Tuesday, January 31, 2012

F.D.A. Approves Cystic Fibrosis Drug - NYTimes.com

F.D.A. Approves Cystic Fibrosis Drug - NYTimes.com

Secretary of State Kemp tries to sell his license-streamline plan - The Times-Herald

Secretary of State Kemp tries to sell his license-streamline plan - The Times-Herald

The Marietta Daily Journal - New private school would serve students with dyslexia

The Marietta Daily Journal - New private school would serve students with dyslexia

Doctors to get paid more for ‘medical home’ | Georgia Health News

Doctors to get paid more for ‘medical home’ | Georgia Health News

Parents Often Forego Booster Seats When Carpooling Kids

Parents Often Forego Booster Seats When Carpooling Kids

A Parent's Nurturing Results In Larger Hippocampus In Children

A Parent's Nurturing Results In Larger Hippocampus In Children

Campaign to end obesity should be about more than shame - chicagotribune.com

Campaign to end obesity should be about more than shame - chicagotribune.com

An Rx? Pay More to Family Doctors - WSJ.com

An Rx? Pay More to Family Doctors - WSJ.com

Final rule regarding Medicaid, insurance exchange eligibility may be near - Healthcare business news and research | Modern Healthcare

Final rule regarding Medicaid, insurance exchange eligibility may be near - Healthcare business news and research | Modern Healthcare

Efforts to curb cigarette smoking failing in Tennessee, Georgia and Alabama | timesfreepress.com

Efforts to curb cigarette smoking failing in Tennessee, Georgia and Alabama | timesfreepress.com

Physicians subject to increasing scrutiny :: Jan. 30, 2012 ... American Medical News

amednews: Physicians subject to increasing scrutiny :: Jan. 30, 2012 ... American Medical News

: Patients feel a little more confident they can pay for care :: Jan. 30, 2012 ... American Medical News

amednews: Patients feel a little more confident they can pay for care :: Jan. 30, 2012 ... American Medical News

States ask Supreme Court to stop Medicaid expansion :: Jan. 30, 2012 ... American Medical News

amednews: States ask Supreme Court to stop Medicaid expansion :: Jan. 30, 2012 ... American Medical News

Normal Weight Doctors Discuss Weight Loss With Patients More Often Than Overweight Colleagues

Normal Weight Doctors Discuss Weight Loss With Patients More Often Than Overweight Colleagues

How Bacteria Behind Serious Childhood Disease Evolve To Evade Vaccines

How Bacteria Behind Serious Childhood Disease Evolve To Evade Vaccines

Research Shows Bedwetting Can Be Due To Undiagnosed Constipation

Research Shows Bedwetting Can Be Due To Undiagnosed Constipation

Thursday, January 26, 2012

amednews: Medicaid medical homes saved $1 billion in North Carolina :: Jan. 23, 2012 ... American Medical News

amednews: Medicaid medical homes saved $1 billion in North Carolina :: Jan. 23, 2012 ... American Medical News

State discusses ideas on new Medicaid design | Georgia Health News

State discusses ideas on new Medicaid design | Georgia Health News

Keep buns in the oven: Hospitals to save $1B by reducing early deliveries - FierceHealthcare

Keep buns in the oven: Hospitals to save $1B by reducing early deliveries - FierceHealthcare

More research needed to curb unnecessary care, spending - FierceHealthcare

More research needed to curb unnecessary care, spending - FierceHealthcare

Pediatric ICUs have more infections than adult ICUs - FierceHealthcare

Pediatric ICUs have more infections than adult ICUs - FierceHealthcare

Majority Of Americans Think Ideology Will Affect High Court’s Ruling On Health Law - Kaiser Health News

Majority Of Americans Think Ideology Will Affect High Court’s Ruling On Health Law - Kaiser Health News

House GOP aims to have reform-replacement legislation ready after high court rules - Healthcare business news and research | Modern Healthcare

House GOP aims to have reform-replacement legislation ready after high court rules - Healthcare business news and research | Modern Healthcare

