Archive: May, 2010
Heart disease is the leading cause of death in America and it’s also a major driver of health care costs.
A study by researchers at the University of Pennsylvania and the Philadelphia VA Medical Center found that newer medical devices are a major reason why heart care costs are rising dramatically. The researchers examined Medicare claims on patients between the ages of 65 and 84 with coronary artery disease and congestive heart failure from 2003 through 2006.
The study found that the inflation-adjusted cost of care for patients with heart disease rose from $12,160 in 2003 to $12,721 in 2006, a 4.6 percent increase. The average cost of care for heart failure patients rose from $17,153 in 2003 to $18,371 in 2006, a 7.1 percent inflation-adjusted increase.
While those numbers seem relatively modest, the impact of medical devices was significant and the cumulative cost of the new technology was huge.
A report by the Center for American Progress and The Commonwealth Fund released Friday found that the health reform bill passed in March 2010 would lower premiums by nearly $2,000 for American families by 2019 and reduce overall health spending by $590 billion from 2010 to 2019.
The analysis, lead by Harvard University economist David Cutler, also projected the federal Medicare program would save $524 million and reduce the budget deficit by $400 billion over the 10-year period. Cutler is also a senior fellow at the Center for American Progress, a left-leaning Washington D.C. think tank headed by President Bill Clinton’s former Chief of staff John Podesta.
The report concluded that by creating new rules for insurers, health insurance exchanges, and payment reform, the law will also lead to needed modernization of the American health system and improve access to care for millions of currently uninsured people.
“With passage of the Affordable Care Act we have entered a new era in American health care – one in which all Americans will be able to get the care they need, and in which families will be protected from high health care costs,” said Karen Davis, president of the Commonwealth Fund, private foundation focused on transforming the health care system. “By changing the way we pay for and deliver care to reward high performance, we will begin to bend the health care cost curve, and all Americans will see real economic benefits.”
Americans without insurance tend to wait longer before seeking care and often rely on hospital emergency rooms for routine care.
But a study by researchers at the University of Pennsylvania and the University of Michigan found that uninsured patients in hospital intensive care units get less aggressive care and die more often than patients with private insurance or Medicaid.
The researchers used billing data to examine 116,995 patients less than 65 years of age who came to Pennsylvania ICUs over a two-year period . Patients without insurance were 21 percent more likely to die than patients with private insurance, the researchers found.
“We found that even when admitted to the same hospitals, and controlling for other differences between patients, critically ill individuals without insurance are less likely to survive than those with private or Medicaid insurance,” said Sarah M. Lyon, the study’s lead author.
About half of the parents who participated in a national survey said they would like electronic communications via email and online portals with their children’s pediatricians, according to a national survey.
The C.S. Mott Children’s Hospital national poll on children’s health found that 55 percent of the 1,612 parents surveyed said they would like access to their kids’ immunization records or to obtain prescription refills electronically. And nearly half, 47 percent would like to get advice regarding minor illnesses via email or other mode of electronic communications. The survey found two in five parents would like to be able to set up appointments electronically.
Yet, fewer than 10 percent of the parents said they could currently accomplish administrative tasks electronically and fewer than 15 percent said they could use electronic communication for clinical tasks such as getting advice or refilling prescriptions.
Matthew Davis, a physician and director of the poll from the University of Michigan Medical School, said some health care providers are concerned about being paid to provide such electronic services because they require staff time and there are also issues related to medical malpractice.
A woman working at the Social Security Administration at 3rd and Spring Garden Streets has been diagnosed with a case of Legionnaires’ Disease, officials at the federal agency confirmed Wednesday. Another worker in the building has tested positive for legionella bacteria, but has not developed the associated pneumonia.
Officials from the federal agency and the Philadelphia Department of Public Health emphasized that the single case is not an outbreak of Legionnaires’, but an isolated instance.
The Social Security Administration has had the water and air conditioning in the building tested and found “no evidence” of legionella, said Terri Lewis, a regional spokeswoman for the agency. The water and air condition systems are the most likely places to find the bacteria that cause the illness. About 1,500 employees work on site.
The series of tests were performed over Mother’s Day weekend – May 7 through May 9 – and “all of those have come back with no issues at all,” Lewis added. She said the agency was working with the Philadelphia health department to respond to what appears to be an isolated case.
