current fellowships and other educational experiences at the FDA, but rather to train a group of investigators intensively in the issues that relate to FDA regulatory science across devices, drugs, biologics, foods and cosmetics. Exposure to FDA law, policy, the federal government budgeting process, networking and leadership skills, international activities, communication with the public and press, biostatistics, epidemiology, clinical trial design, risk assessment and risk management, as well as extensive case-based learning are incorporated into the program. In parallel with this didactic training, the fellows, with the guidance of their preceptors, will engage in a carefully designed and articulated FDA regulatory science project. http://www.fda.gov/commissionersfellowships/program.html
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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. |
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