FEDERAL HEALTH UPDATE
July 3, 2009Produced 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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Executive and Congressional News
Military Health Care News
The 11 new locations join the 49 military clinics and hospitals currently providing chiropractic care to ADSMs. Also, for the first time, ADSMs overseas will have access to chiropractic services, with two of the new locations in Germany and one in Okinawa, Japan. The new sites are tentatively scheduled to be up and running by Sept. 30, 2009. The 2009 National Defense Authorization Act called for the Department of Defense to expand the number of military facilities offering chiropractic services to ADSMs. As a result, TMA identified the best locations to expand chiropractic care to meet the needs of active duty service members. The planned sites are: Air Force
Army
Navy
The Chiropractic Care Program, begun in 2001, is available only to ADSMs at designated military treatment facilities. A service member’s primary care manager determines if chiropractic care is appropriate. TRICARE does not cover chiropractic care, but family members may be referred to non-chiropractic health care services—physical therapy, family practice or orthopedics—for treatment as appropriate. For
a complete list of military facilities offering ADSMs chiropractic care,
or for more information about chiropractic care, see the TRICARE Web
site at http://www.tricare.mil/
The award is the U.S. government’s highest recognition given to employers for exceptional support of their employees serving in the Guard and Reserve. The Secretary of Defense Employer Support Freedom Award is also significant because only members of the National Guard and Reserve or their family members may nominate their employers for the award. TriWest Healthcare Alliance, nominated by a Reserve Component service member from Whiteman Air Force Base in Missouri, and the Salt River Prima-Maricopa Indian Community were selected from more than 3,200 nominations submitted. From the 35 finalists, a national selection board comprised of senior defense officials and business leaders will select the 15 recipients of the 2009 Secretary of Defense Employer Support Freedom Award, which will be announced by the Department of Defense in July. The awards will be presented at a ceremony in Washington, D.C., Sept. 17, 2009, at the Ronald Reagan Building and International Trade Center. For more information about the Freedom
Award, please visit www.FreedomAward.mil.
Heppner, deputy commander of the Walter Reed Army Institute of Research (WRAIR), was honored for his critical role in the development of a promising vaccine against malaria, one of the world’s most devastating diseases of children. The Kiwanis World Service Medal, established in 1985, recognizes individuals who devote a significant part of their lives to meeting the needs of others. In 1990, Heppner joined the Walter Reed Army Institute of Research’s (WRAIR) Malaria Vaccine Development Program to help develop vaccines to protect against deadly tropical diseases such as Japanese encephalitis, hepatitis A, dengue and diarrhea. Heppner himself enrolled as a volunteer in one of the early trials of a malaria vaccine at WRAIR. The test vaccine was ineffective, so Heppner — like the other volunteers in the study —contracted malaria from malaria-infected test mosquitoes and suffered the flu-like symptoms caused by the deadly parasite in the blood. Two days of effective drug treatment cured him, drugs too expensive and too scarce for the world’s malaria-afflicted poor to obtain. Heppner’s quest to defeat malaria continued in malaria-ridden refugee camps on the Thai-Burmese Burma border in 1993 to 1997, where he was stunned to see how malaria devastated families who could not afford effective treatment for their children. He learned even the newest drugs to treat malaria quickly lose potency, underscoring the need to develop a vaccine to prevent malaria. He has played a pivotal role in the development of the world’s most promising malaria vaccine called RTS,S. His team of scientists from WRAIR, working with GlaxoSmithKline (GSK), carried out critical vaccine studies in Africa, Asia, Europe and the USA. With the entry of the Bill & Melinda Gates Foundation, global efforts have broadened, resulting in the start this year of Africa-wide multi-center trials intended to license the RTS,S malaria vaccine for children. The World Service Medal publicizes
inspiring examples of individuals who have recognized a need and taken
personal action to meet that need. One medal is awarded each year, and
the Kiwanis International Foundation adds a $10,000 grant to assist
the honoree in furthering his or her service work. Previous winners
have included Mother Teresa, actors and humanitarians Sir Roger Moore
and Audrey Hepburn and First Ladies Nancy Reagan and Rosalynn Carter.
