Archive for May, 2008

13.7 Million Young Adults Lack Health Insurance Coverage

May 30th, 2008 by Melanie Matthews

The number of uninsured young adults in the United States rose to 13.7 million in 2006 --- an increase from 13.3 million in 2005 --- making the 19-to-29 age group one of the largest and fastest-growing segments of the population without health insurance. According to a newly updated report from The Commonwealth Fund, 38 percent of high school graduates who do not attend college and 34 percent of college graduates will spend some time uninsured in the year after graduation.


  • Working young adults are much less likely than older workers to have access to health insurance through their employers. Just over half (53 percent) of 19- to 29-year-olds were eligible for coverage offered by their employers, compared with about three-quarters (74 percent) of 30- to 64-year-olds.
  • Young adults from low-income households are most at risk: 72 percent of the 13.7 million uninsured young adults live in households with incomes below 200 percent of the poverty level.

Fruits, Vegetables, Teas May Protect Smokers From Lung Cancer

May 29th, 2008 by Melanie Matthews

Tobacco smokers who eat three servings of fruits and vegetables per day and drink green or black tea may be protecting themselves from lung cancer, according to a first-of-its-kind study by UCLA cancer researchers. UCLA researchers found that smokers who ingested high levels of natural chemicals called flavonoids, water-soluble plant pigments that have antioxidant and anti-inflammatory properties that can counteract damage to tissues, in their diet had a lower risk of developing lung cancer, an important finding since more than 90 percent of lung cancers are caused by tobacco smoking. For the UCLA study, researchers looked at 558 people with lung cancer and 837 people who did not have lung cancer and analyzed their dietary history.


  • The flavonoids that appeared to be the most protective included catechin, found in strawberries and green and black teas; kaempferol, found in Brussels sprouts and apples; and quercetin, found in beans, onions and apples.
  • The antioxidant properties found in the flavonoids also may work to counteract the DNA-damaging effects of tobacco smoking, explaining why they affected the development of lung cancer in smokers but not in nonsmokers.

Health and Wellness Coaching Trends in 2008

May 29th, 2008 by Melanie Matthews

Health coaching ­— with its focus on wellness, prevention and healthy lifestyle choices — has established its value to the healthcare industry. Organizations hoping to hop on the health coaching bandwagon are faced with an overwhelming number of choices, including program delivery and referral methods, as well as a methodology for calculating ROI.

Who's currently offering health coaching programs? What are the top delivery methods for health coaching — telephone, e-mail, online or in person? What kind of outcomes are organizations experiencing and what is the patient/client response?

For these answers and much more, download HIN's free health and wellness coaching 2008 white paper. This white paper is based on a February 2008 e-survey by the Healthcare Intelligence Network (HIN) on health and wellness coaching applications. In response, 235 organizations — many of whom have implemented successful coaching programs — discussed patient outcomes, factors that contribute to a successful program and the challenges of calculating ROI in a fledgling coaching program.

May 31 Deadline for PQRI Clinical Registry Self-Nomination Letter

May 27th, 2008 by Melanie Matthews

Self-nomination letters from physician registries requesting inclusion in the CMS PQRI registry payment program must be received by CMS by 5 p.m. Saturday, May 31. The letter should also include which 2008 PQRI measures the registry intends to submit on behalf of its participants. The letter should be sent to: PQRI Registry Self-Nomination Centers for Medicare & Medicaid Services Office of Clinical Standards and Quality Quality Measurement and Health Assessment Group 7500 Security Boulevard Mail Stop S3-02-01 Baltimore, MD 21244.

To qualify for inclusion, registries must have been launched prior to January 1, 2008 and meet other CMS requirements. For details on the PQRI registry self-nomination process and registry requirements, please download the four-page PDF document 2008 PQRI Registry Requirements for Submission Under New Options at the CMS PQRI Web site.

Last month, CMS announced alternative reporting periods and alternative criteria for satisfactorily reporting through qualified registry-based reporting.

Patient registries are playing important roles in disease management and quality initiatives and in the construction of medical homes. The Healthcare Intelligence Network is wrapping up the last few days of an e-survey on patient registry use in the healthcare industry. Complete the survey by May 31 and you'll get a complimentary e-summary of the results.

Pain Management Methods

May 23rd, 2008 by Melanie Matthews

According to the American Academy of Pain Management, about 50 million Americans are living with chronic pain, whether due to a disease, a disorder or an accident. And more than 60 percent of chronic pain patients have been living with their pain for more than five years.

In addition, another 25 million people suffer acute pain brought on by surgery or accident.

Read about therapies used to treat pain as well as the social and legal barriers preventing many healthcare professionals from adequately managing their patients' pain issues.

There are many different approaches to pain management. We recently conducted an e-survey on pain management initiatives and received more than 200 responses. The e-summary will be available soon. If you'd like a copy, please send an email to editor@hin.com.

