Wisconsin Doctors Want Cap Back
Wisconsin doctors hailed the state assembly's passage of a bill from Rep. Curt Gielow (R) that would reinstate a cap on noneconomic damages at $750,000. The 10-year-old cap was overturned by the Wisconsin Supreme Court in 2005, “throwing Wisconsin's once envied medical liability system into turmoil,” according to a statement issued by the Wisconsin Hospital Association and the Wisconsin Medical Society. Following the dissolution of the cap, physicians have cancelled their recruiting visits to the state, and premiums for the Injured Patients and Families Compensation Fund have increased by 25%, the associations claimed. “Four awards have already exceeded the previous cap, the number of lawsuits in excess of $1 million [increased] by over 22%, and a stunning $8.4 million verdict was handed down in Dane County,” the statement said. “This bill helps doctors concentrate on what concerns them the most: caring for patients,” said Dr. Susan Turney, chief executive officer and executive vice president of the Wisconsin Medical Society. “It doesn't change the fact that injured patients are fully compensated for their economic losses yet helps to maintain access to health care in Wisconsin.” The state's high court had ruled that the cap was unconstitutional beyond a reasonable doubt. A similar bill has been introduced in the state Senate.
Hospital Ethnicity Data
Most hospitals collect data about the race, ethnicity, and language preference of their patients, but few are using the data to improve health care quality, according to a study that was conducted by the National Public Health and Hospital Institute. Researchers surveyed 500 acute care hospitals and found that half collect information on patients' language, more than three-fourths collect information on patients' race, and half collect information on patients' ethnicity and language preference. Of the hospitals that did not collect this information, more than half said that they did not see the need to. “We are encouraged to know that so many hospitals already have quality data that enable them to develop and monitor interventions to eliminate racial and ethnic disparities in health care,” said Marsha Regenstein, Ph.D., the study's lead author and director of NPHHI. “Our challenge now is to work with hospital staff to make sure they recognize the importance of this quality data and that they put the data to use immediately.” The study was supported by the Robert Wood Johnson Foundation.
Assessing Pay for Performance
More than 100 pay-for-performance programs were operating around the country as of last September, according to a new report from the Alliance for Health Reform. Members of Congress and the Bush administration also are exploring methods for testing pay for performance within the Medicare program, including Medicare's voluntary physician reporting program, which began earlier this year. So far, the private sector has taken the lead on pay for performance, according to the report. A prime example is the Bridges to Excellence program, sponsored by several large employers and operating in Cincinnati, Louisville, Ky., Massachusetts, and Albany/Schenectady, N.Y. The program is expanding into the District of Columbia/Maryland/Virginia area, Minnesota, and Georgia. The group offers payment incentives to high-performing physicians in the area of diabetes and cardiac care, and in the use of health information technology. But despite the success of the Bridges to Excellence model and some others, critics say that there are a number of unanswered questions. For example, proponents of pay for performance need to identify the size of the bonus or penalty needed to make a difference in quality, and to figure out what adjustments need to be made to payment systems across different medical specialties, according to the report.
Fighting Off Bad Bugs
Congress should be taking more aggressive steps to incentivize pharmaceutical and biotechnology industries to fight antibiotic resistance, physicians and other policy makers said during a press conference sponsored by the Infectious Diseases Society of America. The group released its “hit list” of the six most dangerous, drug-resistant microbes. “These are life-threatening drug-resistant infections, and we're seeing them every day,” explained Dr. Martin J. Blaser, IDSA president. “What is worse is that our ammunition is running out and there are no reinforcements in sight.” Another problem: “Some of better drugs are more toxic,” he said. Robert Guidos, director of public policy with IDSA, noted that Congress has not taken any action to support the implementation of new incentives for drug companies to develop stronger antibiotics. Market exclusivity—a method that has worked favorably in the past for pediatric drugs, would be an option, he said. So would calling for tax credits for the manufacture or distribution of these products. Another option would be to establish an independent commission to identify which drugs are more sufficient in combatting resistant microbes. “The superbugs are not waiting, and neither should we,” Dr. Blaser commented. The top “bad bugs” are methicillin-resistant Staphylococcus aureus; Escherichia coli and Klebsiella species; Acinetobacter baumannii; Aspergillus; vancomycin-resistant Enterococcus faecium; and Pseudomonas aeruginosa, according to the IDSA report.