FEDERAL HEALTH UPDATE
October 10, 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
The USFHP is a Department of Defense (DoD)-sponsored health plan, made available by nonprofit healthcare providers in six service areas across the country. Over the years, DoD has partnered with these former U.S. Public Health Service facilities to provide care for military beneficiaries. Initially, they were given a statutory deemed status as military healthcare facilities. In 1997, Congress mandated that they become a permanent part of the Military Health System, to administer a program that became known as the US Family Health Plan. USFHP offers the TRICARE Prime benefit to over 100,000 military beneficiaries, including active-duty family members, activated Guard and Reserve family members, and retirees and their family members. More than 40 percent of the USFHP participants are 65 and older.
One of the hallmarks of the USFHP is its ability to maintain a consistently high level of patient satisfaction. In 2008, overall satisfaction with the health plan was 87.9 percent, as compared to 61.9 percent for traditional HMOs. Contributing to this high level of satisfaction is a wide array of disease and care management programs, designed to keep members healthy and provide individualized care. Members are provided a comprehensive range of benefits, from preventative and wellness programs to intensive case management for members with chronic or multiple health conditions.
This respite benefit gives caregivers who help homebound ADSMs needing frequent help a break from their responsibilities. It is important to know that “homebound” members are service members whose conditions or injuries make them unable to leave home without taxing effort. “Frequent” means that service members need more than two interventions during the eight-hour period per day that the primary caregiver normally would be sleeping. To provide the best possible help and respite for caregivers, this benefit will provide a maximum of eight hours of respite per day, five days per week. ADSMs, or their legal representatives, can submit receipts for reimbursement of respite care services that were provided after Jan. 1, 2008, by a TRICARE-authorized Home Health Agency. For more information about this benefit visit the TRICARE Web site at http://www.tricare.mil.
The Center for Life calls itself an “integrative medicine specialty clinic,” that considers a patient’s mind, body, spirit and lifestyle while offering clinical and preventive services in a healing environment. Dr. Gordon is the founder of the Center for Mind-Body Medicine in Washington, D.C., which has recently created a program to train health care professionals working with veterans who have served in Iraq and Afghanistan in how to improve resiliency and handle stress in healthy ways. The Defense Center of Excellence for Psychological Health and Traumatic Brain Injury is currently researching complementary and alternative medicine. These therapies, if proven effective, would serve as a complement to traditional approaches to protect service members from and treat traumatic brain injury, post-traumatic stress disorder, depression, anxiety or substance abuse. http://www.health.mil/Press/Release.aspx?ID=355
The questionnaires—one for wounded, ill or injured service members and one for their family members—are available on the Military Health System Web site and will remain open for completion through November, which is designated as Warrior Care Month. Both questionnaires ask for feedback concerning a service member’s experience and satisfaction with the care he or she has received since becoming wounded, ill or injured. To encourage honest and specific answers that will lead to positive changes in how the MHS handles care for wounded, ill or injured service members, all questionnaire responses are anonymous. These questionnaires are part of Defense Secretary Robert Gates’ commitment to support wounded, ill and injured service members—ensuring that their care is DoD’s top priority. The MHS said it hopes that by listening to the opinions of wounded, ill or injured service members and their families, it will be in a better position to meet their needs and expectations. The online questionnaires are available now at http://www.health.mil/Pages/Page.aspx?ID=18.
The Compensation and Benefits handbook was compiled in cooperation with the Departments of Veterans Affairs, Labor, Health and Human Services and Education and the Social Security Administration. Additionally, there are references to assistance provided by other governmental and non-governmental agencies and organizations Web sites and toll-free numbers are provided, and the electronic version includes hyperlinks. The electronic version of the handbook will be updated frequently and the hard copy of the compensation and benefits handbook will be updated annually. The electronic version of the handbook can be found on the five Web sites listed below:
The new study found that TRICARE’s reimbursement rates for mental health services are more than adequate compared to other health plans and that access to care was not affected by the reimbursement rates. Statistics were also released on the usage of the behavioral health care provider locator and appointment assistance service. The study compared TRICARE reimbursement rates to those of other health plans to determine if access to mental health services by TRICARE beneficiaries was impaired in areas where TRICARE reimbursement rates are below the median rates of other health plans. Researchers examined many factors including the number of TRICARE network providers, rate of change over time in the number of network mental health workers and complaints from providers and beneficiaries about rates and services. In the study, TRICARE focused on 33 U.S. market areas and five current procedural terminology (CPT) codes, which are used to communicate consistent information about medical services in the areas of psychiatry, psychology and other outpatient mental health services. For two of the CPT codes commercial insurance payments to psychiatrists exceeded the CHAMPUS maximum allowable charge (CMAC) amount for most claims. Conversely, psychiatrists offered discounts to TRICARE approximately 50 percent of the time. Psychologists gave discounts of 10 to 15 percent from the CMAC for 80 percent of the services they provided to TRICARE beneficiaries. In addition, 70 to 80 percent of other mental health providers offered significant discounts to TRICARE patients. The study concluded that access to care was good. TRICARE also released statistics on the “Behavioral Health Care Provider Locator and Appointment Assistance Service.” The service, launched in December 2007, is for active duty service members and their enrolled family members living in the United States who need help locating and making appointments with behavioral health providers. Since the service began, the regional managed care support contractors (MCSC) have received more than 3,700 calls. The service offers two alternatives for providing information. The MCSC can give the beneficiary phone numbers of providers or establish a three-way call with the beneficiary and the provider. The service has issued more than 2,500 referrals; completed three-way calls with more than 300 people; and directed 800 callers to other resources.