PacMed received a score of 119.7, making it among the top 20 companies to work for in 2009. PacMed’s employees collectively agreed that the organization offers an inspiring workplace with a strong, patient-focused team environment and ample career-building opportunities. The results of the competition were based on surveys of employees who filled in extensive questionnaires about their employer based on a number of criteria, including leadership, communication, benefits, opportunities for growth, and training. Companies that scored among the top of their categories were further vetted by a panel of judges to determine the final scores. The US Family Health Plan at PacMed offers the full TRICARE Prime benefit to active-duty family members, activated Guard and Reserve family members and military retirees and their eligible family members. For more information about the US Family Health Plan, visit www.usfamilyhealthplan.org. Veterans Health Care News
As part of the recovery plan, VA is making one-time payments of $250 to eligible veterans and survivors to offset the effects of the current economy. VA estimates $500 million in payments will be made to approximately 1.9 million veterans and eligible beneficiaries as part of this measure. To be eligible for the payment, VA beneficiaries must have received VA’s compensation, pension, dependency and indemnity compensation (DIC), or spina bifida benefits at any time between November 2008 and January 2009. Also, beneficiaries must reside within the United States, Puerto Rico, Guam, Northern Mariana Islands, American Samoa or the U.S. Virgin Islands. No application is necessary. VA used its existing payment records to determine eligibility for the $250 payment. Beneficiaries will receive their payments the same way they receive their monthly VA benefits — either by direct deposit or in the mail. This tax-free payment is not countable in determining eligibility for VA pension or Parents’ DIC. The law allows one $250 payment per person. VA beneficiaries who also receive benefits from the Social Security Administration or Railroad Retirement Board will be paid through those agencies, and will therefore not receive the payment from VA. The first payments were sent Monday,
June 22. All payments will be distributed by June 30. http://www1.va.gov/opa/
Invented by researchers at the Massachusetts Institute of Technology (MIT) and sponsored by the Department of Veterans Affairs, the design, mechanical characterization and preliminary clinical application of this ankle robot are presented in the June issue of IEEE Transactions on Robotics: Special Issue on Rehabilitation Robotics, the most-cited journal in robotics research. More than 790,000 Americans suffer strokes each year, and nearly 5 million stroke victims are alive today. Reduced mobility and increased fall risk are significant long-term health problems facing those who have chronic gait deficits resulting from stroke. In response, researchers at the Baltimore VA Medical Center and the University of Maryland School of Medicine are using the Anklebot to augment current therapies for improving gait and balance function after stroke. The Anklebot is an impedance-controlled exoskeleton that can be worn during over-ground or treadmill walking, or in seated-recumbent positions for ankle training. The Anklebot has versatile controls that allow assisting users on an "assist-as-needed" basis when they cannot complete a movement. It can also resist movement, providing a modality for ankle resistance training, or it can simply record ankle kinematics and kinetics for application as a clinical measurement or evaluation instrument. In addition, the study presents clinical data to demonstrate the potential of this device as an efficient clinical measurement tool to estimate intrinsic ankle properties; e.g. ankle stiffness in young healthy individuals. In a separate but related study submitted to the Journal of Neurophysiology, Dr. Roy and colleagues have extended their results to measure ankle stiffness using the Anklebot in chronic stroke survivors and have identified frontal plane ankle stiffness to be a potential signature of ankle pathology following stroke. An ongoing clinical study is also being conducted at the Baltimore VA Medical Center that endeavors to help stroke survivors, including veterans, achieve improvement in their gait and balance function via ankle robot-assisted therapy. The study has demonstrated that stroke rehabilitation, when aided by the ankle robot that guides movement of ankles, providing customizable robotic assistance (as-needed), significantly improves walking function and ankle motor control recovery as well as decreases ankle impairments in chronic stroke survivors. Based on current findings, VA, University of Maryland and MIT researchers ultimately envision the Anklebot to facilitate insights into human motor recovery, gait, balance and motor learning by providing a customizable, adaptive and quantifiable measurement and rehabilitative instrument. Future studies will include testing
the efficacy of VA intervention on acute stroke patients to evaluate
whether robotic-assisted movement therapy has a significant and measurable
impact on neurorecovery during the early phase following an injury.
