kaiser

Cost of diabetes care has nearly doubled in six years

Anne Zieger — Wed, 29 Oct 2008 09:45:08 -0400

Over the course of the last six years, the cost of diabetes medicine in the U.S. has nearly doubled, from $6.7 billion in 2001 to $12.5 billion in 2007, according to a new study that appeared in the Archives of Internal Medicine. Often, that's been due to the use of newer, more expensive drugs like Avandia over old-line, cheaper treatments like metformin, the study found.

Researchers from Stanford University and the University of Chicago compiled results from two databases to find the cost of diabetes medicines between 2001 and 2007. Their research, which was funded by the NIH, the Robert Wood Johnson Foundation, and the Agency for Healthcare Research and Quality, found that not only had the medications commonly prescribed for diabetes increased in cost, but patients were much more likely to be on more than one medication for their diabetes. The question that remains open for study: Are the increases in cost generating equivalent improvements in patient outcomes? (It doesn't seem likely.)

To learn more about the study:
- Read this Kaiser Daily Health Policy piece

PacifiCare restores canceled policies

Anne Zieger — Fri, 20 Jun 2008 11:51:13 -0400

Health plan PacifiCare of California has agreed to restore coverage to consumers whose individual policies, the state says, were canceled unfairly. Under the terms of its agreement with state's Department of Managed Health Care, the health plan will offer coverage to three consumers whose coverage was canceled within the last four years, and stand ready to reimburse for past medical claims. The health plan will also offer coverage to 57 former members, as well as expedited dispute resolution for claims. In addition, PacifiCare has agreed to pay a $50,000 fine and agree to a corrective action plan. It must comply with the corrective action plan within one year or face another fine of $500,000.

In settling with the state, PacifiCare is following in the footsteps of Kaiser and Health Net, both of which were slapped with fines of $300,000, and potential added fines of $3 million, over charges that they rescinded coverage inappropriately for members with individual policies. The state has also offered settlements to Blue Shield and Anthem Blue Cross, which are pending.

To learn more about the state's actions:
- read this Sacramento Business Journal article

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Study: Wellness programs common despite lack of savings

Thu, 05 Jun 2008 06:59:54 -0400

According to a new study, health and wellness initiatives seem to be a matter of faith among big employers. According to research by the Center for Studying Health System Change, many employers are adopting such programs, despite the fact that there's currently little evidence such programs actually save money. The researchers, who studied 12 nationally-representative metropolitan communities, concluded that large employers are looking for long-term strategies to address their rising healthcare costs. The large employers also see wellness programs as a means of giving their employees more responsibility for their health care decisions and costs.

For more information:
- read this Kaiser Daily Health Policy Report brief

CA hospital agrees to $1M patient dumping settlement

Mon, 02 Jun 2008 06:59:56 -0400

One of several Los Angeles hospitals caught up in a patient-dumping scandal has agreed to pay $1 million to settle charges that it dumped a paraplegic man on the city's Skid Row in a hospital gown and colostomy bag. The facility, Hollywood Presbyterian Medical Center, also agreed to be monitored by a former U.S. attorney for up to five years as part of the settlement, adopt new discharge rules and improve services for homeless patients. This agreement follows a similar settlement reached between Kaiser and the city of Los Angeles last year. Meanwhile, the Los Angeles city attorney says that it continues to investigate more than a dozen hospitals and medical offices accused of similar acts.

To learn more about the settlement:
- read this article from the Los Angeles Times

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FTC: Pharmas cut 14 deals to delay generic sales in '07

Tue, 27 May 2008 06:59:57 -0400

Makers of brand-name prescription drugs reached 14 agreements with makers of generic drugs to delay the generic drug makers entry into the market, according to a new report released by the Federal Trade Commission. The FTC says these deals, which it has dubbed 'pay-for-delay,' are harmful to consumers, but it hasn't been very successful in blocking them to date. The agency is on record as supporting legislation that would ban such deals, but such measures haven't made much progress on the Hill due to opposition from both brand-name and generic drug makers.

The 14 deals discussed were part of a total of 33 deals between brand-name and generic drug makers for FY 2007 reported to the agency (as required by 2003 Medicare legislation). In each of the 14 deals, the generic maker got some kind of compensation to delay the market entry of their generic product, and in 11 of the agreements, the brand-name drug maker agreed not to sell its own generic when its patents expired.