Medicare nominee gets lifetime payout - Washington Times

Medicare nominee gets lifetime payout - Washington Times

Experiments aim to cut health-care costs - The Washington Post

Experiments aim to cut health-care costs - The Washington Post

Raised Cardiovascular Risk For Adolescents Consuming Large Amounts Of Fructose

Raised Cardiovascular Risk For Adolescents Consuming Large Amounts Of Fructose

Raised Cardiovascular Risk For Adolescents Consuming Large Amounts Of Fructose

Raised Cardiovascular Risk For Adolescents Consuming Large Amounts Of Fructose

Numerous Infant Studies Indicate Environmental Knowledge Is Present Soon After Birth

Numerous Infant Studies Indicate Environmental Knowledge Is Present Soon After Birth

Experts Warn Cost Of Asthma Caused By Traffic-Related Air Pollution Is Much Higher Than Previous Estimates

Experts Warn Cost Of Asthma Caused By Traffic-Related Air Pollution Is Much Higher Than Previous Estimates

Wednesday, January 25, 2012

Improving School Meals In American Schools - USDA Unveils New Standards

Improving School Meals In American Schools - USDA Unveils New Standards

State poised for Medicaid ACO pilots - FierceHealthcare

State poised for Medicaid ACO pilots - FierceHealthcare

Medical News: Reflux Drugs No Help for Children With Asthma - in Pediatrics, Asthma from MedPage Today

Medical News: Reflux Drugs No Help for Children With Asthma - in Pediatrics, Asthma from MedPage Today

Grassley Sends Letters Examining Overprescription of Drugs in Medicaid Programs


Grassley Sends Letters Examining Overprescription of Drugs in Medicaid Programs
By Rebecca Adams, CQ HealthBeat Associate Editor

The top Republican on the Senate Judiciary Committee is demanding that 46 Medicaid directors answer questions about how they are overseeing physicians who may be overprescribing potentially addictive painkiller or mental health drugs.


Sen. Charles E. Grassley, R-Iowa, is one of several senators who has raised concerns about whether some physicians are committing Medicaid fraud or allowing patients to abuse the use of the drugs. Medicaid is the federal-state program for the low-income.


“When a doctor writes more prescriptions than seems humanly possible, it makes sense to ask questions,” Grassley said in a written statement. “Maybe there’s a logical explanation or maybe there’s poor medical care or even fraud...If state and federal taxpayers are being cheated because of inappropriate prescriptions, the state and federal governments have to get to the bottom of it and stop it. Medicaid serves millions of people and costs billions of dollars. The more money wasted, the less there is for the people who rely on the program.”


The Republican is sending letters to 34 Medicaid directors who provided some information after Grassley wrote state officials in 2010 asking them to identify the top prescribers of several pain management and mental health drugs. He is sending another letter to 12 states that didn’t respond to his initial request. Grassley was satisfied with the responses from a handful of other states. The letters were first reported Tuesday by ProPublica.


In the letters, Grassley wrote, “Mental health drugs continue to be prescribed at astounding rates and pain management clinics are turning into a hotbed for black market painkillers. When these drugs are prescribed to Medicaid patients, it is the American people who pay the price for over-prescription, abuse, and fraud. After an extensive review of prescribing habits of the serial prescribers of pain and mental health drugs, I have concerns about the oversight and enforcement of Medicaid abuse in your state.”


Each letter was tailored to cite specific concerns in a state, but Grassley is asking all of the 34 states to answer a dozen questions by Feb. 13. The questions include probes about whether a state’s top prescribers continue to be allowed to bill Medicaid; if the state has a system to monitor excessive prescription writing; what types of sales restrictions and databases to track drug sales exist; and what kinds of interactions the state has had with federal Centers for Medicare and Medicaid Services (CMS) officials about the issue.


Grassley noted that Florida officials “finally terminated a doctor from Medicaid for high numbers of prescriptions but that was slow-going.”


Florida Gov. Rick Scott also signed a law in June to crack down on the state’s “pill mills” that hand out prescription pain drugs. Nearly 15,000 people die every year of overdoses of prescription painkillers, which is more than the number of people who died as a result of overdoses of heroin and cocaine combined, according to the Centers for Disease Control and Prevention.The problem of potential abuse of painkiller or mental health drugs is also a problem in Medicare, the federal program for seniors and people with disabilities. Not only are some physicians writing too many prescriptions, but some patients are apparently visiting multiple doctors to get additional prescriptions. CMS officials have been collecting public comments on ways to strengthen its oversight of prescription painkillers. A Government Accountability Office (GAO) report found that at least 170,029 individuals in Medicare got prescriptions for often-abused painkillers from five or more physicians, which indicated that the patients might be visiting different doctors to get more painkillers than a physician would normally give to one patient.