These studies will also look at developing impedance-controlled gait
algorithms to provide Anklebot facilitated gait training in stroke populations. http://www.prweb.com/releases/
Headquartered in Columbia, Md., PSI delivers an enterprise approach with an emphasis on its core capabilities in the areas of Full Systems Development Life Cycle Support, Healthcare IT Solutions, Information Security, Network / Desktop Services, Distance Learning, and e-Business. PSI will support Veterans Affairs’ My Recovery Plan, which is a set of clinician and veteran-developed enhancements to My HealtheVet, a veteran-focused health care portal for the Department of Veterans Affairs. PSI’s team will help in the development, design, testing, and implementation of My Recovery Plan features for My HealtheVet. The new functionality of My Recovery Plan will integrate veterans into the care and treatment of symptoms of mental illnesses and facilitate, through close coordination with health care providers, recovery-based initiatives for their health and well-being. Since its inception in 1998, PSI
has been providing IT solutions and services to federal government and
private sector organizations. http://healthcare.tmcnet.com/ Health Care News
According to media reports, Wal-Mart’s endorsement of the so-called employer mandate represents a dramatic reversal for the retailing giant and a boost for the White House as it tries to inject momentum into its efforts to secure health care reform. The announcement, following a meeting at the White House with chief of staff Rahm Emanuel, supports administration arguments that rising health costs are an integral of the weakened economy and hamper global competitiveness. The letter cites research by professors at Harvard University, which held that premiums are expected to rise by 20 percent in less than four years, costing 3.5 million workers their jobs and cutting insured workers’ average annual incomes by $1,700. Some employers and business groups have spoken against Democratic plans to include an employer mandate in comprehensive reform packages. Just three years ago, Wal-Mart fought efforts in states such as Maryland that would have required large companies to offer health insurance to workers. Though it succeeded in defeating
those initiatives, the company endured a raft of bad publicity and since
then has moved toward covering more of its 1.4 million employees. http://voices.washingtonpost.
The money was made available by the American Recovery and Reinvestment Act and comes as more Americans join the ranks of the uninsured due to the economic downturn and skyrocketing health costs. The Recovery Act Capital Improvement Program (CIP) grants will support the construction, repair and renovation of over 1,500 health center sites nationwide. More than 650 centers will use the funds to purchase new equipment or health information technology (HIT) systems, and nearly 400 health centers will adopt and expand the use of electronic health records. The health centers deliver preventive and primary care services to more than 17 million patients at over 7,500 service delivery sites around the country. Care is provided to patients regardless of their ability to pay, using an income sliding scale system to set fees. The Capitol Improvement grant awards are the third set of health center grants provided through the Recovery Act. On March 2, President Obama announced grants worth $155 million to establish 126 new health center sites. Those grants will provide access to essential preventive and primary health care for more than 750,000 people in 39 states and two territories. To see a list of Recovery Act CIP
grantees by state, go to www.hhs.gov/recovery.
The report, mandated by the American Recovery and Reinvestment Act, is designed to help HHS and lawmakers improve the quality of care for patients and provide patients and doctors with the best information possible to make decisions about health care. The report also catalogues current federal activities on CER, which had not been previously inventoried. The council was charged by Congress to identify key areas of comparative effectiveness research where funding could make the greatest impact to improve health outcomes. The council heard many perspectives, including public input from hundreds of diverse stakeholders, which influenced the entire report. The report includes a definition of CER, criteria for determining which research projects should be a priority, and a strategic framework to identify gaps and future priorities. The council focused on the unique role that the Office of Secretary funds could play in complementing and leveraging funding currently allocated to the Agency for Healthcare Research and Quality, National Institutes of Health, and other government agencies. The council’s report will help
to inform Secretary Sebelius’ submission of an operational plan for
the combined $1.1 billion allocated for patient-centered research, which
includes the $400 million allocated to the Office of the Secretary at
HHS. This investment will empower clinicians and patients with the information
needed to achieve the best outcomes possible.
