Healthcare Insights To Launch in 2009!

We're getting ready to launch a new blog that looks at the broader issues of Healthcare, providing breaking news, insights and strategies into Health Plan business and operations., update your RSS feed now as we get it ready for our official launch:

http://healthcareinsights.blogspot.com/

See you at MAC!

For some time now you've probably noticed our linking to a new sister blog titled Medicare Advantage Congress. Our new blog will looks at the healthcare landscape from academic, industry, policy & provider view points on all issues related to Medicare Advantage.

Since we've established this corresponding blog we want to officially invite you to join us and subscribe to our feed: http://feeds.feedburner.com/MedicareAdvantageCongress

As you've already seen, we've been building up the Medicare Advantage Congress blog with the same quality content that you find here. Beginning today, this will be our last post on this blog but you can join us on the MAC blog, where we hope you'll continue to actively participate as you have here. Thank you and we look forward to seeing you!

Brand-Name Drugs are Favored by Medicare Beneficiaries

According to this article in EmaxHealth, brand-name medications account for almost two-thirds of all prescriptions filled by Medicare beneficiaries. Patients are asking for brand-name drugs when the program provides coverage and are asking pharmacists for generic drugs when they have to pay out of pocket.

When patients switch from brand-name to generic drugs, more than likely they’ve reached the coverage gap in which they must cover the full cost of the prescriptions. Woody Eisenberg, Medco Chief Medical Officer mentions that when Medicare beneficiaries become aware of the coverage gap they "become acutely aware of the cost difference between brand-name and generic drugs and most make the switch."

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Billions Paid in Medicare Suspect Claims

The National Center for Policy Analysis reports that billions of taxpayer dollars have gone to waste because Medicare has paid out claims with blank or invalid diagnosis codes over the past decade according to a new Senate report.

Claims for wheelchairs, drugs, and other medical supplies of Medicare patients were reviewed from 2001 to 2006. During these years, they found at least $1 billion of medical equipment which listed diagnosis codes that had little or no connection to the reimbursed medical items. Here are some findings from the report:

• Medicare paid millions of dollars to medical suppliers for blood glucose test strips -- used exclusively for diabetics -- based on non-diabetic diagnoses.
  
• Roughly $4.8 billion in payments were made from 1995 to 2006 despite invalid coding or nothing listed at all; about $23 million of that amount was paid after 2003, when federal rules made clear the codes were required.
• Based on a sample of 2,000 of those invalid coding claims, investigators found more than 30 percent could not be verified as legitimate and "bore characteristics of fraudulent activity."
• Federal regulations require that Centers for Medicare and Medicaid Services (CMS) pay only for items that are deemed "medically necessary," yet, CMS does not examine diagnosis codes to determine whether the equipment is actually necessary before making payment.
• Only 3 percent of claims are reviewed after payment is made.
  

Sources:
http://hsgac.senate.gov/public/
http://townhall.com/news/us/2008/09/24/probe_medicare_paid_billions_in_suspect_claims

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare Monthly Premium Costs Remain the Same for Elderly and Disabled in 2009

AHN reports that Medicare premiums for the disabled and elderly will remain constant at $96.40 next year, according to the U.S. Centers for Medicare & Medicaid Services.

The premium and deductible paid by consumers cover home health facilities, durable medical equipment, and cost of physicians. The Medicare Part B Program will also retain its costs at $135 this year. So far the only costs expected to rise is monthly premium payment for Part A coverage which will rise form $423 to $443 in 2009.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare rates to stay the same for 2009

According to Elder Law Answer, it was announced recently that Medicare's monthly premium will stay the same for the first time in eight years. The monthly premium will remain the same, totaling $96.40 a month.

This fee covers portions of fees related to physicians services, outpatient hospital services, and other items.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

More advertising dollars going to Medicare Advantage

In a recent study done by the Kaiser Family Foundation, detailed here at the Washington Post, they found that insurers spent three times more money promoting comprehensive Medicare plans rather than stand alone drug plans. The study was conducted between October 1 and December 31, 2007, with an increased effort looking at what's going on with Medicare marketing practices. For the most part, the commercials emphasized the benefits centered around preventative care, vision and hearing benefits.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Restrictions placed on cold calls by insurance agents

Effective October 1, insurance agents will no longer be able to cold call the elderly and disabled when trying to sell prescription drug plans. According to the AP, this new law will be enforced by an increased amount of surveillance on the agents as well as reviews of media and print ads published by those.

The new restrictions include:

- No unsolicited contacts with beneficiaries, such as visiting their home or calling them. The prospective customer must initiate the contact.

- No selling of other insurance products, such as annuities or life insurance, to beneficiaries.

- No free meals at promotional or sales events.

- New requirements for training or testing of agents.

Penalties for breaking these law could result in up to $25,000 worth of fines.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare Hospice Protection Act

US Representative Maurice Hinchey has introduced a new bill to Congress to block a new bill from the Bush administration. According to The Ithaca Journal, a bill going into affect October 1 will begin reducing Medicare reimbursement rates by $2.2 billion over the next five years. This could result in hospice patients loosing their hospice care across the country, as it could cost certain hospices $50,000 next year across the country, and as much as $150,000 over the next three years. Hinchey is encouraging Congress to swift action due to the tight time frame they’re working with.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Welcome to Doughnut Hole Season

In a recent article at the Dallas Morning News, they discuss the current stress one in five seniors is now facing until the end of the calendar year. Doughnut Hole Season is the time of year when low co-payments reach their gap in the drug coverage provided by Medicare, and, as a result, they are faced with staggeringly high payments for their medication. In 2007, 3.4 million seniors faced this situation.