But Grassley said that efforts to crack down on overprescribing in Medicaid have been lackluster.
“I haven’t noticed a groundswell of state or federal efforts to get to the bottom of anything that looks questionable since I made my original inquiry in 2010,” he said in his statement.

Medicaid ‘Very Serious’ Issue in Health Care Challenge, States’ Lawyer Says


Medicaid ‘Very Serious’ Issue in Health Care Challenge, States’ Lawyer Says
By Jane Norman, CQ HealthBeat Associate Editor

One of the top lawyers representing those challenging the health care law said Monday that even opponents were surprised that the Supreme Court ordered arguments on the measure’s Medicaid expansion. And a second plaintiff attorney characterized it as a “very serious issue” that goes to the heart of the question of the overhaul’s constitutionality.

Their remarks again underlined the significance of the unexpected entry into the legal fight of the law’s provision that states must expand their Medicaid rolls to uninsured adults earning less than 133 percent of the federal poverty level. States say that requirement usurps a traditional federal-state partnership and crosses the line into coercion because if they opt out, they’d have to give up the federal Medicaid funding that makes up a large portion of state budgets.

Although federal district courts and appeals courts ignored states’ protests, the Supreme Court has slotted an hour of argument about Medicaid on March 28 as the finale to three days of battle over the overhaul (PL 111-148, PL 111-152). Some supporters of the law fear that if the court strikes down the Medicaid expansion, it could also lead to a wider unraveling of the federal government’s power to impose conditions on state spending (See related story, CQ Weekly, Nov. 21, 2011).

Randy Barnett, who’s among the lawyers representing the National Federation of Independent Business, and Paul Clement, who represents the 26 state attorneys generals and governors fighting the law, appeared at a Georgetown University Law Center event to discuss the suit. NFIB and the states are plaintiffs along with four individuals. Also on the panel was Randy Moss, a partner at WilmerHale and assistant attorney general for the Office of Legal Counsel during the Clinton administration.

States have long argued that the law disrupts their sovereignty, including its requirement that they expand their Medicaid rolls to cover poor adults, said Barnett.

“That’s a very important part of the litigation. It became more important than any of us imagined when the Supreme Court granted cert on that issue,” he said. The addition of the Medicaid issue also has helped to set up the suit to be one of the most important cases in the nation’s constitutional history when it comes to the scope of federal powers, he said.

That’s because Congress uses its power under the Commerce Clause of the Constitution and its spending power as authority for nearly everything it legislates, he said. “If a court is actually going to do something important on one side of the line, the commerce side of the line, it would be very good for them to be mindful of what’s happening on the spending side of the line,” Barnett said.

Clement warned, “Don’t forget about the Medicaid part of the case.” He said that constitutional lawyers are “really excited” about arguments in the case over whether or not the individual mandate violates the Commerce Clause and tend to miss the separate question of whether states have been coerced into increasing their Medicaid case load.

Clement said the Medicaid expansion is the mechanism through which many very poor people will comply with the individual mandate. “But there’s no other way in the statute for the poorest of the poor to get qualifying coverage,” he said. “There is no Plan B for a very good reason: No state given their current dependency on Medicaid can make a rational, voluntary decision to refuse the expanded terms of the Medicaid provision.”

Government lawyers have defended the expansion as permissible because it was done in accordance with previous court rulings. Those rulings say such a provision must provide for the general welfare of Americans, have a “reasonable” relationship to the goals of the law, allow states to “knowingly” exercise a choice and not force states to take unconstitutional actions.
A federal district court judge who ruled the rest of the health care law unconstitutional in January 2011 said that there was “simply no support” for the Medicaid coercion claims by the states.
Neither Barnett nor Clement would predict how the high court might rule, though Barnett dismissed as “spin” predictions by some legal experts that it might turn out to be an 8-1 or 7-2 decision. “I think this is a difficult case and that’s part of the reason the court allocated so much time to it,” he said. “I would discount those who make that prediction and whether they even believe it themselves.”

Moss, however, predicted that the court will uphold the law, though he said justices likely will look for a principle — raised by Barnett — that addresses whether there are any limits on Congress’ ability to make individuals enter into contracts with private companies, such as health insurance companies.

