Poor Marks for PQRI
Most physicians who participated in Medicare's 2007 Physician Quality Reporting Initiative found the program at least moderately difficult, according to a survey conducted by the American Medical Association. Only 22% of respondents to the online survey were able to successfully download their feedback report. Of those who downloaded the report, less than half found it helpful. In an open-ended question about their experience with the program, nearly all the responses were negatives, according to the AMA. The results are based on responses from 408 physicians. The AMA plans to work with Congress and the administration to alter the program to provide physicians with interim feedback reports and an appeals process. A recent survey from the Medical Group Management Association reported similar problems in accessing feedback reports.
Many Have Drug 'Gap' Coverage
A total of 13% of Medicare beneficiaries enrolled in Part D prescription drug plans and 63% of those in Medicare Advantage plans with prescription benefits had some form of coverage in the “doughnut hole,” or coverage gap, according to a Centers for Medicare and Medicaid Services study on Part D drug claims. The study, which included data on Medicare drug claims for the 25 million Part D beneficiaries, also indicated that the vast majority of enrollees used the drug benefit: In the program's first year, 90% of enrollees filled at least one prescription. In addition, the use of generic drugs has been high in Part D, rising from 60% in 2006 to nearly 68% in the first quarter of this year.
Resuscitation Practices Ineffective
An overwhelming majority of emergency physicians believe that resuscitation practices in the United States are not very effective, according to a survey released by the American College of Emergency Physicians. In addition, more than half of emergency physicians surveyed believe that poor survival rates from sudden cardiac arrest are related to the aging population, while one-quarter of respondents said that obesity has contributed most to poor survival rates. Increased bystander CPR, faster patient-to-doctor time, improved data collection and sharing, and greater use of technology all are critical to improving resuscitation, the survey concluded. “It is necessary for communities to encourage more CPR trainings, offer more access to a broader range of critical life-saving technologies, and report sudden cardiac arrest cases more consistently,” said ACEP President Nick Jouriles.
HIPAA Enforcement 'Limited'
The Centers for Medicare and Medicaid Services has not provided effective oversight and has taken only “limited actions” to ensure that covered entities adequately implement patient privacy regulations contained in the Health Insurance Portability and Accountability Act of 1996, according to a report from the Health and Human Services Department's Office of Inspector General. The OIG found that the CMS had not conducted any compliance reviews of covered entities, and instead relied on complaints to target investigations. However, the CMS has received very few complaints about violations, the report said. “As a result, the CMS had no effective mechanism to ensure that covered entities were complying with the HIPAA security rule” or that electronic health information was being adequately protected, the report concluded. CMS has taken steps to begin conducting compliance reviews in an effort to identify security problems and vulnerabilities under HIPAA, the OIG said.
Mass. Blues Require e-Prescribing
Blue Cross Blue Shield of Massachusetts said it will require all physicians to prescribe electronically beginning in 2011 in order to qualify for any of the health plan's physician incentive programs. Currently, 99% of primary care physicians and 78% of specialists participate in the insurer's incentive programs, which reward physicians for meeting nationally recognized quality standards and patient safety goals. Currently, e-prescribing is an optional measure in the plan's incentive programs. The insurer said it realized that start-up costs involved with implementing an e-prescribing system continue to be a barrier to adoption for physicians, and said it would provide some financial assistance for doctors in 2009 to offset those start-up costs. A 2006 study by the plan showed that physicians who used an e-prescribing device were able to choose more cost-efficient drugs, and therefore saved 5% on their drug costs relative to physicians who did not use the technology.
Program Cuts Illicit Drug Use
A government-supported program used to screen patients seeking health care for signs of substance abuse can reduce illicit drug use among patients seeking medical care in a wide variety of health care settings, a study found. The Screening, Brief Intervention, and Referral to Treatment program uses a variety of techniques to screen patients for signs of substance abuse. If a patient screens positive, immediate steps are taken to help the patient effectively deal with the problem. The study, published in Drug and Alcohol Dependence, found that rates of illicit drug use dropped by nearly 68% 6 months after patients using illicit drugs had received help through the screening program. Illicit drug users receiving brief treatment or referral to specialty treatment also reported other quality of life improvements. The Substance Abuse and Mental Health Services Administration has been awarding grants to expand the screening program since 2003.