September 7, 2012
By Allison Cohen*
Experts Question Whether Affordable Care Act Quality Incentives Are Substantial Enough to Achieve Their Intended Effect
Kaiser Health News (9/4) reports that health quality experts are expressing concerns about whether bonuses and penalties associated with the Value-Based Purchasing Program and patient quality measures in the Affordable Care Act will be large enough to affect hospital practices. They are questioning whether incentives will actually impact base revenue. In the upcoming moths, Medicare will release official payment adjustments based on past performance scores on quality measures from July 2011-March 2012. It remains to be determined whether the goals of improving care, patient outcomes, and avoiding poor quality rankings are significant enough to transform hospital behavior even if monetary incentives are modest.
Medical Centers Are Responding to Failures to Identify Addictions and Associated Conditions by Providing Specialist Training Programs
Kaiser Health News (9/3) reported that findings by the National Center on Addiction and Substance Abuse (CASA) at Columbia University indicate that doctors often do not recognize or diagnose substance abuse, resulting in undertreatment. Including nicotine, forty million people in America are addicted to at least one substance. The CASA report links more than seventy diseases and conditions and one third of inpatient hospital costs to addiction. At the same time, doctors are rarely taught how to identify or address addiction. To address this, ten academic medical centers in the United States are offering one- and two-year residencies to train doctors who have already finished training for another specialty.
Thomas Jefferson University Hospitals Remains a Leader in Fighting Pancreatic Cancer
Medical News (9/6) reports that after performing its 500th whipple procedure, Thomas Jefferson University Hospitals maintains the status of the regional leader in fighting pancreatic cancer. Dr. Charles J. Yeo, MD, FACS, and his team at the Jefferson Pancreas Biliary and Related Cancer Center have performed more than 800 whipple procedures and more than 1,100 pancreatic resections over the past six years. In addition, the Jefferson Pancreas Tumor Registry has helped families record medical history and lifestyle data to further understanding of genetic and sporadic pancreatic cancer.
Researchers Find That Dabigatran is Increasingly Used Off Label
MedPage Today (9/6) reports that, according to researchers from the Johns Hopkins University Bloomberg School of Public Health, off-label use has increased for the Dabigatran, the first oral anticoagulant for stroke reduction approved by the U.S. Food and Drug Administration since warfarin. The researchers found that its use for Afib declined. Some of the most prevalent off-label uses of Dabigatran include hypertensive heart disease, coronary artery disease, and venous thromboembolism.
Institute of Medicine Report Explains the Tools and Transformation Needed to Provide Quality Healthcare at a Lower Cost
Congressional Quarterly (9/6) reports that a recent Institute of Medicine (IOM) report explains that wasted healthcare spending and healthcare quality improvements will require the transformation of our healthcare system into a "learning system." This will only occur by "embracing new technologies to collect and tap clinical data at the point of care, engaging patients and their families as partners and establishing greater teamwork" in healthcare organizations. "Also, incentives and payment systems should emphasize the value of outcomes of care." The report explains that new tools including computing power, management science, mobile technologies, and electronic health records can help with this transformation. Therefore, IOM recommends that clinicians and healthcare organizations adopt these tools in order to make the changes needed to provide quality care at lower costs. (Note: registration is required to access this article.)
*We would like to thank Allison M. Cohen, Esquire (Arlington, VA), for providing this week's update.