The project represents the largest construction contract ever awarded by VA. The medical center, which will be part of VA's Southern Nevada Health Care System, will provide medical, surgical and mental health care, as well as ambulatory care facilities. It is designed to meet the needs of a growing Las Vegas area veterans’ population with a full-service facility providing radiology, magnetic resonance imaging, nuclear medicine, pharmacy, laboratories, education, and diagnostic and treatment clinics. The new hospital, separate nursing home and ancillary structures are being located on a 150-acre campus in North Las Vegas at Pecos Road and the Woodbury Beltway near Nellis Air Force Base on an undeveloped parcel of land transferred from the Bureau of Land Management. Features of the new hospital include the capability to remain fully operational in the event of a loss of public utilities with full emergency power, reserve water supplies, and waste-water storage capacity for up to four days. The project also involves environmentally friendly "sustainable design" elements in its planning, including the reuse of building materials and design elements for the building that will promote energy efficiency. The new facility supplements existing inpatient services for Nevada's estimated 246,000 veterans in facilities at Reno and in shared space at Nellis Air Force base. VA also operates 10 outpatient clinics in Nevada, four of them in Las Vegas. Previous contracts have been awarded to construct a 120-bed nursing home, energy center and the foundations for the hospital. In fiscal year 2007, VA provided 5,467 inpatient admissions and 690,036 outpatient visits in these facilities. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1591
According to the report, adults gain substantial health benefits from two and a half hours a week of moderate aerobic physical activity and children benefit from an hour or more of physical activity a day. The guidelines are designed to help individuals fit physical activity into their daily plan and incorporate activities they enjoy. Regular physical activity reduces the risk in adults of early death, coronary heart disease, stroke, high blood pressure, type 2 diabetes, colon and breast cancer, and depression. It can improve thinking ability in older adults and the ability to engage in activities needed for daily living. The recommended amount of physical activity in children and adolescents improves cardio-respiratory and muscular fitness as well as bone health, and contributes to favorable body composition. The Physical Activity Guidelines for Americans are the most comprehensive of their kind. They are based on the first thorough review of scientific research about physical activity and health in more than a decade. A 13-member advisory committee appointed in April 2007 by Secretary Leavitt reviewed research and produced an extensive report. Key guidelines include:
The Web site, designed by NIH’s National Heart, Lung, and Blood Institute (NHBLI) in collaboration with New England Research Institutes and Hands On Productions, describes why research in children is important, how studies are conducted and what measures are taken to protect participants' safety and privacy. Additional support was provided by the NIH Foundation; NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Center for Research Resources; and the National Marfan Foundation. NHLBI supports pediatric research on asthma, heart disease, sickle cell anemia, obesity, and other conditions. Research studies can enroll healthy children or children with specific conditions. They can involve simple observations or health tests, such as weight and height, or more complex tests, vaccines, or treatments for a condition. The Children and Clinical Studies Web site includes a list of questions for parents to consider asking the research team when deciding whether to enroll their child in a study. Other topics include:
For more information, please visit www.nhlbi.nih.gov.
Over the past few months, SAMHSA has announced awards for 30 programs, 12 of which fund suicide prevention efforts from tribes/tribal organizations. These tribes/tribal organizations will receive over $16 million in grants over the next three years. The 18 awards to states are funded up to $500,000 per year in total costs. Continuation awards are subject to the availability of funds and progress achieved by awardees. To view the entire list of awardees, please visit http://www.samhsa.gov/newsroom/advisories/0810062052.aspx
PATH is an international, nonprofit organization that creates sustainable, culturally relevant solutions to improve global health and well-being. PATH-MVI supports the development of malaria vaccines and is expected to spearhead the efforts to ensure their availability and accessibility in the developing world once a safe and effective vaccine becomes available. The PATH-MVI collaborative project is expected to span about three years and is being conducted under the Cooperative Research and Development Agreement (CRADA) program, which allows federal laboratories and businesses to form partnerships that help expedite research activities. Recent scientific advances suggest that vaccines based on live, weakened (attenuated) malaria parasites may be possible in the future but assessing safety and effectiveness in the early stages of product development is challenging. Under this CRADA, PATH-MVI provides the FDA with about $1.5 million to develop tests for evaluating malaria vaccines early in their development. To date, there are no approved vaccines to prevent malaria but several vaccines are in development. This CRADA will help develop laboratory tests to assess whether a vaccine candidate is safe enough to begin Phase I clinical trials. Each year 350-500 million cases of malaria occur worldwide, killing an estimated one million people, most of them young children in sub-Saharan Africa. Travel between the United States and the affected areas, as well as men and women in the U.S. military who are stationed in regions at high risk for malaria, can bring the disease into the United States. The Center's Global Vaccine Initiative fosters the development, evaluation and availability of vaccines needed to protect against major global infectious diseases and is part of the Center's commitment to work with others, including the World Health Organization, in advancing global public health. The Critical Path Initiative is the FDA's effort to stimulate and facilitate a national effort to modernize the sciences through which FDA-regulated products are developed, evaluated and manufactured. http://www.fda.gov/bbs/topics/NEWS/2008/NEW01897.html
