Public NPI Directory Possible
The Centers for Medicare and Medicaid Services is strongly considering publishing a directory of physicians who have National Provider Identifiers. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that all providers who submit claims or conduct other transactions subject to the law must have an NPI by May 23, 2007. However, the law did not allow for a directory of NPI providers to be published. Physicians have said that such a directory helps facilitate referrals. Medicare's Practicing Physicians Advisory Council endorsed the idea of publishing a directory in August. At a PPAC meeting in December, Dr. William Rogers, director of the Physicians Regulatory Issues Team at CMS, said that the agency agreed and that it would pursue development of an online directory for physicians and their office staff.
Poll: No Off-Label Use
About half of Americans said physicians should not be allowed to prescribe pharmaceuticals for unapproved uses, according to a recent
Better Quality at Integrated Groups?
University of Pittsburgh researchers say patients receiving care at integrated medical groups may be getting better-quality care, according to a study in the Dec. 5 issue of Annals of Internal Medicine. Dr. Ateev Mehrotra and colleagues analyzed data from 119 California physician groups that contracted with PacifiCare from 1999 to 2000. The authors found that patients in integrated medical groups were more likely than were those in independent practice associations to receive four of the six clinical quality measures—mammography, Pap smear screening, chlamydia screening, eye exams for diabetes patients, controller medications for asthma patients, and β-blockers for heart attack patients. Integrated medical groups were more likely to report using electronic medical records and quality improvement strategies, but that did not fully explain the difference, the authors said. The study was limited in that it only captured a fraction of potential quality measures and relied on self-reports, they said. In an editorial in the same issue, Dr. Lawrence P. Casalino of the University of Chicago said the results were not likely to be generalizable and should be interpreted with caution because they were based on only 19 large groups and six quality measures.
Consumer-Directed Plans Dictated
Many individuals enrolled in consumer-directed health plans may not have much of a choice in the matter, according to a report from the Center for Studying Health System Change. The report, based on survey responses from employers, found that about 39% of the 2.7 million American workers enrolled in employer-sponsored consumer-directed health plans had no other health plan choice in 2006. When employees had a choice of plans, they were more likely to choose a PPO or an HMO. Of the 8.9 million employees who had a choice of at least one other type of health plan, about 19% of employees chose consumer-directed health plans, compared with 55% of employees who chose PPO plans when given a choice. “Despite the buzz, consumer-directed health plans have barely gained a toehold among Americans with employer-sponsored insurance,” Jon Gabel, vice president of the Center for Studying Health System Change, said in a statement. The study was funded by the Robert Wood Johnson Foundation and is based on a 2006 random survey of more than 2,000 private and nonfederal employers with three or more workers. The survey's response rate was 48%.
Medicare Advantage Costs More
If the incoming Democrat-majority Congress is looking for funding to expand the Medicare drug benefit, Medicare Advantage may be a ripe target, according to an analysis from the Commonwealth Fund. Researchers at the fund estimate that in 2005 the federal government paid private Medicare managed care plans, known as Medicare Advantage plans, an average of $922 more per enrollee than comparable beneficiaries would cost under the traditional fee-for-service program, for a total of $5.2 billion. “Medicare should carefully examine whether extra payments to Medicare Advantage plans are the best use of dollars for the beneficiaries the program is designed to serve,” Commonwealth Fund President Karen Davis said in a statement.
ALS Linked to Military Service
There is “limited and suggestive evidence” of a link between military service and the later development of amyotrophic lateral sclerosis (ALS), according to a report from the Institute of Medicine. A panel of experts convened by IOM reviewed the literature and identified one high-quality study that showed an association between military service and the development of ALS. Three other studies supported this link but had limitations. Another study did not show an association. The IOM committee recommended that the Department of Veterans Affairs, which sponsored the study, conduct additional research into the risk factors for ALS related to military service.