News & Commentary

Briefly Noted December 2017

Most cases of measles in the United States occur among unvaccinated patients, according to the CDC. According to researchers, 69.5% of 1,789 measles cases in the country between 2001 and 2015 struck unvaccinated patients. The researchers note that endemic measles, defined as a transmission chain that lasts a year or longer, was eliminated from the United States in 2000. Measles is still very rare, with the yearly number of cases varying between 24 and 658 during the study period.

More physicians who reach retirement age are less likely to do just that, according to a study by health care staffing company Comp-Health and as reported by Medical Economics. The desire for social interaction topped the list of why older doctors stay working. About half of the respondents said that their ideal retirement plans included working occasionally or part-time.

Baptist Health System in San Antonio saw a 21% drop in average Medicare spending for joint replacement episodes between 2008 and 2015 after implementing a Medicare joint replacement bundled payment program, according to a study in JAMA Internal Medicine. Medicare episode expenditures declined from $26,785 to $21,208 for 3,738 episodes of joint replacement without complications and 13.8% from $38,537 to $33,216 for 204 episodes of joint replacement with complications, according to University of Pennsylvania researcher Amol Navathe and his colleagues.

HHS investigators say that Medicare needs to take quick action against a disturbing situation: One in four cases of possible sexual or physical abuse to nursing home residents go unreported, the AP reports. “Using investigative data analysis techniques, auditors from the inspector general’s office identified 134 cases in which hospital emergency room records indicated possible sexual or physical abuse, or neglect, of nursing home residents,” the AP reports.

ADHD symptoms for children three- to eight-years-old improved with the use of a basic parenting skills program, according to a review of 11 studies by University of North Carolina researchers. Designed for parents with high-risk children and children with behavioral problems, the Incredible Years Basic Parent Program teaches the importance of establishing ground rules, addressing misbehavior, and setting limits. It also emphasizes incentives and praise. The UNC researchers set out to tease out whether the program was specifically effective for ADHD.

Anthem is going all in on independent imaging facilities, mandating that beneficiaries go to them rather than the more expensive hospital-owned outpatient imaging centers, Kaiser Health News reports. Anthem wants to reduce costs, of course, and says that quality won’t suffer. Critics argue that the move will lead to fragmented care for patients.

Using trained non-clinicians to visit high-risk patients enabled Regal Medical Group in California to cut 30-day hospital readmissions by 67%, HealthLeaders Media reports. The program is in its second year. The 67% reduction is double the reduction during the previous year. Regal is one of the largest physician practice networks in Southern California.

Whirlpool has expanded its wellness efforts for some 4,000 workers by hiring eight onsite health care providers for the company’s 12 southwest Michigan locations, reports the Herald-Palladium of Saint Joseph, Mich. Employees can get a quick checkup that involves no copay. “Something unique Whirlpool added this year is a 49-point biometric screening that is tied into the employee’s health insurance,” the newspaper reports.

Increasing access to ICU care didn’t reduce the death rate among older people seen in emergency departments in France, according to the results of a study reported in JAMA. In fact, it appears to have made it worse. Twenty-four hospitals were randomly assigned to either a program that promoted systematic ICU admission or to usual care. Patients in the systematic strategy group had an increased risk of death at six months (45% vs. 39%) despite increased ICU admission (61% vs. 34%).

Children’s hospitals are exempt from federal regulations mandating they adopt bundled payment systems and value-based purchasing programs. Yet many children’s hospitals are going in that direction anyway because they see value-based care as the best way to improve quality, reports Healthcare Finance.

A blueprint for high-volume, high-quality lung cancer screening that is detecting cancer earlier—and helping to save lives

Clinical Brief

Multiple Sclerosis: New Perspectives on the Patient Journey–2019 Update
Summary of an Actuarial Analysis and Report