pilot program

Case study: NY health plan, group test 'medical home' model

Fri, 23 May 2008 06:59:54 -0400

While there's much discussion of the "medical home" model at industry meet-ups, few health plans have gotten to the point where they're actually putting their money where their mouth is. Albany, NY-based Capital District Physicians Health Plan (CDPHP), however, has decided to make a commitment to the medical home approach.

The regional health plan has put aside $1 million to mount a pilot program testing out its theory that a medical home approach can make practices more efficient, improve outcomes, raise doctor and patient satisfaction and cut costs.The plan includes three medical practices--Latham Medical, Community Care Schodack and Capital Care Family Practice--that will begin offering the program in January 2009. To build the it, CDPHP is working with TransforMED, an affiliate of the American Academy of Family Physicians that just completed a major study of medical homes. TransforMED will begin helping the practices prepare for the transition this month.

What makes the CDPHP program unusual not only is the care model, which stresses team care lead by a physician, but also the fact that physicians are compensated differently than they have been in the past, including pay for phone calls and paperwork. Not only that, physicians' pay service fees would be based on a risk-adjusted model based on a patient's condition, with additional pay for good outcomes and strong patient satisfaction.

To learn more about the CDPHP program:
- read this piece from The Business Review of Albany

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NIH offers free care to patients with rare illnesses

Wed, 21 May 2008 06:59:54 -0400

The NIH has launched a new pilot program designed to find patients with rare, hard-to-detect diseases and treat them--for free. The new Undiagnosed Disease Program is far from a panacea for such patients, as it can only take about 100 applicants per year, but it does offer help for some. NIH officials, for their part, hope that in treating such illnesses, they'll find clues for treating more common maladies.

The new program is aimed at patients who typically would be turned away from NIH programs because there are no studies for their condition, either because the condition is rare or because it may not have been discovered yet.

To learn more about the program:
- read this Associated Press article

Medicare lab test pilot on hold

Tue, 15 Apr 2008 06:59:56 -0400

Medicare has been forced to put a pilot program designed to cut the cost of lab tests on hold after losing a battle in court. CMS had asked labs to bid competitively on prices to provide 303 standard tests to Medicare patients in San Diego County, but three healthcare companies objected and filed suit to stop the program. The companies--Sharp Healthcare, Internist Laboratory and Scripps Health--contended that they'd be forced to cut their workforce and slash medical services if they lost their guaranteed Medicare lab test income. Now, the agency is pondering its options. It's not clear whether it will go ahead with a redesigned pilot of some kind, or drop the idea entirely.

To learn more about the pilot and the controversy:
- read this Associated Press article

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Labs, systems file lawsuit to stop CMS pilot
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Study: Crowding may increase hosp. stay for some children

Thu, 10 Apr 2008 06:59:54 -0400

A new study suggests that if the hospital is crowded on the day a child is admitted, that child may be in for a longer stay if he or she has a less-complicated illness that requires ongoing monitoring. While crowding doesn't affect lengths of stay for children with serious, complex conditions--like bacterial meningitis--children with respiratory conditions may see an impact, according to researchers with The Children's Hospital of Philadelphia. And this has a big impact, since respiratory conditions are the most common reason for pediatric hospitalizations, the authors said.

To draw this conclusion, researchers looked at all children admitted to 323 hospitals in Pennsylvania and New York between April 1996 and June 1998 with one of 19 common pediatric conditions. Researchers found that for children admitted with diseases like viral and bacterial pneumonia, asthma and bronchitis, admission day occupancy above 60 percent resulted in a 25-day increase in the average length of stay per 100 patients. This is a concern, given that the average occupancy for hospitals studied was 75 percent.

Researchers theorize that the need for frequent monitoring can strain the resources of hospitals already near-capacity, and with caregivers stressed, children's care isn't as efficient.

To learn more about this study:
- read this press release

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MDs fight to keep Medicare pilot program

Fri, 28 Mar 2008 07:59:58 -0400

An article in The Tennessean reports that, according to Healthways, more than 300 doctors, group practices and health systems are fighting to continue a pilot program that provides support for chronically ill Medicare recipients in Maryland and Washington, D.C. According to some within the program, it has served "more than 75 percent of the 20,000 beneficiaries originally eligible." Healthways is based in Nashville and is one of five participants in the pilots. The program is in danger because the Centers for Medicare and Medicaid Services said the pilots "weren't meeting requirements for improving clinical quality and customer satisfaction and weren't hitting savings targets."