Through the current program, seniors are responsible for full costs once all of Medicare’s payments (co-pays and deductibles) have reached $2150. They do not pick up payments again until citizens spending exceed $5726. However, only one in five will reach this amount.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Senate Investigates Medicare Call Centers

Yesterday's Wall Street Journal reported on Senator Gordon Smith (R-OR) and his investigation into the quality of Medicare's call center brought to Capitol Hill. The call centers, run by Vangent, are under investigation because "In 50 test calls placed last month, wait times ranged from zero to 45 minutes, and six calls were disconnected while on hold. Call centers have provided at least one piece of incorrect information or been unable to provide a response to at least one question in 90% of test calls placed in the past year," reported the WSJ article. Vangent denies the allegations citing their high customer satisfaction percentages. What do you think of Senator Smith's investigation?

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Humana looses some Medicare Enrollees

As a result of premium bids that are higher than low income, government assigned members of Medicare, Humana expects to loose 10% of them at the beginning of 2009. However, according to the Wall Street Journal, they believe this could be positive for Humana due to the fact that higher prices would increase the bottom line, shares dropped 5% to $41.75 when it was announced that this could lead to a los of 380,000 eligible Medicare members. To ensure drug coverage for these dropped Medicare enrollees, the government will automatically re-enroll them in private drug care provider programs.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare Made Easy

In a latest release, Experion Systems has launched a new edition of their PlanPrescriber tool as reported by MarketWatch. Created by Glen Urban, a Professor at MIT, this new tool gives seniors access to “unbiased advice” for determining their Medicare Insurance plan. It is a free online tool designed to save seniors time, and money, and starts by simply entering a zip code. Those without access to Internet, can also call 877-900-4824. As Ross Blair, Experion Systems CEO, stated:

"The rising costs of prescription drugs is a real burden for seniors on a fixed income. PlanPrescriber allows seniors to switch to the optimal plan based on their individual needs. Seniors can typically save 25% to 50% of their annual prescription drug costs by joining the optimal insurance plan."

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Marketing Documents for Medicare Prescription Drug Benefits is Confusing

The Wall Street Journal blog discusses how marketing brochures for Medicare prescription drug plans are doing a bad job of meeting guidelines set forth by the feds in this latest post.

A report published by the inspector general’s office in the Department of Health and Human Services found that 85% of marketing materials did not meet guidelines set out by the Center for Medicare and Medicaid Services. Some problems with the documents are that a lot of marketing documents that are produced in conjunction with an insurer and a pharmacy fail to mention that other pharmacies are available. This is required by law. Another problem is that some documents do not include required information on the subsidy that is available to beneficiaries with low incomes.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

CDC and Columbia find no link between autism and MMR vaccine

According to this post at the Wall Street Journal Health Blog, the Center for Disease Control and Prevention and Columbia University did a study that found that there is no connection between the Measles, Mumps and Rebella vaccine and autism.

The two researchers conducted a study based on:

The measles virus from the vaccine could reproduce in the intestinal tract, leading to inflammation and bowel permeability. That leaky bowel could permit the release of chemicals that would make their way to the nervous system, causing trouble.

When conducting the research, they looked at children with gastrointestinal problems who had autism and children with gastrointestinal problems with no autism. Studies showed there was no difference between the two sets of children.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Satisfied Medicare Providers

In a survey conducted by CMS this year, which was administered to 35,000 randomly selected individuals and organizations including physicians, hospitals, and skilled nursing home facilities, Medicare health care providers are still satisfied with Medicare fee-for-service contractors. As indicated by this article, this shows that

Medicare health care providers continue to be satisfied by Medicare fee-for-service contractors showing a relatively smooth transition to the new Medicare Administrative Contractors (MACs).

This year the average score was 4.51 based on a scale from 1 to 6, which is very close to last years score of 4.56. How Medicare contractors dealt with “provider inquires” continued to be the leading sign of satisfaction. This is the third year in a row where this has been the case

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare and Medicaid Rise to the Top

The Wall Street Journal blog reports that while the share of Americans that got health insurance through work or bought it on the private market last year declined, the number of Americans insured through Medicaid and Medicare has increased. These are numbers based on the latest report from the US Census Bureau.

This change shows that there is an overall decline in the percentage of Americans who are uninsured, and this goes against recent trends of rising uninsurance rates. See the full report here.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

“Billing balance” stirs up controversy

Business Week recently collaborated with the CBS Evening News educate the nation on the nature of “billing balance.” When an insurance company covers less of the medical payments than doctors want them to, they turn to the customer for the rest of the payment. Since patients think that their unpaid bills will turn their credit bad, many automatically pay the bills. This has resulted in patients paying $1 billion more a year in medical bills than they’re supposed to. The California Association believes that 1.76 million policy holders paid $5.28 million more than they were suppose to, including 56% of those who were billed.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare Pays Too Much for New Generics

According to this article on The Wall Street Journal Blog when the price of generic drugs plunges, Medicare is slow to reflect that price change.

A report published by the Health and Human Services’ inspector general looks at irinotecan, which is a cancer that went generic in February of this year. The average price of the drug factoring in sales of the branded version was $52. During the current quarter, Medicare was paying about $75 for irinotecan, which is still far above the average price.

Read the full report here.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Numbers of uninsured dropped

In a recent report released by the census bureau, they state that the number of uninsured has decreased 3.2% to 45.7 million, which is 15.3% of the population. According to this article here at Modern Healthcare, authorities state that the reasons why uninsured numbers have decreased is still unknown. The number of uninsured children has dropped as well to 8.1 million, down from 8.7 million in 2007 which is a 6.9% drop.

Oversight in Medicare Drug Fraud

As reported in this Wall Street Journal article, the Government Accountability Office released a report stating that some insurers do not have “in place all the fraud controls they’re supposed to.” This means that some of them have not “met the requirements for employee training and internal monitoring and auditing. The GAO also stated that this oversight “risks significant misuse of funds in this $39 billion program.” Acting administrator for Medicare, Kerry Weems, has stated that he disagrees, however, has admitted the funding cap for the Medicare Integrity Program has, “seriously degraded [Medicare’s] ability to meet its responsibilities in combating fraud abuse.”A copy of the full report can be found here.