Moss said that as a lawyer reviewing legislation at the Office of Legislative Counsel, he would not have objected to the health care law. “I don’t think I would have raised any constitutional concerns,” he said, because it appears legal under the Commerce Clause and deals with a large portion of the economy. “There’s no doubt this legislation plays a very significant role in the regulation of interstate commerce,” Moss said.

Tuesday, January 24, 2012

Responsibility for reporting child abuse would expand under proposed bill - State Legislature - Macon.com

Responsibility for reporting child abuse would expand under proposed bill - State Legislature - Macon.com

Plan would add residency slots in Georgia | Online Athens

Plan would add residency slots in Georgia | Online Athens

amednews: Tax on sugary beverages projected to have broad health benefits :: Jan. 24, 2012 ... American Medical News

amednews: Tax on sugary beverages projected to have broad health benefits :: Jan. 24, 2012 ... American Medical News

Free preventive visit can end in sticker shock for patients :: Jan. 23, 2012 ... American Medical News

amednews: Free preventive visit can end in sticker shock for patients :: Jan. 23, 2012 ... American Medical News

Childhood Obesity Should Be Tackled Through Family Focus

Childhood Obesity Should Be Tackled Through Family Focus

Monday, January 23, 2012

Georgia budget offers breathing room for medical segment | The Augusta Chronicle

Georgia budget offers breathing room for medical segment | The Augusta Chronicle

Benefits Of High Quality Child Care Persist 30 Years Later

Benefits Of High Quality Child Care Persist 30 Years Later

Lack of dental coverage sends patients to ER for pain - USATODAY.com

Lack of dental coverage sends patients to ER for pain - USATODAY.com

Key report on Medicaid calls for big change | Georgia Health News

Key report on Medicaid calls for big change | Georgia Health News

The Marietta Daily Journal - Lawmakers split on drug testing for aid recipients

The Marietta Daily Journal - Lawmakers split on drug testing for aid recipients

Friday, January 20, 2012

Medicaid enrollment steady with tech overhauls - FierceHealthIT

Medicaid enrollment steady with tech overhauls - FierceHealthIT

Health care spikes worry Ga. lawmakers | The Augusta Chronicle

Health care spikes worry Ga. lawmakers | The Augusta Chronicle

WABE: Georgia receives failing grades for tobacco control policies (2012-01-19)

WABE: Georgia receives failing grades for tobacco control policies (2012-01-19)

When Anticipating Rewards, Adolescents' And Adults' Brains Respond Differently

When Anticipating Rewards, Adolescents' And Adults' Brains Respond Differently

Junk Food Linked To Weight Gain In Schools? Apparently Not

Junk Food Linked To Weight Gain In Schools? Apparently Not

Thursday, January 19, 2012

Wednesday, January 18, 2012

States Ease Barriers To Medicaid, CHIP Enrollment, Survey Says – Capsules - The KHN Blog

States Ease Barriers To Medicaid, CHIP Enrollment, Survey Says – Capsules - The KHN Blog

A Family History Of Alcoholism May Make Adolescent Brains Respond Differently

A Family History Of Alcoholism May Make Adolescent Brains Respond Differently

Childhood Obesity Rates In The USA Have Changed Little

Childhood Obesity Rates In The USA Have Changed Little

A Step Closer To Unlocking A Mystery That Causes Epileptic Seizures In Babies

A Step Closer To Unlocking A Mystery That Causes Epileptic Seizures In Babies

Medical News: Deaf Kids Benefit from Implants in Both Ears - in Pediatrics, General Pediatrics from MedPage Today

Medical News: Deaf Kids Benefit from Implants in Both Ears - in Pediatrics, General Pediatrics from MedPage Today

DCH awaits report on Medicaid privatization

DCH awaits report on Medicaid privatization

Tuesday, January 17, 2012

Consumer groups urge Medicaid, PeachCare revamp | Georgia Health News

Consumer groups urge Medicaid, PeachCare revamp | Georgia Health News

Should Teens With Autism Drive? - Disability Scoop

Should Teens With Autism Drive? - Disability Scoop

Homicide drops off US list of top causes of death - Yahoo! News

Homicide drops off US list of top causes of death - Yahoo! News

Medicare panel's payment recommendations pit hospitals against doctors - The Hill's Healthwatch

Medicare panel's payment recommendations pit hospitals against doctors - The Hill's Healthwatch