The new reports are available at www.HealthReform.gov and include information on health care cost and quality in all fifty states. Each report includes state-specific data such as:
The free Web site was developed particularly for small and mid-size companies, which typically have more limited resources to devote to obesity prevention efforts. However, the tools and resources available on CDC LEANWorks! can benefit companies of any size. CDC LEANWorks! can help employers calculate the cost of obesity for their organizations and develop tailored approaches to help control these costs through interventions such as fitness classes, lunchtime health education sessions, weight management programs, and more. The Web site provides a variety of resources to employers including:
Obesity is a risk factor for high blood pressure, type 2 diabetes, stroke, and heart disease. Obese individuals spend 77 percent more money for necessary medications than non-obese persons. Research has shown that obesity affects more than just health care costs. It also has a significant impact on worker productivity because the more chronic diseases employees have, the more likely they are to be absent from work, or less productive if they come to work sick. Because organizations do not usually
publish information about their worksite programs in the scientific
literature, CDC visited select businesses to identify promising worksite
obesity prevention and control practices. The CDC LEANWorks! Web site provides case studies from some of
those businesses to provide examples of successful worksite obesity
prevention programs.
As in previous years, AHRQ's 2008 State Snapshots show that no state does well or poorly on all quality measures. The 2008 State Snapshots provide state-specific health care quality information, including strengths, weaknesses and opportunities for improvement. The state-level information used to create the State Snapshots is drawn from the 2008 National Healthcare Quality Report. The 2008 State Snapshots summarize health care quality in three dimensions: type of care (preventive, acute and chronic care), setting of care (hospitals, ambulatory, nursing homes and home health care) and by clinical areas (cancer, diabetes, heart disease, maternal and child health and respiratory disease). The 2008 State Snapshots allow users to explore whether a state has improved or worsened compared with other states in several areas of health care delivery. New features in the 2008 State Snapshots provide more ways to analyze the quality of health care for each state compared with all states, as well as states in the same region. Enhanced features include:
AHRQ's annual State Snapshots are
based on data drawn from more than 30 sources, including government
surveys, health care facilities and health care organizations. To access
this year's State Snapshots tool, go to: http://statesnapshots.ahrq.
Germino will help oversee an annual budget of $1.9 billion and a staff of 630 scientists, physician-scientists and administrators at NIDDK’s research facilities in Bethesda, Md., and Phoenix, Ariz. About 80 percent of the institute’s budget goes into local economies to support research and research training at universities, institutions and medical centers throughout the Unites States. The NIDDK’s research interests include common conditions such as diabetes and obesity and rare diseases such as sickle cell disease, Cooley’s anemia and polycystic kidney disease, an inherited condition characterized by the development of cysts in the kidneys. As a research investigator at The Johns Hopkins University School of Medicine, Germino made important contributions to understanding the genetic origins of polycystic kidney disease. In addition to the scientific and managerial leadership he will provide to the NIDDK, he will also continue his own research in polycystic kidney disease. In 1979, Germino received his undergraduate
degree in biology from Loyola University of Chicago and in 1983 received
his medical degree from the Pritzker School of Medicine at the University
of Chicago. In the same year, he began further training in internal
medicine and nephrology at Yale and stayed on as a junior faculty member
for another four years. He also spent a research year at Oxford University
in England. Germino moved to The Johns Hopkins University in 1992 and
became a full professor in 2003.
In a Federal Register notice, the FDA invites the public to provide information and share views on a wide range of topics, from product content to advertising and marketing. All public comments will be posted online. For more information
about the FDA and tobacco regulation, see: http://www.fda.gov/NewsEvents/
The two drugs combine a narcotic with acetaminophen, the ingredient found in popular over-the-counter products like Tylenol and Excedrin. High doses of acetaminophen are a leading cause of liver damage, and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect. Acetaminophen is combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of its experts. Vicodin and its generic equivalents alone are prescribed more than 100 million times a year in the United States. A 2005 study found that most poisonings resulted from patients’ taking Vicodin and similar products that combine a narcotic with acetaminophen. The agency is not required to follow the recommendations of its advisory panels, but it usually does. The panel also voted on a number of other issues regarding the use of acetaminophen:
NQF is a nonprofit organization dedicated to improving the quality of American health care by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance and promoting the attainment of national goals through education and outreach programs. In her role at NQF, Miller will provide operating leadership, development and direction in achieving NQF’s mission. She will oversee organization programs and provide leadership in formulating NQF’s operations and policies. Ms. Miller will also assist in identifying new initiatives and opportunities for NQF and help establish the organization’s growth plan. Miller has more than 25 years of experience working in health care operations. As deputy undersecretary for Health for Operations and Management at the U.S. Department of Veterans Affairs, Miller was the chief operating officer for the VA health care system and directed all VA healthcare facilities. She achieved significant improvements in patient safety and quality that resulted in the Veterans Health Administration’s achieving the highest levels in 18 national measures of care quality. Before joining NQF, Miller served as the interim executive director of the National eHealth Collaborative, an organization to advance the interoperability of health information technology. She established the board of directors, bylaws, strategic plan and operational plans for the new organization. Miller was honored twice with the
Presidential Rank Award, including the Distinguished Rank Award, the
highest civilian award. Miller received Masters of Public Administration
and Bachelor of Arts degrees from the University of Missouri.
