News & Commentary

Briefly Noted January 2018

CMS’s Patients Over Paperwork program aims to lessen the regulatory burden on physicians. CMS administrator Seema Verma likens the effort to scraping off old layers of paint before repainting a house, reports MedPage Today. She said that requirements concerning what and how much information physicians must enter into electronic health records has become too much of a burden, but that’s only one thing being looked at. She said that over the past five years, the agency released 58 rules. Michael Munger, president of the American Academy of Family Physicians, says one place Verma and CMS could start would be to repeal the Advancing Care Information framework—the portion of the MACRA Quality Payment Program that replaces the meaningful use requirements—and instead require physicians to use a certified electronic health record.

Nurses who report being in poor health have a greater chance of committing medical errors, according to a study in the Journal of Occupational and Environmental Medicine. Researchers found that 54% of 1,790 U.S. nurses surveyed reported poor physical and mental health. “Compared to nurses with better health, those with worse health were associated with 26% to 71% higher likelihood of having [made] medical errors,” the study stated. “There also was a significant relationship between greater perceived worksite wellness and better health”.

Only a third of Americans have written down what kind of medical care they would want if they became seriously ill, according to a Kaiser Family Foundation poll. But they think it’s a good idea to do so, with 87% of respondents indicating that writing down medical care wishes is very important. Not surprisingly, people 65 or older are more cognizant of the need. Most (58%) have written advance directives, and two thirds (67%) have chosen a surrogate who would make those decisions.

Army veterans who have a disease or injury they believe is related to being part of biological or chemical testing from 1942 to 1975 may seek treatment from the Army, reports the Army Times. Treatment became available because of a lawsuit filed by Vietnam Veterans of America, Swords to Plowshares, and individual veterans seeking medical care for troops who participated in the programs at Edgewood Arsenal and Fort Detrick in Maryland. A 2015 court decision said the Army, not the VA, was responsible for providing care.

Demographics aren’t on the side of Massachusetts prison officials who want to keep health care costs down, according to WBUR. The public radio station in Boston cites a recent study by the Pew Charitable Trusts that says that more than 14% of inmates in the state are 55 or older, the highest percentage among the states.

CMS awarded 26 Medicare Advantage and prescription drug plans five-star ratings for 2018. Last year, 14 health plans received a five-star rating. Star ratings measure quality and performance in five categories: managing chronic conditions, screening tests, member complaints and Medicare problems, member ratings of the health plan, and the handling of customer appeals. The difference between four and five stars can mean tens of millions of dollars to MA plans from CMS.

The shift to high-deductible health plans could put providers and consumers on a collision course. So argues Suzanne Delbanco, executive director of the Catalyst for Payment Reform, and Roslyn Murray, a project and research assistant with that organization, in a Health Affairs blog post. For one thing, physicians don’t want to be on the hook when the advice they give patients is ignored. But high-deductible plans may create a financial incentive for not following a physician’s advice.

Careful what you say, doctor, because your patient might be recording you. Medical Economics reports that not only are more patients requesting to record medical consults but that some patients are secretly recording them. Physicians, of course, have concerns that what’s recorded could be used against them in future lawsuits.

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