Georgia lawmakers to take close look at pulse ox screenings for newborns - The Times-Herald

Georgia lawmakers to take close look at pulse ox screenings for newborns - The Times-Herald

Unmet social needs worsen health :: Jan. 2, 2012 ... American Medical News

amednews: Unmet social needs worsen health :: Jan. 2, 2012 ... American Medical News

Small medical practices greatly at risk for data breaches :: Jan. 16, 2012 ... American Medical News

amednews: Small medical practices greatly at risk for data breaches :: Jan. 16, 2012 ... American Medical News

Former drug reps eyed to pitch physicians on referrals :: Jan. 16, 2012 ... American Medical News

amednews: Former drug reps eyed to pitch physicians on referrals :: Jan. 16, 2012 ... American Medical News

Sex education guidelines generate discussion | Online Athens

Sex education guidelines generate discussion | Online Athens

Fewer Children Admitted To Hospital For Drowning Incidents

Fewer Children Admitted To Hospital For Drowning Incidents

Junk Food In Schools Is Not Responsible For Weight Gain Among Children

Junk Food In Schools Is Not Responsible For Weight Gain Among Children

Monday, January 16, 2012

A sea change in how doctors practice | Georgia Health News

A sea change in how doctors practice | Georgia Health News

Legislature pauses to consider budget | savannahnow.com

Legislature pauses to consider budget | savannahnow.com

Internet Addiction Linked To White Matter Differences In Teen Brains

Internet Addiction Linked To White Matter Differences In Teen Brains

Child Care Centers Lack Sufficient Outdoor Activity

Child Care Centers Lack Sufficient Outdoor Activity

Don't Miss This Event! Winter Symposium to be held February 25, 2012

GAAAP is launching a new CME event this winter with a first-ever CME meeting between the Chapter and the Georgia OB/Gyn Society, on Saturday, Feb. 25th. The session is entitled "Pediatricians & OB/Gyn's: Working Together to Improve Patient Care" will be held at the Marriott Buckhead Hotel, 3405 Lenox Rd., Atlanta. 


We look forward to meeting with our OB/Gyn's colleagues to discuss mutual issues in patient care. You won't want to miss this special meeting.  Click here for the Agenda and Registration Form.

Save the Date! February 8, 2012! GAAAP Legislative Day @ the Capitol.

 The Georgia General Assembly has convened to begin its 2012 legislative session. On Wednesday, February 8, we'll have our Legislative Day at the Capitol when we'll get to meet legislative leaders and hear about the issues that effect pediatrics in our state. Plan to attend this interesting and informative half-day event.


Please click on the following link for a registration form and further details! GAAAP Legislative Day @ the Capitol

Thursday, January 12, 2012

For pediatric ACOs, providers need not apply - Window to Washington, the government affairs blog by Jessica Zigmond and Rich Daly

For pediatric ACOs, providers need not apply - Window to Washington, the government affairs blog by Jessica Zigmond and Rich Daly

Do No Harm — And Keep An Eye On Costs - Kaiser Health News

Do No Harm — And Keep An Eye On Costs - Kaiser Health News

State won’t act on health insurance exchange | Georgia Health News

State won’t act on health insurance exchange | Georgia Health News

Deal wants 400 more slots for residents at Georgia hospital | jacksonville.com

Deal wants 400 more slots for residents at Georgia hospital | jacksonville.com

Deal seeks more than $900M in new spending - Atlanta Business Chronicle

Deal seeks more than $900M in new spending - Atlanta Business Chronicle

Caesarean Birth Increases Risk Of Developing Asthma By Age Of 3

Caesarean Birth Increases Risk Of Developing Asthma By Age Of 3

Breastfed Babies Cry More, Harder To Soothe

Breastfed Babies Cry More, Harder To Soothe

Wednesday, January 11, 2012

States oppose Obama healthcare Medicaid law | Reuters

States oppose Obama healthcare Medicaid law | Reuters

Georgia Lawmakers: More bills introduced requiring drug tests for state benefits - The Times-Herald

Georgia Lawmakers: More bills introduced requiring drug tests for state benefits - The Times-Herald