On Sunday, the U.S. Food and Drug Administration sent a notice to pediatricians, family doctors and public health professionals reiterating the agency’s decision that both vaccines against rotavirus are safe despite the presence of pig viruses.
“Based on a careful evaluation of laboratory results from the manufacturers and its own laboratories, a thorough review of the scientific literature, and input from scientific and public health experts, the agency is revising its recommendation to temporarily suspend use of the Rotarix vaccine,” the FDA said. “FDA has also determined that RotaTeq vaccine should remain in use.”
And the agency added that the benefits of the vaccines that have been shown to prevent hospitalizations for acute diarrhea in American children and hundreds of thousands of deaths in the developing world, out weigh the “theoretical” risk of the pig viruses – PCV1 or PCV2 – found in the vaccines made by Merck & Co. (RotaTeq) and GlaxoSmithKline (Rotarix).
“FDA and the manufacturers will continue to investigate the findings of PCV in rotavirus vaccines and will evaluate information from ongoing testing by FDA and the manufacturers,” the agency stated in its notice on Sunday.
A study from the Journal of Infectious Diseases released Friday reported that vaccines against the rotavirus had nearly cut in half hospitalizations of children in the U.S. in just two years.
Also on Friday, the U.S. Food and Drug Administration reversed course and said that pediatricians and other clinicians should use GlaxoSmithKline’s Rotarix vaccine to immunize infants against rotavirus. The agency also reaffirmed its position that Merck & Co.’s RotaTeq vaccine should remain in use.
Rotavirus often starts with a fever and can be followed by a week or more of watery diarrhea and vomiting. The infection is one of the most common causes of death in young children worldwide.
The FDA’s decision on the vaccines followed a controversy on the vaccines, which are both given by mouth, after researchers discovered fragments of a pig virus in the Rotarix vaccine. And then Merck announced in early May that its scientists found fragments of two pig viruses in RotaTeq. In Saturday's Inquirer my colleague Marie McCullough examined the FDA decision and controversy surrounding the discovery of DNA in the vaccines.
Eleven universities and medical research institutions in Pennsylvania, New Jersey and Delaware were awarded more than $100 million in federal grants to build or renovate laboratories, the National Institutes of Health announced Friday.
The grants were part of more than 146 awards made nationwide for construction or renovations of scientific facilities. The grants, worth more than $1 billion, were part of the 2009 federal stimulus bill – the American Recovery and Reinvestment Act.
The University of Pennsylvania was awarded nearly $13 million to build its Center for Chronobiology where scientists and doctors will explore biological rhythms and develop medical applications. Temple University will get nearly $12 million to build a facility for research into brain trauma and neurodegenerative diseases.
Other local institutions getting awards included Fox Chase Cancer Center ($8 million), Thomas Jefferson University ($6.7 million), Children’s Hospital of Philadelphia ($2 million), and Drexel University ($500,000).
The Hospital of the University of Pennsylvania earned the top spot among local hospitals with a profit of $119.3 million on operating revenues of $1.8 billion in the year that ended June 30, 2009, according to the latest report on hospital fiscal health by the Pennsylvania Health Care Cost Containment Council.
In a year of tightening margins at hospitals, Penn, Children’s Hospital of Philadelphia ($57.5 million in the black) and the three acute-care hospitals of the Main Line Health System ($92.7 million in profits) bucked the trend. Still, 15 of 41 hospitals in Philadelphia and its four suburban Pennsylvania Counties lost money in fiscal 2009 compared with 14 that had incomes of $10 million or more.
Among the biggest losers were Northeastern Hospital which was closed in 200x by the Temple University Health System. Temple attributed a $46.9 million loss to that hospital for the year.
On Thursday an alphabet soup of government investigative agencies from the HHS OIG to the DOJ’s FBI reported that the new health reform law – the Affordable Care Act – gives them new tools to help fight fraud and protect tax dollars.
The new law “strengthens our ability to stop fraud before it starts by making it harder to submit false claims and easier to catch those who try to cheat,” said Health and Human Services Secretary Kathleen Sebelius.
But even as the Obama administration touts its approach to proactively stop health fraud rather than the old “pay and chase” model, that old approach has been paying huge dividends.
In 2009 pharmaceutical giants Pfizer and Eli Lilly paid $2.3 billion and $1.4 billion respectively to settle charges stemming from whistle-blower lawsuits of the improper marketed drugs to doctors.