New Drug to Help Blood Clotting is Approved

The NY Times reports regulators have approved Amgen’s new drug called Nplate, which treats a rare blood clotting disorder that affects about 140,000 people. The disorder causes the body to attack platelets, which are tiny components that help with blood clotting. The drug will encourage platelet production by stimulating patient’s bone marrow.

There are some risks to taking the drug so regulators will require all patients to enroll in a long-term safety study. Some patients who have enrolled in the study have developed leukemia due to bone-marrow abnormalities. More studies will need to be done though to determine whether the development of leukemia may relate to the use of Nplate.

Measles outbreaks are at alarming levels

According to a news report at ABC, measles infections are at their highest level in a decade. So far there have been 131 cases this year in the United States as opposed to 42 cases throughout the entire last year. Over half of those infected are children who did not receive the vaccine. Also alarming is the number of outbreaks, in a normal year there is one in the United States. This year, as of July 30, there have been seven outbreaks. The reason for the rising number of children not receiving the shots is because of the fear that the immunization leads to autism in some children.

Miracle Baby

According to this Reuters report, a baby that was pronounced stillborn in an Israeli hospital, “came back to life” after spending about 5 hours in a refrigerated storage unit at the hospital. The mother had, had to have an emergency abortion because of internal bleeding. Upon birth, at 23 weeks, the baby weighed 600 grams which is approximately 1.32 pounds. Hospital deputy director Moshe Daniel had this to say:

"We don't know how to explain this, so when we don't know how to explain things in the medical world we call it a miracle, and this is probably what happened”

One explanation that was supplied, by Motti Ravid a professor of internal medicine, was that the lower temperatures slowed down the metabolism of the baby, which might have helped her to survive. Currently the baby is a neonatal intensive care unit. The doctors are still unsure of her prognosis, and do not know if she will be able to survive.

Fruit Juice Can Reduce Effectiveness of Drugs

BBC News reports findings discussed in a recent US event suggest that fruit juice could reduce the effectiveness of some medicines, including anti-allergy drugs. Grapefruit, orange, and apple juice are said to contain ingredients that interfere with the effectiveness of medication.

Researchers discovered that grapefruit juice especially had a reverse effect to fexofenadine, which is an antihistamine drug, thereby making it less potent. Researchers used volunteers to take the medication with water and with the juice. When taken with the juice, only half of the drug was absorbed. So far, these juices have been found to affect the oral absorption of etoposide, a chemotherapy drug, some beta-blocker drugs used to treat high blood pressure, and cyclosporine, taken by transplant patients to prevent rejection of their new organs. The study author Dr David Bailey mentions:

"This is just the tip of the iceberg - I'm sure we'll find more and more drugs that are affected this way."

Road rage in the operation room

In a recent article at the Boston Globe, they report on a serious matter when it comes to doctors in operation rooms. In some hospitals, there are frequent outbursts from doctors that include fits of swearing, yelling and throwing objects in the emergency room. The Globe paralleled this behavior to road rage. According to a study done at Vanderbilt, 4 to 6% of doctors have frequent outbursts in the operation room. The study found that the more outbursts doctors have, the more likely the hospital is to be sued due to the fact that bad behavior in the surgery room is often connected to medical errors.

So some hospitals are stepping up and solving the problem. The Joint Commission is mandating that all hospitals and nursing homes adopt a zero tolerance policy by January 1 that will include rules and processes on: including codes of conduct, ways to encourage staff to report bad behavior, and a process for helping and, if necessary, disciplining offenders.

Turning Blue

I came across this article in ABC health news about a little known medical syndrome called argyria, also known as silver poisoning. This syndrome results in skin discolorations caused by silver that entered through the blood stream, and deposits on the skin as brown particles. The result however, is that skin looks gray/blue. Many who have been diagnosed with this system had been ingesting colloidal silver as a remedy for various elements. Many mainstream doctors have argued about the effectiveness of silver as a treatment, however, as the article points out, Paul Karason, a person affected by argyria is a proponent. He maintains that it has helped with various problems. As he states

"The acid reflux problem I'd been having just went away completely. I had arthritis in my shoulders so bad I couldn't pull a T-shirt off. And the next thing I knew, it was just gone."

Floridashealth.com posted this image of a man suffering from this syndrome and cautions individuals to consult with physicians before ingesting any silver.

Exercise is Key for Cancer Patients

This article in the NY Times discusses how fitness can be beneficial to hasten the recovery of cancer patients as well as fighting the effects of cancer such as the fatigue from chemotherapy, the loss of muscle tone, and the swelling of lymphedema.

Programs are opening up everywhere including the a new partnership between the Y.M.C.A. and the Lance Armstrong Foundation which will offer cancer fitness classes at more than 12 Y’s in 10 states. Cancer survivors are organizing their own classes at Curves International has created new routines for overweight-breast-cancer patients.

Data and research conducted by the National Cancer Institute within the past decade show that cancer patients who exercise regularly have less fatigue, better aerobic capacity, and greater strength than those who do not exercise. There are times though when patients will not be able to perform such strenuous activities, and all exercise plans should be discussed with their oncologists.

Debate raging over infant organ donation

An approach to infant organ donation is causing debate. Some doctors are removing infants organs before they are considered brain dead. Instead, doctors are removing the organs after the babies are declared dead cardiocirculatory (after the heart stops). This article at ABC News explores both sides of organ harvests, whether the infants give up their organs before or after they are brain dead.

Doctors believe that there is a greater chance at saving more babies if their organs are harvested after their heart stops and the parents choose not to resuscitate the child. This situation could lead to a dramatic increase in the number of infants that become organ donors, which in turn saves more lives. Doctors for this method see two problems solved by obtaining the organs after the baby’s heart has stopped: fewer infants die while they are waiting on transplants, and there will be more parents who will have the opportunity to donate their children’s organs.