Medicaid debate: Does managed care work? | Georgia Health News

Medicaid debate: Does managed care work? | Georgia Health News

Medicaid: a year of excruciating decisions

Medicaid: a year of excruciating decisions

Measuring Quality: 368 New Ideas For 2012 – Capsules - The KHN Blog

Measuring Quality: 368 New Ideas For 2012 – Capsules - The KHN Blog

Deal’s priority: Keeping doctors in Georgia | Georgia Health News

Deal’s priority: Keeping doctors in Georgia | Georgia Health News

Medical News: Diabetes Expert Disses Weight-Loss Programs - in Endocrinology, Diabetes from MedPage Today

Medical News: Diabetes Expert Disses Weight-Loss Programs - in Endocrinology, Diabetes from MedPage Today

States oppose Obama healthcare Medicaid law

States oppose Obama healthcare Medicaid law

Hospital uncompensated care remains flat despite economy - FierceHealthFinance - Health Finance, Healthcare Finance

Hospital uncompensated care remains flat despite economy - FierceHealthFinance - Health Finance, Healthcare Finance

Deal To Release 2013 Budget

Deal To Release 2013 Budget

Deal outlines plans for economy, education  | ajc.com

Deal outlines plans for economy, education | ajc.com

Gastrointestinal Problems In Autistic Children May Be Due To Gut Bacteria

Gastrointestinal Problems In Autistic Children May Be Due To Gut Bacteria

When Teens With Autism Want To Drive

When Teens With Autism Want To Drive

Tuesday, January 10, 2012

Retail health clinics to resurge in 2012 - FierceHealthcare

Retail health clinics to resurge in 2012 - FierceHealthcare

amednews: 5 simple ways to cut medical practice costs :: Jan. 9, 2012 ... American Medical News

amednews: 5 simple ways to cut medical practice costs :: Jan. 9, 2012 ... American Medical News

amednews: Safety research found lacking for outpatient visits :: Jan. 9, 2012 ... American Medical News

amednews: Safety research found lacking for outpatient visits :: Jan. 9, 2012 ... American Medical News

Rotavirus Vaccine Re-Introduction Not Linked To Increase In Intussusception

Rotavirus Vaccine Re-Introduction Not Linked To Increase In Intussusception

Decision sharing tied to lower cost for kids' care


Decision sharing tied to lower cost for kids' care


  By Kerry Grens
NEW YORK | Wed Dec 21, 2011 1:29pm EST


NEW YORK (Reuters Health) - Parents who report having an increased involvement in making decisions about their children's medical treatment are more likely to see lower risks of their kids going to the emergency room or being hospitalized, according to a new study.
The researchers, who looked only at families with children who have long-term health conditions, also found that those who joined doctors in making medical decisions had lower costs for their kids' medical care.


"This suggests that if you involve people in decision-making, they may be making choices that lead to decreasing the financial burden on them," said the study's lead author, Dr. Alexander Fiks, a professor at the Children's Hospital of Philadelphia.


Cost is especially important for these families, Fiks told Reuters Health, because there's a large out-of-pocket burden for kids who have asthma, autism or other chronic health problems.
His study, published in the journal Pediatrics, used responses from a large, annual health care spending survey, and they compared the results over two years.


The parents of more than 2,800 kids with special health care needs answered questions not only about costs, but the relationship they had with their child's doctor.


For instance, the survey asked how often doctors invited the parents to help in making decisions about treatment, and how often health care providers listened carefully to the parents.
Shared decision-making in medicine is considered a relatively new approach to determining a plan of treatment for patients, compared to the older, more paternalistic approach of the doctor calling the shots without input from the family or patient.


Fiks and his colleagues found that about half of the families experienced a high level of shared decision-making with doctors over the two years, while 17 percent continued to have a low level of participation.


About 16 percent of the families played an increasing role in making decisions over the span of the study, which was linked with a drop in trips to the hospital.


In the first year, seven out of every 100 kids in this group of families were admitted to the hospital, compared to three out of every 100 kids in the second year of the study.


Similarly, 26 out of every 100 kids went to the E.R. in the first year, compared to 15 in the second year.


Dr. Stephen Berman, a professor of pediatrics and public health at the University of Colorado and a medical editor of the Foundation for Informed Medical Decision Making, said he wasn't surprised to see these kids avoiding the hospital.


"In my own practice I find that when parents become partners in these decisions...they understand the care plan much better and they're much more compliant with giving medications (to their kids) and recognizing danger signs," said Berman, who was not involved in this study.