A Nurse Practitioner’s View of the Medical Home

May 23rd, 2008 by Melanie Matthews

Stephen Ferrara, nurse practitioner and blogger for A Nurse Practitioner's View, weighs in on the medical home model, whose success will depend heavily on NPs:

I am encouraged by this model and anticipate that it will not only improve patient outcomes but will also drive down costs of health care. This is the part that is largely unknown: will it curb the needless spending and duplication of tests/screenings ordered for what is largely considered defensive medicine and will outcomes improve by keeping folks out of the hospital?

Gym To-Do’s: Work Out, Choose a Doctor, Get a PHR

May 20th, 2008 by Melanie Matthews

Recruiting Patients at the GymAt my health club last week, a local provider of concierge medicine held a recruiting event that attracted about a 100 individuals of more or less Medicare-eligible age. The approach struck me as an unusual way to build a practice. What also interested me was what a member would get for their annual fee — besides a comprehensive annual physical, priority access to physicians and appointments and a personalized Web-based wellness plan, members receive a complete PHR on CD-ROM.

This provider's PHR is one of many available in the current consumer-driven healthcare climate. In this week's issue of the Healthcare Weekly Business Update, we highlight a new CMS pilot that encourages Medicare beneficiaries to track their healthcare services via an online PHR. And in last month's HIN e-survey on PHR use, more than 200 health plans, providers and employers told us about their PHR adoption and use. About a third of respondents have introduced PHRs in one format or another, with another third poised to do so in the next 12 months. Not surprisingly, Internet-based PHRs are the favored format. Respondents gave us lots more detail on PHR components, portability and interoperability, as well as the challenges of and benefits from a PHR launch. The e-summary will be available soon. If you'd like a copy, please send an email to editor@hin.com.

New York Hospitals Take Time Out to Avoid Preventable Complications

May 19th, 2008 by Melanie Matthews

Staffers at 11 New York hospitals are taking time out to wash hands, put on hairnets and complete procedure-specific checklists in order to reduce the number of serious infections that afflict hospital patients, according to a story in today's New York Times.

As a result, hospital-acquired infections in the Big Apple have dropped dramatically since 2005, according to statistics released last week by the city's Health and Hospitals Corporation (HHC), which administers the city's 11 hospitals.

In late 2005, the HHC adopted a series of simple, standardized protocols based on those developed by Dr. Peter J. Pronovost, a crusader against preventable hospital deaths and a professor of anesthesiology and critical care medicine at Johns Hopkins University. Dr. Pronovost calls his protocols a checklist, and that is pretty much what they are.

A red binder at the nursing station at Woodhull contains dozens of forms, labeled “Central Venous Catheter Insertion Checklist,” which instruct doctors to, first of all, make sure that they have the right patient and are planning the right procedure. The 14-item list goes on to include washing hands; putting on caps, masks, sterile gowns and gloves; draping the patient from head to toe; preparing the patient’s skin with chlorhexidine antiseptic; maintaining a sterile field; and applying a sterile dressing.

One person, usually a nurse, acts as the referee by calling, “Timeout!” and checking off the “completed” or “not completed” columns on the list as each step is called out and performed.

Beginning in October, Medicare, the federal insurance program for the elderly, will no longer cover the additional cost of eight preventable complications: falls; mediastinitis, an infection that can develop after heart surgery; urinary tract infections that result from improper use of catheters; pressure ulcers; and vascular infections that result from improper use of catheters. In addition, the conditions include three "never events": objects left in the body during surgery, air embolisms and blood incompatibility.

Asthma Awareness

May 16th, 2008 by Melanie Matthews

May 6th marked World Asthma Day, an event organized by Global Initiative for Asthma (GINA) to improve asthma awareness and care around the world. Find out how adolescents' deliberate misuse of asthma inhalers is leading to even greater problems. In addition, researchers from the University of Pittsburgh School of Medicine are on their way to developing more effective drugs for treating asthma and allergic disorders.

CHCS Offers ROI Forecasting Calculator for Quality Initiatives

May 8th, 2008 by Melanie Matthews

Scenario 1: Your members make four or more visits to the ED per quarter. You want to try to lower that to three visits per quarter. But how? What kind of changes in staff will you need? What utilization changes will you need to make?

Scenario 2: Your organization wants to expand their interventions. At what point will you see a positive ROI? How many members can you then serve?

Thanks to a tool from the Center for Health Care Strategies, Inc. (CHCS), wonder no more. CHCS has developed an ROI Forecasting Calculator, a Web-based tool to help Medicaid and health plans predict cost-savings potential of efforts to improve quality.

A recent CHCS webinar made possible by the Commonwealth Fund and the Robert Wood Johnson Foundation walked participants through the tool and also offered experience on how the participants in the ROI Purchasing Institute used the tool to plan for and support specific state initiatives.

According to CHCS 's Program Officer Allison Hamblin, the tool "puts a price tag on potential quality savings" as users enter assumptionsto estimate potential savings. Assumptions needed include factors regarding intervention, target population, utilization, program costs and discount rates.