There is a fear that doctors will look over the dying children, and instead focus on the ones they can save. However, each child’s life is precious, and many doctors will focus on saving their patients. What do you believe is the best approach for infant organ donation?

Marry For Health Reasons? Maybe Not Necessary

One common conception that scientists in the past have validated is that for your health, it is better to be married. A new study as reported in BusinessWeek, however, is suggesting otherwise.

Hui Liu, study’s lead author from Michigan State University stated

"One of the most-often documented facts is that married people are healthier than non-married people, but the difference between married and unmarried people has changed over the past few decades."

As the article further reports:

- the self-reported health status of never-married adults increased significantly over time

- self-reported health status of married women also increased

- the gap between married and never-married women's health stayed about the same

- never-married men narrowed the health gap between themselves and married men

Some of the speculated reasons for the results of the study include that with the mores in society changing, it is no longer imperative to have a spouse for social status and acceptance. In addition, currently there are more support systems in place for those who are unmarried that may help them to not experience the negative side effects that in the past have been associated with being single.

Living Near Highways Can Increase Risk of Low-Birth Weight

The NY Times reports that a recent Canadian study shows that mothers who live near highways are more likely to give birth to low-weight and preterm babies. The study, which was published in Journal of Epidemiology and Community Health, looked at medical records of nearly 100,000 births in Montreal from 1997 to 2001. Researchers measured distances to the nearest highways and determined socioeconomic and education levels from census data.

Researchers found that compared to wealthy neighborhoods, mothers who lived within 220 yards of a highway were linked to a 58 percent chance of preterm birth, and a 81 percent chance of increased risk of low-birth weight.

Dr. Mélissa Généreux, a resident physician at the University of Montreal mentions:

“Low-income mothers are exposed to more risk factors — smoking, poor nutrition, poor access to prenatal care, domestic violence. More advantaged mothers are protected from these risk factors, so they might be more affected by the addition of a single new risk factor, pollution from highways.”

FDA Drug Approvals low in 2008

At the end of June, only nine drugs had been approved by the FDA. According to this article at CNN Money, this slow pace could result in the lowest drug approval year since 2003. Some of this has to do with the FDA’s harsher rules that have the safety of the public in mind. The FDA cites faltering research as a reason for fewer approvals. However there have been 18 molecular entities approved that have not yet been used in an FDA approved drug.

Prescription drugs increasing in price

According to this article at the USA Today, drug companies are quietly but dramatically increasing the price of certain prescription drugs. Hikes have been seen anywhere from 100% to 1000% over the past year on a small number of prescription drugs. The number of drugs that have increased in price by 100% has nearly doubled this year. The majority of drugs affected by the price increase are typically older drugs that treat rare conditions. An example of this is Acthar, which treats spasms in babies. One bottle used to cost $1,650, but how has risen to the cost of $23,000 per bottle. Consumers are indirectly affected by the dramatic increase. Hospitals, the majority using these drugs to treat patients, pass of the cost to the insurers, which in turn increase insurance premiums for their customers.

Alzheimer’s Breakthrough

TauRX recently announced data on their drug remberTM has shown that in 81% of users, there is been a slow down in the cognitive decline in patients with Alzheimer’s. As Fierce Biotech reported this disease has been especially difficult for researchers to find a cure. Professor Claude Wischik offers some hope saying that

"This is an unprecedented result in the treatment of Alzheimer's disease. We have demonstrated for the first time that it may be possible to arrest progression of the disease by targeting the tangles which are highly correlated with the disease."

This news comes on the heels of the announcement from Myriad Genetics who announced that they are abandoning their over $60 million effort on Flurizan which had failed in late stage trials.

Broccoli Reduces Heart Damage Caused by Diabetes

BBC News reports that a study conducted by the University of Warwick suggests that a compound found in broccoli called sulforaphane encourages production of enzymes which protect the blood vessel. People with diabetes are five times as likely to develop cardiovascular diseases such as strokes and heart attacks, and both of these are directly linked to damaged blood vessels.

The team at Warwick tested the effects of sulforaphane on damaged blood vessels and they recorded a 73% reduction Reactive Oxygen Series (SOS), which can damage human cells. Researchers also noted that sulforaphane activated a protein called nfr2, which protects cells and tissue from damages.

New Study: Men over 75 shouldn’t be tested for Prostate Cancer

According to a recent study by the US Preventative Task Force, detailed here at the WSJ Health Blog, says it’s not healthy for men over the age of 75 to be tested for prostate cancer. Unless the man is showing signs that he is suffering from the disease, it’s not necessary to test for the disease due to the risks and stress that the test can cause. It’s far more likely at that point that the men will die of a non-prostate cancer related cause.

Getting Healthy While at Work

Dr. Jim Levine had conducted a study two years ago where the results shocked him. He found that 90% of overweight individuals were sitting 2.5 hours longer per day than individuals who were not considered obese. ABC Health reports that after seeing these results

“It was so staggering that Levine hasn't stopped walking since and even does his work while walking at a low speed on a treadmill.”

The concept behind this, is to introduce low intensity activity into an individuals everyday activities in order to help combat activity. In Levine’s own words

"I spend my entire work day at one mile an hour," he said. "I work at my computer at one mile an hour. I have my meetings at one mile an hour."

This past September he started on a 6 month study to determine if a “treadmill desks at work” would help with obesity. He used the SALO office as his lab, and the office staff who were interested as his subjects. His results show that “low-level activity is crucial to fighting chronic obesity.” Over the course of the 6 months, the staff lost a combined total of over 200 pounds. Levine says that individuals who have the highest success rate are those

“making a commitment to a lot of small adjustments. It's almost a matter of saying, I'm going to change my chair-based life to a dynamic and sort of more exciting life."