"If families are following treatments more closely, it's possible that the kids may get better," Fiks said.


SPENDING DROPS
Health care spending for kids also dropped in the second year of the study if families had a growing part in making decisions.


The total spending on health care was more than $2,000 in the first year, and dropped to about $1,700 in the second year.


Fiks and his colleagues didn't prove that sharing decisions was the sole reason for the benefits they saw.


There are other possibilities that could explain why the researchers found a benefit for families who took a larger part in making choices in the second year.


For one, parents who are stronger advocates for their children -- and who are more likely to aggressively pursue treatments -- might seek out doctors willing to involve them in making decisions.
Another explanation is that as children get sicker, their parents might be less willing or able to make choices, and the decisions fall primarily on the doctor. On the flip side, as kids gets healthier, their parents might be more able to take on a greater role in their care.


Fiks said he'd like to see future studies work out whether shared decision-making alone can result in cost savings and health benefits for children with health problems.


"I personally believe that when we do those studies...we will find an impact from shared decision-making," Berman told Reuters Health.

Private insurers increasingly reliant on government business


Private insurers increasingly reliant on government business

By N.C. Aizenman, Published: January 4

Despite the sluggish economy, the nation’s major health insurers have prospered in large part by expanding their role in government programs such as Medicare and Medicaid, according to a study released Thursday.
The share of large insurers’ revenues contributed by their Medicare and Medicaid business has jumped from 36 to 42 percent over the past three years. And the report by Bloomberg Government, a research division of Bloomberg LP, suggests that insurers will further increase their reliance on federal dollars with full implementation of the health-care law in 2014 — when Medicaid will expand to cover an eventual 16 million additional low-income Americans and the federal government will begin subsidizing private-insurance policies for an estimated 19 million more.

The study found that since 2009, carriers have enjoyed substantial growth to their operating margin, the share of a company’s revenue left over after accounting for operating expenses.

During last year’s first three quarters, the combined operating margin of the five largest publicly traded insurance companies averaged 8.65 percent — the best three-quarter performance of the past three years.
This occurred even as revenues from traditional private-insurance business have remained virtually flat since the end of 2008.

The five insurers combined — UnitedHealth Group, Wellpoint, Aetna, Humana and Cigna — cover 42.3 million people, or about 17 percent of Americans with health insurance. The report is mostly based on an analysis of their filings with the U.S. Securities and Exchange Commission. The study also found evidence that nonprofit Blue Cross Blue Shield plans, which cover a comparable share of the insured, likely performed similarly well.

The insurers’ government business involves taking over components of the Medicare and Medicaid programs that government policymakers are increasingly outsourcing in hopes of cutting expenditures.

Essentially, the private companies are hired to run managed-care plans as an alternative to the traditional fee-for-service plans provided by the two programs. Under the arrangement, the insurer receives a fixed amount from the state or federal authority ultimately responsible for a given Medicaid or Medicare population. In many cases, the insurer can then keep part of any savings it generates by managing the care of the covered population more cost-effectively.

The practice is attractive to states seeking to curb spending on Medicaid, which is funded with a combination of state and federal dollars. Privately run Medicare managed-care plans — called Medicare Advantage Plans — have also long been common.

The health-care law will actually reduce federal payments to Medicare Advantage Plans by $136 billion. Nonetheless, the study’s author, Peter Gosselin, posits that insurers still expect the plans to prove profitable, because the current national focus on debt reduction will give them political cover to manage beneficiaries’ care more tightly than was considered palatable in years past.

That same logic might explain why insurance companies and their investors appear unruffled by the possibility that the health-care law could be overturned by the Supreme Court or drastically altered by the next Congress.

In the absence of the law, Medicaid might not be expanded. But the political imperative will still be to reduce spending on both Medicaid and Medicare — and this would probably be done through further outsourcing to private companies.

“It seems as if insurers have figured out a way to win whether the law is fully implemented or not,” Gosselin said.


