CPAP Coverage Expanded
Medicare now will pay for continuous positive airway pressure therapy for obstructive sleep apnea diagnosed by home sleep testing, according to the Centers for Medicare and Medicaid Services. Previously, the agency covered CPAP only if obstructive sleep apnea was confirmed by polysomnography in a sleep laboratory. Under the new rules, initial coverage of CPAP is limited to a 12-week period for beneficiaries whose obstructive sleep apnea is diagnosed using clinical evaluation and testing with an unattended home sleep monitoring device. If the beneficiary's condition improves as a result of CPAP during this 12-week period, then coverage will continue, the CMS said.
Consumer-Directed Plans Gain Fans
The number of people enrolling in consumer-directed health plans has increased 25% from last year, according to a survey of nearly 2,800 private insurance enrollees by the Blue Cross and Blue Shield Association. The survey also found that consumers in CDHPs are more cost conscious than are non-CDHP consumers; they are 30% more likely to track their health expenses than are those in more traditional health insurance plans and 27% more likely to ask their doctors about the cost of treatment. “[CDHP] consumers are demonstrating more active engagement in their own health care than are non-CDHP consumers, as evidenced by an increased use of health and wellness programs and better tracking, estimating, and budgeting for health care costs,” said Maureen Sullivan, senior vice president for strategic services at BCBSA. The 39 independent Blue Cross and Blue Shield companies serve a total of 4.4 million CDHP enrollees—an increase of 50% from last year.
But PCPs Lack Knowledge on CDHPs
Many primary care physicians said they knew little about how CDHPs work, and also reported limited readiness to advise patients on issues of cost and medical budgeting, a study in the American Journal of Managed Care reported. In the survey of 528 primary care doctors, 40% said they had CDHP enrollees in their practices. Of the physicians surveyed, 43% said they had low knowledge of CDHP cost sharing, and about one-third reported low knowledge of how medical savings accounts function. Overall, physicians with CDHP enrollees in their practices knew more than did physicians without those patients, but one in four of these providers said they knew little about CDHP cost sharing. More than two-thirds said they were ready to advise patients on the costs of office visits, medications, and laboratory tests. But half or fewer said they were ready to discuss the costs of radiologic studies, specialist visits, and hospitalizations.
More Trouble With Health Expenses
About one-third of Americans now say their family has had problems paying medical bills in the past year, up from about a quarter of respondents 2 years ago, according to a survey of more than 1,200 adults by the Kaiser Family Foundation. And nearly one in five Americans (18%) report household problems with medical bills amounting to more than $1,000 in the past year. In addition, almost half of respondents report that someone in their family has recently skipped pills or postponed or reduced medical care. In particular, just over one-third say they or a family member put off or postponed needed care, and 30% admitted to skipping a recommended test or treatment—in both cases, an increase of 7 percentage points from last April. “Health care is now every bit as much an economic issue for the American people as job insecurity, mortgage payments, and credit card debt,” said Drew Altman, the foundation's president and CEO.
GAO: FDA Needed Broader Pool
Food and Drug Administration officials might have avoided some conflicts of interest on their scientific advisory committees by expanding recruitment efforts beyond word-of-mouth nominations, according to a report from the Government Accountability Office. The report, released last month, analyzed the recruitment and screening of FDA advisory committee members before the agency changed those processes in 2007. The FDA could have reached out beyond its usual source of experts to retired professionals, university professors, and experts in epidemiology and statistics, the GAO concluded. The evaluation was requested by members of the Senate.
Benefits Seen for National Health ID
A national patient identifier system would improve health care quality and efficiency, according to a study from the RAND Corporation. Because no current national identifier exists, most health systems use a technique known as statistical matching, which retrieves a patient's medical record by searching for attributes such as name, birth date, address, gender, medical record numbers, or Social Security number. Past studies have found that such systems return incomplete medical records about 8% of the time and expose patients to privacy risks because of the large amount of personal information that is out in the open during a search. The RAND researchers estimated the costs of creating a unique patient identification system at $11 billion, but noted that it would return more than that amount in benefits such as the elimination of medical record errors and the reduction of repetitive and unnecessary care. “Establishing a system of unique patient identification numbers would help the nation to enjoy the full benefits of electronic medical records and improve the quality of medical care,” said Richard Hillestad, the study's lead author.