Publishing its report in the Annals of Internal Medicine, the Task Force found good evidence exists that using these methods save lives. Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. In 2005, only about half of adults age 50 and older had been screened for the disease. The Task Force recommends against routine colorectal cancer screening in adults between the ages of 76 and 85 because the benefits of regular screening were small compared with the risks. The Task Force also recommends that adults over the age of 85 not be screened at all because the harms of screening may be significant and other conditions may be more likely to affect their health or well-being. For people of all ages, the Task Force found insufficient evidence to assess the benefits and harms of computed tomographic (CT) colonography and fecal DNA testing as screening methods for the disease. Further, these recommendations don't apply to people with a personal history of certain types of polyps who are being monitored regularly for the condition or to those who have a family history of rare syndromes that increase a person's chances of getting colon cancer. This recommendation strengthens the Task Force's previous position in 2002, when it recommended screening for colorectal cancer but noted that evidence was insufficient to recommend one screening method over another. This is also the first time that the Task Force has indicated an age that people should stop being screened for colorectal cancer. http://www.ahrq.gov/news/press/pr2008/colcanscr.htm
The University of Michigan will lead the effort to expand and enhance the molecular data needed to develop computer programs that more accurately predict potential drug candidates. The data will be housed in a Web-based resource that the scientific community and others interested in this information can access for free. The resource is estimated to receive up to $5 million over five years from NIH's National Institute of General Medical Sciences (NIGMS). Chemist Heather Carlson, Ph.D., of the University of Michigan's College of Pharmacy will oversee the creation and operation of the new Community Structure-Activity Resource, which will include detailed molecular information about proteins that bind small, drug-like molecules called ligands. Most drugs work by latching onto proteins and altering a biological process. Researchers can use computational tools to study the structural and biophysical properties of a target protein and, from among tens of thousands of possible ligands, predict the relatively few that bind to the protein in a potentially useful way. These ligands may warrant further study as so-called lead compounds for drug discovery. Computational tools can also indicate which compounds may interact with other proteins and cause unwanted side effects that could limit therapeutic use. To build the resource, Carlson and her co-investigators at the University of Michigan will gather molecular data from existing resources and will work with others to generate new data. A major activity will be the collection of unpublished data from pharmaceutical company scientists, who emphasized both the need for this information and a willingness to share it during public meetings leading to the establishment of the new resource. The team also will draw from published literature as well as from Carlson's Binding MOAD (for "Mother of All Databases"), which contains more than 11,000 protein-ligand complexes, and the PDBbind database, which was developed by co-investigator Shaomeng Wang, Ph.D., and provides experimentally measured binding data. The team will conduct experiments to address any gaps in the data and sponsor community-wide events to facilitate collaboration among scientists. http://www.nih.gov/news/health/oct2008/nigms-09.htm
The contract with ATCC is for one year, with the option to renew each year for up to 10 years. The system will allow researchers, developers and public health officials improved access to a repository of influenza viruses, including influenza viruses that could pose a pandemic risk, as well as kits and reagents (certain substances used in the testing process) through a secure internet web portal for approved users. In the event of an emerging pandemic, the CDC-IRR will serve as a source of reagents for qualified laboratories to provide additional support. During a pandemic, laboratories will play a critical role in detecting and confirming initial cases, characterizing viruses, monitoring the progression of the pandemic, and selecting vaccine strains. Scientists around the world are concerned that the influenza virus could one day mutate and acquire the properties needed to quickly spread between people, resulting in a pandemic. For more information, please visit www.cdc.gov and www.pandemicflu.gov According to a new report by the Commission to Build a Healthier America at the Robert Wood Johnson Foundation, the health of children is affected by the state they live in and their family's income and education.
In addition, the study compared the percentages of children with "optimal" health — based on assessments by parents of whether the health of their children ranged from "poor" to "excellent" — in families with annual incomes that ranged from the federal poverty level to four times that amount. As income levels increased, parents were more likely to report the health of their children as excellent, the study found. Nationwide, the study found that 15.9 percent of children are not at optimal health. Texas had the highest percentage of children who are not at optimal health, at 22.8 percent, and Vermont had the lowest percentage, at 6.9 percent. Texas also had the highest percentage of children in lower-income families who are not at optimal health, at 44.1 percent, as well as the largest gap between the percentage of children in lower-income families who are not at optimal health and the percentage of those in higher-income families who are not at optimal health, according to the study. According to the study, states in the South and Southwest have the largest gaps and states in the northern Midwest, northern Great Plains and Northeast have the smallest gaps. For the study, researchers measured infant mortality rates and the general health of children in each state based on data from surveys conducted by the U.S. Census Bureau and CDC.
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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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