The report, “Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2008,” presents the latest insurance estimates for the United States. The report also contains new estimates of health insurance coverage for the 20 largest states. The report found that Massachusetts had the lowest percentage of uninsured individuals under age 65 (3.4 percent) in 2008. In contrast, approximately 1 in 4 persons under age 65 lacked coverage in Florida and Texas; and 1 in 5 lacked coverage in Arizona, California and Georgia. Nationally, 16.7 percent of those under age 65 were uninsured in 2008. The report provides information on both private and public insurance coverage. Among the states examined, private coverage rates for people under age 65 ranged from 78.9 percent in Massachusetts to 56.2 percent in Florida. Nationally, 65.4 percent of people under age 65 had private health insurance coverage. Data on children under the age of
18 show that the percentage of children with no health insurance was
8.9 percent in 2008, the same as in 2007, but down significantly from
13.9 percent in 1997. A total of 34.2 percent of children had public
health coverage. Among the states examined in this report, public coverage
for children ranged from 22 percent in New Jersey to 41 percent in Georgia
and North Carolina.
Findings in the 1959-2007 report include:
The full reports are available at www.cdc.gov/nchs.
The drug is approved to be used in patients whose hearts have returned to normal rhythm or who will undergo drug or electric-shock treatment to restore a normal heart beat. Multaq, manufactured by Paris-based sanofi-aventis, may cause critical adverse reactions, including death, in patients with recent severe heart failure. The drug’s label will contain a boxed warning, the FDA’s strongest warning, cautioning that the drug should not be used in severe heart failure patients. In a multinational
clinical trial with more than 4,600 patients, Multaq reduced cardiovascular
hospitalization or death from any cause by 24 percent, when compared
with an inactive pill (placebo). Most of that effect represents reduced
hospitalizations, especially hospitalizations related to atrial fibrillation.
Atrial fibrillation and atrial flutter cause the heart to beat abnormally
fast and sometimes prevent blood from being properly pumped out of the
heart. http://www.fda.gov/NewsEvents/
As announced by Health and Human Services’ (HHS’) Secretary Karen Sebelius, the HHS is responding to a request from PAHO to help increase the PAHO stockpile of Tamiflu available for Latin America and the Caribbean countries. PAHO is working to ensure that its member countries have the capacity and resources to respond to outbreaks of H1N1. HHS holds approximately 50 million courses of antiviral medications in the Strategic National Stockpile (SNS). In April, HHS deployed 11 million treatment courses from the SNS to the states across the country to fight the H1N1 influenza. Since then, HHS has purchased antiviral drugs to replenish the SNS along with an additional 2 million treatment courses. Transmission of the virus within the region and throughout the Americas is a significant U.S. health security concern because of the vast amount of travel and commerce in the hemisphere. The U.S is working closely with the
World Health Organization and PAHO to monitor the virus in the southern
hemisphere. The information collected will assist the U.S in making
future decisions about the use of vaccine, antiviral medications and
the steps needed to protect our communities.
The CMS proposal would:
CMS opted to revise physician payments in response to projections that physicians will face a 21.5 percent Medicare rate reduction in 2010. The rule also includes new regulations on consultation codes and physician-administered drugs. For more information on the proposed
rule, please visit www.federalregister.gov/ Reserve/Guard
Reports/Policies
Legislation
Hill Hearings
Meetings / Conferences
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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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