The “Exercise” Pill

According to this article in the NY Times researchers at the Salk Institute in San Diego reported that they have engineered two pills that trick the muscles into thinking that they have been working out furiously. For now, testing has been only done on lab mice. These drugs have shown up to 75% increase in endurance in mice, and the results will likely apply to people as well since muscle tone from human and mice are similar.

Dr. Ronald M. Evans, leader of the Salk group, mentions:

“It’s a little bit like a free lunch without the calories.”

The pills should be able to help people who are too frail to exercise, and those who suffer from diabetes and obesity. Diet and exercise are crucial to the treatment of diabetic patients, so there is a possibility that this drug could become widely used if it passes FDA guidelines. More testing and research is still needed in order to finalize the drug before it reaches consumers.

Off-Label Drug promotions are not likely to be caught by the FDA

A new government study performed by the Government Accountability Office, detailed here at FDA News, states that if a company has off-label drug violations, they are unlikely to be caught by the FDA. The FDA issued 42 letters to companies between 2003 and 2007, but none of these cases reached the Justice Department. The eleven cases that were settled by the Justice Department were brought to the court by someone other than the FDA.

The article concludes by saying that the FDA doesn’t have an organized system that makes the FDA’s system unlikely to find off-label violations.

Medical Malls

Running late at the mall and still need to fit in a physical? No problem, according to this article, in Prince George’s County in Maryland, you can stop by the doctors office while shopping. Officials said that they made the decision to provide these services since there was no foreseeable downside. Some of the positives include generation of jobs, and tax revenue as well as increased access by the public to medical services. Individuals from less advantaged neighborhoods previously may not have always been able to go see the doctor, but with this new service, accessibility would be increased. As the Washington Post reports:

Under the plan, the county would partner with private retail owners to renovate or build spaces where customers could, for example, buy a pair of shoes in one end of the mall and get a mammogram or a physical in another. The partnership would be paid for with public and private dollars.

While to some this may seem like a novel idea, it has been around for 20 years, with approximately 50 “medical malls” currently across the U.S. What are you opinions for this interesting concept in health care? Do you think that this will catch on and become a new trend?

Falls Among Elderly is a Big Concern

This article in the NY Times details that even though injuries from falls in people over 65 do not seem serious at times, many complications such as rhabdomyolysis, which causes kidney failure, can arise from such falls. In the article, an 88 year old woman was admitted into the hospital after falling and lying on the floor for more than 15 hours. Even though there was no bruising or visible injuries, by lying in her bedroom floor for so many hours with her legs pinned beneath her, her muscle cells became inflamed.

A solution that prevents kidney failure in rhabdomyolysis is sodium bicarbonate infusions, but the problem is that treatment could overwhelm the heart of a senior citizen by building excess fluid in the lungs which can prove to be fatal. According to the Centers for Disease Control and Prevention, falls are the leading cause of death from injury among people over 65. Relatives and friends should inspect the homes of seniors for slippery surfaces and other fall-inducing conditions regularly to prevent falls from occurring.

Mail-In prescriptions on the rise

Medco, one of the major suppliers of mail-in prescription drugs, is seeing a huge benefit to increased gas prices: more customers. Medco sites fewer people paying for gas to drive to the pharmacy have lead to an increase in their sales, which shows increased revenue of 27% leading profits to $5.45 billion. In the second quarter of 2008, earnings increased 12% and they dispensed 26.3 million prescriptions according to this blog at the Wall Street Journal. However, with the poor economy, they point out that are also loosing a high volume of patients, because as companies lay off their workers in this economic slump, they are loosing people paying for their prescriptions.

Trans Fat Ban in California

It is a historic day in the fight against trans fat. This article from abchealthnews.com announced that Arnold Schwarzenagger, has just signed into law today a ban against trans fats in California. As announced in this separate article from Harvard School of Public Health, Mayor Michael Bloomberg of New York City, was responsible for making New York City the first city to ban trans fats in all restaurants. He was a recipient of the Richmond Award for promotion of public health, for his proactive stand. In fact, as announced here, July 1^st 2008, marked the completion of the final phase for restaurants in the city to comply to the zero trans fat policy.

What makes the case in California special is that it is the first state in the nation to pass the legislature on such a large scale. While the U.S. is still lagging in terms of making the ban on trans fat a nationwide policy, with the example of California it will interesting to note if the rest of the country follows suit. Also of potential interest, while there is not much text on the role insurance providers play on trans fat legislation, it might be something to see if they will start lobbying Washington for this change.

Bill Gates and Michael Bloomberg Team Up For New Anti-Smoking Effort

According to this latest article in the NY Times, the World Health Organization estimates that tobacco will kill about a billion people in the 21^st century, which is 10 times as many people that it killed in the 20^th century. Most of the deaths are expected to come from poor countries like Bangladesh and middle-income countries like Russia. The Bill and Melinda Gates Foundation has partnered with the Bloomberg Foundation to spend a total of $500 million to stop people around the world from smoking.

Mr. Bloomberg mentions:

“All the money in the world will never eradicate tobacco, but this partnership underscores how much the tide is turning against this deadly epidemic.”

The campaign, named Mpower, will urge governments to prohibit smoking in public places, raise tobacco taxes, start anti-smoking ad campaigns, outlaw tobacco advertising to children, and offer nicotine patches in order to help people quit. Other countries like India and China who have begun anti-smoking ad campaigns in the past have are experiencing an increasing number of people who have quit smoking. The $500 million will be allocated over a time span of 5 years.

Study finds Epilepsy Drug Harmful to Pregnant Women

In a recent study, detailed here in the LA Times, doctors in the UK found that women taking Topiramate, sold in the US by Johnson and Johnson under the name, Topomax, can lead to serious birth defects if the users are pregnant when taking the drug. Topiimate is a common drug used to control seizures and often given to those who suffer from migraines. Of the 203 women tested, it was found that chances for a birth defect was increased by 14-fold.