Monday, January 9, 2012

Collaborative Efforts Can Save Money And Improve Care - Kaiser Health News

Collaborative Efforts Can Save Money And Improve Care - Kaiser Health News

Blues plans create Medicaid HMO | Top Story | Health News Florida

Blues plans create Medicaid HMO | Top Story | Health News Florida

Child care rating system draws interest  | ajc.com

Child care rating system draws interest | ajc.com

Capitol Who’s Who: The most powerful players  | ajc.com

Capitol Who’s Who: The most powerful players | ajc.com

Legislature could get off to a fast start  | ajc.com

Legislature could get off to a fast start | ajc.com

2012 Legislative Session Begins

2012 Legislative Session Begins

Colorful Plates Boost A Picky Eater's Appetite

Colorful Plates Boost A Picky Eater's Appetite

Thursday, January 5, 2012

Southern Regional Hospital baby kidnapping suspect to appear in court | 11alive.com

Southern Regional Hospital baby kidnapping suspect to appear in court | 11alive.com

Teaching hospitals ramp up advertising to gain clinicians, patients - FierceHealthcare

Teaching hospitals ramp up advertising to gain clinicians, patients - FierceHealthcare

Legislative preview: The health care lineup | Georgia Health News

Legislative preview: The health care lineup | Georgia Health News

HHS issues 26 Medicaid quality measures - FierceHealthcare

HHS issues 26 Medicaid quality measures - FierceHealthcare

Rise In Body Fat Driven By Calories Consumed Rather Than Protein

Rise In Body Fat Driven By Calories Consumed Rather Than Protein

amednews: Editorial - Anti-tobacco funding gone up in smoke :: Jan. 2, 2012 ... American Medical News

amednews: Editorial - Anti-tobacco funding gone up in smoke :: Jan. 2, 2012 ... American Medical News

Chronic Missed Naps Could Put Toddlers At Risk For Mood-Related Problems Later In Life

Chronic Missed Naps Could Put Toddlers At Risk For Mood-Related Problems Later In Life

School Performance And Physical Activity Positively Linked

School Performance And Physical Activity Positively Linked

CDC: Twin birth rate climbing - USATODAY.com

CDC: Twin birth rate climbing - USATODAY.com

Emory bans smoking on campus, even in private cars - Atlanta Business Chronicle

Emory bans smoking on campus, even in private cars - Atlanta Business Chronicle

Wednesday, January 4, 2012

Parents are the biggest obstacle to letting kids play, says study in Pediatrics - On Parenting - The Washington Post

Parents are the biggest obstacle to letting kids play, says study in Pediatrics - On Parenting - The Washington Post

Diabetes during pregnancy may raise ADHD risk - CNN.com

Diabetes during pregnancy may raise ADHD risk - CNN.com

Grim childhood obesity ads stir critics  | ajc.com

Grim childhood obesity ads stir critics | ajc.com

Chief Justice Backs Peers’ Decision to Hear Health Law Case - NYTimes.com

Chief Justice Backs Peers’ Decision to Hear Health Law Case - NYTimes.com

Should Doctors Be ‘Parsimonious’ About Health Care? – Capsules - The KHN Blog

Should Doctors Be ‘Parsimonious’ About Health Care? – Capsules - The KHN Blog

Emory, St. Joseph’s tie the knot | Georgia Health News

Emory, St. Joseph’s tie the knot | Georgia Health News

Remembering a brilliant and devoted doctor | Georgia Health News

Remembering a brilliant and devoted doctor | Georgia Health News

Tuesday, January 3, 2012

More doctors rejecting new Medicare patients | www.wsbtv.com

More doctors rejecting new Medicare patients | www.wsbtv.com

Connecticut Drops Insurers From Medicaid - Kaiser Health News

Connecticut Drops Insurers From Medicaid - Kaiser Health News

Unmet social needs worsen health :: Jan. 2, 2012 ... American Medical News

amednews: Unmet social needs worsen health :: Jan. 2, 2012 ... American Medical News

Texas Medicaid managed care expansion approved :: Jan. 2, 2012 ... American Medical News

amednews: Texas Medicaid managed care expansion approved :: Jan. 2, 2012 ... American Medical News

Doctors have to manage smartphone distractions :: Jan. 2, 2012 ... American Medical News

amednews: Doctors have to manage smartphone distractions :: Jan. 2, 2012 ... American Medical News

Toddlers Don't Listen To Their Own Voice Like Adults Do

Toddlers Don't Listen To Their Own Voice Like Adults Do

Legislative Preview: Revenues up as lawmakers prepare to convene Jan. 9 - The Times-Herald

Legislative Preview: Revenues up as lawmakers prepare to convene Jan. 9 - The Times-Herald