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Part A to Go Broke in 2017

The Medicare Hospital Insurance Trust Fund will run out of money in 2017—2 years earlier than predicted last year—in part because the fund is collecting fewer payroll taxes during the recession, trustees of the fund announced in their annual report. If lawmakers don't make changes in the program, in 2017 the Part A Hospital Insurance Trust Fund could pay only 81% of anticipated benefits, and that would decline to about 50% in 2035 and 30% in 2080, the trustees said. The trustees also predicted that premiums for Medicare Parts B and D will continue to rise much faster than inflation, and the separate Medicare Supplemental Insurance Trust Fund that in part finances those benefits will require additional money from the general treasury. Health and Human Services Secretary Kathleen Sebelius said in a statement that the report should spur action on the part of lawmakers considering overall health care reform. “This isn't just another government report,” Ms. Sebelius said. “It's a wake-up call for everyone who is concerned about Medicare and the health of our economy. And it's yet another sign that we can't wait for real, comprehensive health reform.”

Mental Heath Parity Comments Due

The federal government is seeking public comments before implementing a law that demands broader insurance coverage for mental health benefits. The Mental Health Parity and Addiction Equity Act of 2008 requires that health plans use the same rules for cost-sharing and visit limits in offering mental health and addiction treatment that they use for medical and surgical treatments. Together, HHS and the Labor Department said they want to know the financial and treatment limits that plans currently impose, the plans' practices in determining medical necessity for and denying mental health benefits, and how plans handle out-of-network mental health benefits.

Families Can't Afford Insurance

The majority of uninsured American families can't afford to buy nongroup health insurance, according to a study from the Agency for Healthcare Research and Quality. The study measured families' median net worth—their savings plus other assets minus debt—rather than just income. The AHRQ concluded that while an income-based model works well to estimate how many families will enroll in employer-based coverage, it overestimates nongroup health insurance enrollment for families with low net worth and underestimates enrollment for families with high net worth. Also, families without access to employer-based coverage were much more likely than those with access to earn below 200% of the federal poverty level, the study showed.

Medical Homes Are Challenging

Transforming a primary care practice into a patient-centered medical home requires “epic whole-practice reimagination and redesign,” according to researchers reporting on one of the first demonstrations of the model. The results of the 2-year pilot project, launched in 2006 and supported by the American Academy of Family Physicians, showed that the technology needed to run a patient-centered medical home (PCMH) was especially difficult to implement. In addition, transitioning to a PCMH required physicians “to change their professional identity and the socialized ways they currently deliver primary care.” For example, physicians must learn to work in practice teams, manage chronic care differently, incorporate populationwide health management, use evidence at the point of care, and partner with patients, the researchers said in the May/June Annals of Family Medicine.

Promo Items Influence Students

Subtle exposures to small promotional items, such as notepaper with printed logos, influences medical students' attitudes toward pharmaceutical brands, a study in the Archives of Internal Medicine showed. However, medical school policies on pharmaceutical advertising might also affect students' attitudes toward drug brands, the researchers noted. At one institution with a strong policy on pharmaceutical marketing, the students increased their negative reactions to a brand-name drug after exposure to small promotional items. At another institution without such a policy, students had more positive reactions to the same product after the same exposure. “The data suggest that adopting these more restrictive policies will reverse long-standing adverse trends on physicians' prescribing habits,” Dr. Philip Greenland of Northwestern University wrote in an accompanying editorial. “It is time to act.”

New Web Site Pushes Reform

Doctors for America, a new grassroots physician organization, is launching a campaign to get physicians' voices heard on health care reform. The “Voices of Physicians” campaign has collected and published comments from doctors nationwide at

www.voicesofphysicians.org

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