Of the 203 pregnancies in the test, there were two still births, five induced abortions, and 18 pregnancies that ended in spontaneous abortions. Of the 178 babies born, there were also 16 infants who suffered from major birth defects.

Doctors current suggestions for users was to stop taking the drug if the use is for treating migraines, but continue to use the drug if epilepsy is the reason for use, as seizures be harmful to the fetus.

Jalapeno Linked with Salmonella Outbreak

We have been keeping you up to date with information on the salmonella outbreak as with this recent post on our blog. In latest news concerning this subject, the FDA has found the same rare strain of salmonella on a jalapeno pepper that was grown in Mexico and stored in a Texas warehouse. According to this article from the San Francisco Chronicle this is the first piece of produce that has the matching strain of bacteria. Despite this lead the FDA still recommends caution saying that “the ultimate source of the contamination has yet to be found” even though last week they did claim that it was safe to eat tomatoes.

As Tom Nassif, chief executive for Western growers stated

"It's a great relief to know it's not tomatoes, even though the CDC (federal Centers for Disease Control and Prevention) and the FDA will never admit it wasn't tomatoes,"

Dr. David Acheson, FDA associate commissioner in charge of the investigation believes, however that

“during the initial outbreak - where cases were found as early as April 10 - there was a ‘clear association’ with consumption of fresh tomatoes. Only later were peppers clearly implicated, as well. “

Meanwhile California is bracing itself for another economic blow since they produce approximately $45 million worth of jalapeno peppers a year. They already suffered some setback in the form of a 40% decline in their tomato market.

US Healthcare Failing Nation

In a recent article at the Washington Post, they report on the failing grade the US health care system received last year. Although the health care in the US hasn’t improved since 2006, the US spends more on health care than any other nation. In 2003, 35% of Americans had no health insurance. In 2007, this number had risen to 42%. The quality of health care was also dramatically different from state to state, and region to region.

The scores of efficiency rated among the lowest of variables. Some of the reasons were:

-Fragmented, poorly coordinated care
-Lack of access that leads to avoidable hospitalizations
-Variations on costs with no return in quality
-Lack of investment in IT
-High insurance overhead costs

Cathy Schoen, the senior vice president for research and evaluation at the Commonwealth Fund had this to say of the situation:

“Overall, we find a failure to improve, with steep declines in access with growing numbers of uninsured and underinsured and ever less affordable care. Overall, the U.S. score averages just 65 out of a possible 100, falling far short of benchmarks with wide gaps in all dimensions of the health system.”

Healthy Dieting: Beyond Weight Loss

According to this article in the NY Times, a study conducted at the Nuclear Research Center in Dimona, Israel followed the patterns of 322 dieters, both men and women, on three different types of diets- a low-fat diet, a Mediterranean diet; and a low-carb diet based on the Atkins diet plan.

By the end of the two year study low-fat dieters had a net loss of six pounds, and the Mediterranean and low-carb dieters had a net loss of about 10 pounds. Even though weight loss was modest, researchers claimed that there were noticeable improvements in cholesterol and other health indicators. Iris Shai, the study’s lead author mentions:

“This suggests that healthy diet has beneficial effects beyond weight loss.”

Intel Health Guide

According to this article on eWeek, a small touch screen PC that includes a new online interface released by Intel that allows patients to connect with their doctors has won approval by the FDA.

The Intel Health Guide will be able to handle a series of patient care services. The system will take the burden away from insurance companies, since the monitoring of patients with chronic and outgoing patients will be done at home instead of the hospital.

Louis Burns, VP and general manager of Intel's Digital Health Group mentions:

"With more people living with chronic diseases, we believe care can be increasingly moved outside of the hospital to the home. Through our research, we've learned that a home-based model of care becomes more than just delivering care to patients at home—it is about creating connections to family, friends, caregivers, and the care team."

Glucose monitors, blood pressure monitors, and other medical devices can be attached to the Intel Health System, and the information gathered can be shared with doctors on the Internet through a secure host server. We can expect the Intel Health System to reach the US market by end of 2008 or by the first quarter of 2009.

Deaths of Infants in Argentina blamed on influenza vaccine

Pharmalot reports that a clinical trial for a pneumonia vaccine in Argentina by GlaxoSmithKline has resulted in the death of twelve infants. There were 15,000 infants who participated in this trial. The article states that the majority of the participants came from underprivileged familes, who could not read the consent form at the time of the agreement. Pneumonia is the leading cause of death in infants from infectious diseases and results in the death of two million children around the world under the age of five.

GlaxoSmithKline pointed out: the infant post-neonatal mortality rate of children participating in the COMPAS study does not exceed the post-neonatal mortality rate in the countries participating in the study.

Obesity in the Maternity Ward

Over the past couple of decades, we have seen the obesity epidemic spread through every demographic group, but now according to this article in the NY Times, 1 out of every 5 women who give birth in the U.S. is obese, ranging from 400 to sometimes 600 pounds. Pregnancy is made riskier with this excess weight, and obese women are more likely to develop diabetes, hypertension, and to deliver prematurely. Dr. Mark Chames, an obstetrician at the University of Michigan Health System at Ann Arbor, has directed a new center for Bariatric Obstetric Care to address this problem.

New treatment and procedures are needed in care for obese women. For example, an ultrasound signal can not penetrate through the tissue so instead Dr. Chames uses a vaginal probe. Weight loss is even encouraged in this center, as evidence suggests that women who maintain or lose weight during pregnancy experience fewer complications and deliver healthier babies. Still, much more research is needed to make this approach more popular in other hospitals.