- read the article in The Tennessean

ALSO NOTED: TN Medicaid to test e-prescribing program; NIH alerts patients of stolen personal information; and much more...

Tue, 25 Mar 2008 07:59:50 -0400

> Tennessee's Medicaid program and one of its Medicaid managed care providers have announced that they plan to kick off an e-prescribing pilot program in 13 of the state's rural counties. Report

> New calls for old drug data in the U.K. have experts second-guessing big drug-safety scandals. If scientists and regulators had had access to every bit of data on Vioxx from the get-go, for instance, would heart attacks and strokes have been averted? Report

> After waiting for nearly a month, officials at the NIH alerted some 2,500 people that their names, addresses and detailed personal health information gathered from heart scans in a clinical trial were purloined when an unknown person stole a government laptop with the data on it. Report

And Finally... Looks like breakfast really is the most important meal of the day. Article

VA puts together travel nurse program

Thu, 13 Mar 2008 07:59:55 -0400

In an effort to cope with the nationwide shortage of nurses, the Department of Veterans Affairs has decided to create its own group of nurses whose job it is to travel and work throughout the agency's sprawling system. The Travel Nurse Corps, which will be headquartered at the Phoenix VA Health Care System, is starting out as a three year pilot program that will place up to 75 nurses at VA medical centers nationwide. The idea not only is to fill vacancies, but also to cut reliance on contractors and staff specialized services and procedures. The travel nurses may also be asked to help provide services to veterans based in rural areas.

To learn more about the program:
- read this press release

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Study: Sticking to one MD helps pediatric patients

Fri, 07 Mar 2008 06:59:54 -0500

New research suggests if a child sees the same doctor consistently for six months, they're more likely to get all of the recommended preventive screenings by age two. The study, which was conducted by researchers at Children's Hospital of Philadelphia, looked at the care given to 1,564 Medicaid-insured infants born at three hospitals in their region. Researchers found that children who saw the same pediatrician for six months received screens for treatable illnesses like lead poisoning, anemia and tuberculosis more reliably. In response to their findings, researchers recommended that parents increase the number of times they bring their children to primary care providers.

To learn more about the study:
- read this Philadelphia Inquirer piece

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Freeze proposed on Medicare audit program

Mon, 03 Mar 2008 06:59:58 -0500

A federal legislator has proposed legislation that would place a one-year national freeze on Medicare's recovery audit program, which has drawn criticism from many observers for the way it rewards recovery contractors. The program, which started in 2005, now includes providers in California, Florida, New York, Massachusetts, South Carolina and Arizona. As things stand, the pilot program will be expanded to a total of 19 states by the spring, and would add yet another five states by the end of the year.

However, opponents of the audit program have argued that contractors have too much of an incentive to challenge provider payments, given that they get 20 percent of any funds they get back for Medicare. Meanwhile, sponsor Rep. Lois Capps (D-CA) notes that the program is imposing particular harm on rehab providers, as 88 percent of all challenged payments are requested by such facilities. Not only that, providers are forced to turn over challenged payments immediately, and can only get them back after moving through an appeals process. CMS Administrator Kerry Weems, for his part, is trying to mollify such critics by making changes in the program. For example, he's noted that once the program goes national, all contractors will be required to have a staff medical director. Also, CMS will limit how far back auditors can search for errors to three years. What's more, records filed before Oct. 1, 2007, would be exempt.

To learn more about the proposed audit freeze:
- read this Kaiser Daily Health Policy Report item

Program involves pharmacists in chronic disease care

Tue, 02 Oct 2007 06:59:55 -0400

A new pilot program underway at a string of federally-funded community health centers hopes to improve patient care and lower costs by involving pharmacists in the care of chronically-ill patients. The program's participants include JWCH Clinic at the Weingart Center in Los Angeles, which has had such a program for diabetes for the past two years. Diabetics who participated in the program reduced their blood sugar levels by 3.7 percentage points and reduced blood pressure to almost-normal levels. Another participating facility is El Rio Community Health Center in Tucson, AZ, where participating diabetics had lower blood sugar levels than patients who got standard care. Jimmy Mitchell, Office of Pharmacy Affairs director for the Health Resources and Services Administration, calls the program the "future of the practice of pharmacy."

To find out more about the program:
- read this Kaiser Daily Health Policy Report item

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Study: Pharmacist oversight improves cardiac outcomes. Report