NMHA Names New President
The National Mental Health Association has named David L. Shern, Ph.D., as the organization's new president and CEO. Dr. Shern is currently dean of the Louis de la Parte Florida Mental Health Institute at the University of South Florida, Tampa, and has had 30 years' experience in mental health, particularly in the translation of research into policy and practice. “David Shern has the vision, expertise, and background to lead NMHA into a new era,” said Sergio Aguilar Gaxiola, the association's acting chair. His “leadership will enable NMHA to make significant inroads in public opinion, policies, and services for the mental health of all Americans.”
Drug-Related ED Visits
Of the 2 million drug-related visits to emergency departments that occurred in 2004, the majority (1.3 million) were for drug misuse or abuse, according to data from the Substance Abuse and Mental Health Services Administration. The findings appear in a new report, “Drug Abuse Warning Network, 2004: National Estimates of Drug-Related Emergency Department Visits.” Of the ED visits for misuse or abuse, 30% involved illicit drugs; 25% involved prescription or over-the-counter medications; 15% percent involved illicit drugs and alcohol; 8% involved illicit drugs and pharmaceuticals; and 14% involved illicit drugs, pharmaceuticals, and alcohol. “Most of the 1.3 million visits to emergency rooms involving drug or alcohol misuse or abuse are an opportunity for the health care system to intervene and direct patients to appropriate follow-up care,” noted SAMHSA Administrator Charles Curie. Since the survey is considered a new baseline, no comparative data from previous years were available.
Hospital Payments Increased
Medicare is increasing overall payments to inpatient psychiatric facilities an average of 4% beginning next month, the Centers for Medicare and Medicaid Services announced. The increase will go to about 1,800 facilities, including hospitals which only treat psychiatric patients, distinct psychiatric units in acute care hospitals, and critical access hospitals that are paid under a prospective payment system. “We think that's a fair increase,” said Mark Covall, executive director of the National Association of Psychiatric Health Systems, adding that this is the first increase since CMS implemented the prospective payment system for inpatient psychiatric facilities in early 2005.
GAO Raps FDA Decision Making
The Food and Drug Administration lacks a clear and effective process for making decisions about postmarketing drug safety issues, according to a recent report from the Government Accountability Office. The GAO noted that “there has been high turnover of Office of Drug Safety directors in the past 10 years, with eight different directors of the office and its various predecessors.” Communication is also an issue; insufficient communication between the Office of Drug Safety and the Office of New Drugs divisions has been an ongoing concern and has hindered the decision-making process, the report said. The GAO suggested that Congress consider expanding FDA's authority to require drugmakers to conduct additional postmarket studies when needed. The GAO also recommended establishing a mechanism for specifically tracking postmarketing safety issues, and clarifying the Office of Drug Safety's role in the agency's advisory committee meetings. FDA called the report “well done” and said that the GAO's conclusions were “reasonable and consistent with actions” already underway or planned.
Part D: No Help for Poor Seniors
Less than one-fourth of the Medicare beneficiaries eligible for subsidies under Medicare Part D have enrolled in a plan, according to a report from Families USA. The report, based primarily on enrollment data from the Centers for Medicare and Medicaid Services, found that only 1.7 million of the 7.2 million low-income seniors eligible for the subsidies–or about 24%–have enrolled in Part D. And in 16 states and the District of Columbia, at least four out of five seniors eligible for low-income subsidies are not receiving them, according to the report. “Contrary to promises by the President and congressional leaders, low-income seniors are not receiving help to make their medicines affordable,” said Ron Pollack, the group's executive director. “These are the very people who need help the most, yet the administration's promises to them are much more rhetorical than real.”
Malpractice “Crisis” Questioned
The idea that malpractice premiums have risen greatly and constitute a “crisis” for physicians is false, according to an article in the May/June issue of Health Affairs. Author Marc A. Rodwin, Ph.D., a law professor at Suffolk University, Boston, and Suffolk law students Hak J. Chang and Jeffrey Clausen, looked at American Medical Association surveys of self-employed physicians from 1970 to 2000. The surveys indicated that, in constant 2000 dollars, premiums rose until 1986, then declined until 1996, and then started rising again but were still lower in 2000 than in 1986. In terms of practice expenses, malpractice premiums rose from being an average of 6% of total expenses in 1970 to 11% in 1986, dropped back to 6% in 1996 and rose to 7% in 2000. The authors acknowledged that their study had limitations, such as the fact that a premium crisis might not be apparent in the study if it existed in only a few states, and that it didn't take into account the effect of state caps on damage awards.