Latest Update in Salmonella Outbreak

In this post on July 2, we brought you information stating that the salmonella outbreak may not have been caused by raw tomatoes as was first thought. Since then it has come to light, according to this report from MSNBC, that jalapeno peppers are another potential culprit that has come under investigation from the CDC

This has been one of the largest outbreaks, with over 1,000 reported cases, in recent history. Since May, it has been determined that the outbreaks occur in clusters of individuals across the country that have eaten foods containing both raw tomatoes and jalapenos. As a result, Dr. Robert Tauxe, from the CDC, made this statement:

“We are quite sure that neither tomatoes nor jalapenos explain the entire outbreak at this point. ... We’re presuming that both of them have caused illness,” Tauxe said.

Meanwhile the economic toll totals over $100 million in losses for the tomato industry alone. Industry wide totals for other affected foods like jalapeno and cilantro have not yet been calculated.

Improvements in IVF

As reported in this article from BBC News Health, there may be a chemical “fingerprint” that can help doctors determine which embryos will implant more successfully for IVF patients by as much as 15%.

Scientists from Yale created the ViaTestE which scores the metabolic activity of some of the fluid surrounding the embryo with spectrophotometry. In a research trial testing this new way in comparison to traditional methods, it was found that the accuracy of ViaTestE is between a 60% and 70%, while currently there is only a 40% accuracy rate

This is especially helpful since doctors are trying to head in the direction of just implanting one embryo instead of multiple. Dr. Daniel Brison, co-director of North West Embryonic Stem Cell Centre had this important thought

"If we can get better at choosing the best embryo to implant then we can increase the efficiency of IVF, move towards single embryo transfers and thus reduce the risk to mothers and babies."

Health Care Concerns

The main theme discussed in this post on The Healthcare Blog seems to be that consumers are more concerned about the cost of healthcare than the illness itself. Most Americans are often confused when given many choices of insurance providers to shop for. Consumers aren’t used to shopping for insurance, and so it can be quite troublesome.

A survey conducted by McKinsey also found that there are also differences in health concerns varying by age. Younger people aged 18-34 are far more concerned with dental and accidents, whereas older people are more worried about LTC and major medical events. There is still a long way to go in the health care system when fighting costs is a major concern over fighting diseases.

Link Found Between Serotonin and SIDS

LA Times reported in this article about a study conducted by Dr. Cornelius Gross, author and head of the European Molecular Biology Laboratory in Monterotondo, Italy, which shows that there may be a link between serotonin and sudden infant death syndrome (SIDS). Scientists made a statement to the journal, Science, that mice who were genetically altered to produce excess serotonin died young with similar symptoms to human infants who have passed away from SIDS. The initial study was conducted to determine how serotonin affects aggression and anxiety, and as Dr. Gross stated about the results, “This was a chance discovery.”

Dr. Gross also hopes that his study will lead other researchers to "to devise diagnostic tests to try to identify those kids most likely to . . . die of SIDS." His findings have already been supported by Dr. Hannah Kinney who in 2006 had conducted a study regarding abnormal serotonin production in infants who died of SIDS.

In addition, Dr. Gene Nattie, a colleague of Kinney, and professor of physiology at Dartmouth Medical School remarked "The main impact is if you produce a very specific deficit in the serotonin system, you get a disastrous result. That's why the paper is important. It's certainly a big step forward."

Cholesterol Screening at an Earlier Age

This recent article in the NY Times points out that pediatricians are beginning to recommend aggressive cholesterol screening for children as early as eight years old. Many experts claim that signs of heart disease show up early in kids, especially when 30 percent of the nation’s children are obese and overweight.

Previously, cholesterol lowering drugs were recommended for children above the age of 10, and only if they fail to lose weight during a 6-12 month period. But now according to the American Academy of Pediatrics, cholesterol drugs might be our youth’s best hope in preventing heart disease. Screenings are highly recommended for those who have a family history of high cholesterol levels. Even though children will now undergo drug treatment at an earlier age, the first goal will still be to lower bad cholesterol through diet and a rigorous exercise program.

FDA Urges Longer Testing Periods for Diabetes Drugs

The NY Times reports in a recent article that Diabetes drugs must face tougher safety standards that protect patients from heart risks associated with these drugs. The FDA has voted 14-2 to prolong trial study time to assure that diabetic drugs do not carry risks of heart problems.

This concern on diabetic drugs came about shortly after the FDA was criticized for handling the release of the GlaxoSmithKline pill. The drug was released in 1999, but only last November was a warning issued about potential heart risks. The problem lies in the testing phase; it takes nearly five to seven years to complete. Studies should begin way before drugs are submitted to the FDA, and finished shortly after its release.

Tainted Tomatoes May not be Cause of Salmonella Outbreak

Two weeks ago we posted on this blog about tainted tomatoes causing a salmonella outbreak. Several news sources, including the Wall Street Journal in this article, have announced that the FDA and the CDC are now saying that they are unsure if tomatoes are truly the culprit. Officials have expanded their investigation, to include other foods, since it is estimated that in only 80% of the 869 reported cases of salmonella poisoning people consumed tomatoes. Many of these individuals reported eating tomatoes that were incorporated into dishes such as salsa, and guacamole which are composed of numerous other raw foods. While tomatoes are still the main suspected cause, the FDC and CDC are looking at other foods such as cilantro which is often eaten in conjunction with tomatoes.

In related news the economic impact of this food scare is estimated at over $250 million according to Donna Garren, vice president of health and safety regulatory affairs for the National Restaurant Association. With other food items coming into focus the financial blow is only going to increase.

Good Cholesterol Improves Memory

The NY Times reports today that higher levels of good cholesterol, known as HDL, might prevent a decline in memory loss. The study led by Archana Singh-Manoux, appears in Arteriosclerosis, Thrombosis and Vascular Biology, an American Heart Association Journal, found that people with more high-density lipoprotein cholesterol did better on memory tests than people with lower levels.