To learn more from the report, and get more context:
- read this Kaiser Daily Health Policy Report item

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Merck agrees to $58M settlement on Vioxx ads

Wed, 21 May 2008 06:59:58 -0400

Merck has agreed to a $58 million settlement with 29 states and the District of Columbia to settle allegations that it downplayed heart risks created by Vioxx in direct-to-consumer advertising. Under the terms of yesterday's agreement, Merck will submit all new TV ads for its drugs to the FDA for seven years, and follow all agency-suggested changes before airing the ads. Merck also agreed to end its practice of "medical ghostwriting," in which paid consultants or employees, rather than physicians listed as lead authors, wrote studies on Vioxx.

The agreement follows a $4.85 billion settlement, which is still pending, that ended most lawsuits resulting from findings that the drug doubled risks of heart attack and stroke. Merck withdrew Vioxx from the market in 2004.

To learn more about the new agreement:
- read this Kaiser Daily Health Policy Report item

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Study: Care at safety net hospitals lagging

Wed, 14 May 2008 06:59:55 -0400

Care at safety net hospitals is of significantly lower quality than hospitals that don't serve the poor and underserved, according to a new study appearing in the Journal of the American Medical Association. The study, which looked at data collected between 2004 and 2006 from 3,665 safety-net and non-safety-net hospitals, concluded that hospitals serving a low percentage of Medicaid patients had far more improvement in quality over time than safety-net facilities.

For example, while safety-net hospitals improved heart attack care by 2.3 percentage points, hospitals treating a low volume of Medicaid patients improved heart attack care by 3.8 percentage points, researchers said. Generally speaking, hospitals with a high volume of Medicaid patients saw CMS quality ratings drop from 10.1 percent in 2004 to 2.8 percent in 2006, while non-safety-net hospital ratings climbed from 13.6 percent to 19.7 percent.

To address this gap, the government should offer safety-net hospitals funding specifically targeted to improving care quality, rather than focusing solely on what levels they've already achieved, researchers said.

To learn more about the study:
- read this HealthDay News piece

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Study: Acute shortage of adult primary care MDs coming

Thu, 01 May 2008 06:59:54 -0400

A new study appearing in the journal Health Affairs attaches some numbers to a problem we all see coming--the growing U.S. shortage of primary care physicians. According to the study, by 2025 the U.S. will see a shortage of 35,000 to 44,000 family or general internal medicine physicians who care for adults. Worse, with population growth and an aging population figured in, existing family physicians and general internists will see their workloads grow by a substantial 29 percent by 2025 (versus 2005 levels) if nothing is done.

To learn more about the study:
- read this Kaiser Daily Health Policy Report item
- check out the study abstract

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Hospitals requiring upfront cash payments

Tue, 29 Apr 2008 06:59:57 -0400

Of late, a growing number of hospitals--including not-for-profits--have been insisting on cash payments before they offer services to non-emergency patients. While it may not generate the best PR, it's a matter of survival, hospitals say. Uncompensated care has been flattening hospitals nationwide, with the burden climbing 44 percent in 2006, to $31.2 billion, from $21.6 billion in 2000. Hospitals are being sapped by care for growing numbers of uninsured patients, and say that unless they get tough on patients with some means, some of them simply won't survive. However, such a strategy can rebound when not-for-profits take this stand. For example, this week the Wall Street Journal brought some unflattering attention to the M.D. Anderson Cancer Center, which in late 2006 asked a leukemia patient for $105,000 up front because it wasn't satisfied with her insurance coverage.

To learn more about this trend:
- read this Kaiser Daily Health Policy Report item

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Healthcare industry top spender on federal lobbying in '07

Wed, 16 Apr 2008 06:59:56 -0400

It's good to get attention from federal legislators, but it's going to cost you. That's no mystery to some key healthcare groups, who collectively spent $445 million on federal lobbying during 2007, according to new research from the Center for Responsive Politics. That's more than any other sector of the economy, and tops on the list for the second year in a row, according to the CRP. This number includes 20 industry subsectors, including pharmaceutical and medical products companies ($227 million), health insurance companies ($138 million), hospitals and nursing homes ($91 million) and health professionals ($70 million.) Among those who follow lobbying, it will come as no surprise that leading spenders included the Pharmaceutical Research and Manufacturers of America ($22.1 million) and the American Medical Association (another $22.1 million).

To learn more about CRP's research on lobbying:
- read this Kaiser Daily Health Policy Report item

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