The study was performed on more than 3,600 British civil servants ranging from 55 to 61 years of age. The test consisted of reading a list of 20 words, and then jotting down as many as they could remember in a span of two minutes. Those with higher HDL levels performed better and those whose HDL levels declined also saw a decline in their performance.

Hospitals May Have to Pay for Their Own Mistakes

As reported in this blog post from the Wall Street Journal, currently the state of California, and its MediCal program, is saddled with the cost of preventable hospital errors. A new bill has been introduced, AB 2146, where the government of California will stop reimbursement to hospitals for these avoidable mistakes based on Medicare’s no-pay list.

Maine, Massachusetts, Pennsylvania, and New York, make up a list of some states that have already limited payments. Hospitals in Minnesota, Washington, and Vermont, have already accepted responsibility by stating that they will not request payment from patients for hospital errors.

Privately owned companies, such as Cigna and Wellpoint, have also announced that they will be following this trend, and refuse payment for specific mistakes.

What’s the Real Cost of Healthcare?

Trisha Torrey brings up a good point in her latest post on the Patient Empowerment Blog, the true cost of healthcare remains a mystery still to many patients.

First is the copay, then the insurance takes the rest of the doctors charges if the patient is insured. If there is a balance after the insurance has paid their stated amount, the patient is responsible for remainder of the payment. Costs are sometimes negotiated between insurance companies and doctors, but for those who don’t have insurance, negotiations are made between the patient and the doctor. So here’s a solution that can possibly help patients make wiser decisions when it comes to costs.

Change Healthcare is an online service that finds average costs of doctor visits, services, and what insurance companies typically negotiate with doctors. You can upload information about your own costs to the website. By sharing information, it is possible to help people in your area discover the true costs of healthcare.

New Vaccine for US Infants

The FDA has just approved a new vaccine, Pentacel, for the immunization of infants. As stated here at Pharmalot, it provides immunization for these five diseases: Haemophilus influenza type b (HIb), diphtheria, tetanus, pertussis (whopping cough) and poliomyelitis. The doses are given to infants at 2, 4, 6, and 15 to 18 months. This single shot four times can reduce as many as 23 injections otherwise needed for the immunization of infants.

According to this article here at HealthNews, the vaccine was approved after 5,000 infants in Canada and the United States showed that the vaccine was safe and effective against those diseases. This immunization has been used in Canada since 1997, and immunizations in the United States will begin this summer.

Safety Checklist to be Circulated

BBC News reports that a list compiled by the World Health Organization designed to cut the risk of surgical complications will be issued to doctors world-wide. This list is being compiled due to a Lancet study that found that safety measures across hospitals are commonly overlooked.

The Harvard School of Public Health has aided WHO in drawing up this list and its main aim is to reduce the following complications during surgery: preventable infections, preventable complication from bleeding, and safety in anesthesia. The list includes six very basic steps in surgical care including verification of the patient, ensuring that equipment is not neglected and left inside the patient, and administering an antibiotic before making an incision which reduces the risk of infection by at least 50%.

Worldwide, about one million people die a year following major surgery, so hopefully this list can serve an intervention to help prevent common mistakes made in surgical care.

Exercise Helps Battle Age Related Diseases

This latest NY Times article reports that as people age they lose muscle strength and flexibility, and as a result of this it leads to frailty in bones and a loss of mobility. According to Miriam Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts University, exercise is becoming increasingly important in improving quality of life and decreasing the risk of chronic age-related diseases.

A common misconception is that exercise will cause injury or pain, especially with those who suffer from arthritis, but the truth of the matter is that building muscle strength and their joints it will actually reduce pain and decrease the risk of injury. The perfect balance of physical fitness preferred includes aerobic workouts (cardio, swimming, treadmill, crosstrainer), stretching, and muscle training (which can be done in a gym with a series of machines, or dumbbells or resistance bands and tubes at home).

Emerging Trends & Opportunities for Healthcare Organizations to Leverage Web 2.0

As part of this blog, we want to bring you the latest up-to-date information in wellness, prevention, and disease management. In conjunction with the 13^th Annual Health Management Congress, we’ve put together a free web seminar with John Sharp from Cleveland Clinic entitled “Emerging Trends & Opportunities for Healthcare Organizations to Leverage Web 2.0”. I’d like to invite you to join us on Wednesday June 23, 2008 from 2:00 PM to 3:00 PM EDT.

Here’s a brief overview of the webinar:

The social-networking revolution is coming to health care, at the same time that new Internet technologies and software programs are making it easier than ever for consumers to find timely, personalized health information online. Patients who once connected mainly through email discussion groups and chat rooms are building more sophisticated virtual communities that enable them to share information about treatment and coping and build a personal network of friends. At the same time, traditional Web sites that once offered cumbersome pages of static data are developing blogs, podcasts, and customized search engines to deliver the most relevant and timely information on health topics.

What you will learn by attending:

• Improve care self-management using Web 2.0 strategies & resources
• Analyze the impact of Web 2.0 on healthcare stakeholders
• Leverage Web 2.0 content to drive traffic to your site and customers to your facility
• Explore the return on investment for these technologies

Take advantage of this free webinar and register now. Stay tuned to this blog for other updates on webinars within the healthcare industry.

Your Immune Cells May Help Treat Skin Cancer

This article in the NY Times that a man recently had a complete remission of melanoma, a deadly skin cancer, after treatment that boosted his immune system to fight the cancerous cells.

Doctors have long known that immune cells can effectively attack cancerous cells, but Dr. Steven Rosenberg of the National Cancer Institute recently took a different approach. Instead of focusing on the “T cells”, they decided to focus on specific helper T cells that help lock into the cancerous cells and guide the killer cells to fight off the bad cells. Researchers drew blood from 8 patients and grew more of the helper T cells in the laboratory. They later infused the patients with 5 billion of the cells back. After two months, one patient had no signs of tumors in his skin, and after two years he showed no symptoms.

More research is needed since only one of the eight patients who underwent the treatment survived.