Emergency Visits Are Increasing, New ACEP Poll Finds; Many Patients Referred By Primary Care Doctors

/PRNewswire/ -- More than 80 percent of emergency physicians responding to an ACEP poll said emergency visits are increasing in their emergency departments, with half reporting significant rises, and more than 90 percent expecting increases in the next year. Almost all (97 percent) reported treating patients on a daily basis who were referred to them by primary care doctors, going against a widely-held assumption that people are choosing to go to the emergency department instead of seeking primary care.

At the same time, 97 percent of emergency physicians also report treating Medicaid patients on a daily basis who could not find any other doctor to accept their health insurance. If the new health care reform legislation provides insurance coverage that reimburses doctors at Medicaid rates, this could exacerbate a lack of access to medical care.

"This poll confirms what we are witnessing in Massachusetts — that visits to emergency rooms are going to increase across the country, despite health care reform, and that health insurance coverage does not guarantee access to medical care," said Dr. Sandra Schneider, president of the American College of Emergency Physicians. "Emergency medicine provides lifesaving and critical care to millions of patients each year and yet only represents 2 percent of the nation's health care expenditures. Emergency physicians command the resources of a hospital to provide the best care for patients, but we must be prepared for increasing numbers of patients, not fewer, especially given our growing elderly population."

ACEP conducted the poll from March 3 to March 11, 2011. E-mails were sent to 20,687 emergency physicians, and 1,768 responded. The survey has a theoretical sampling error range of plus/minus 2.23.

While 79 percent of responding emergency physicians said their emergency departments use resources efficiently, nearly half of respondents (44 percent) said the fear of lawsuits was the biggest challenge to cutting emergency department costs. More than half (53 percent) of emergency physicians reported that fear of lawsuits is the main reason for ordering the number of tests they do.

"Emergency departments need more resources, not fewer, and medical liability reform would help reduce overall costs by reducing the need for defensive medicine," said Dr. Schneider.

Two-thirds of emergency visits occur after business hours, when doctor's offices are closed and patients have nowhere else to turn. Visits to ERs reached an all-time high of nearly 124 million in 2008, according to the Centers for Disease Control and Prevention (CDC) and are expected to rise nationwide.

Physicians responding to the poll attribute the overall increase in emergency patients to patients without health coverage (28 percent) and a growing elderly population (23 percent) are seen by physicians as the most important reasons for the overall increase in ER patients.

An overwhelming 89 percent of physicians believe the number of visits to the emergency department will increase as health care reforms are implemented with 54 percent of them expecting to see a significant increase.

"Emergency visits have increased at twice the rate of the U.S. population, and less than 8 percent of those patients have nonurgent medical conditions, meaning the vast majority need to be there," said Dr. Schneider. "At the same time, hundreds of emergency departments have closed. The new health care reform law does not address these problems and with the elderly population and more emergency departments forced to shut down, this crisis will only get worse."

More than 1,400 (82.5 percent) responding to the poll said that lives were saved every day in their emergency departments. "Emergency medicine is critical at any hour of the day. It must be there when you need it," said Dr. Schneider.

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HUD and HHS announce joint effort to assist nearly 1,000 non-elderly persons with disabilities to move from institutions to independence

U.S. Housing and Urban Development (HUD) Secretary Shaun Donovan and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today a joint partnership between the two agencies to help nearly 1,000 non-elderly Americans with disabilities leave nursing homes or other healthcare facilities to live independently. This is the first time two federal agencies are offering a combination of rental assistance, health care and other supportive services targeted to this population.

HUD is providing $7.5 million in rental assistance vouchers that will help nearly 1,000 individuals with disabilities rent private apartments. Public housing authorities in 15 states will administer the rental subsidies and will work with state human service agencies to identify eligible individuals who could benefit from the program. For a local breakdown of the funding announced today, visit HUD's Web site.

Individuals receiving rental assistance through the program will also receive health and social supports that will enable them to live independently. These supports are provided through the HHS Centers for Medicare and Medicaid's "Money Follows the Person" (MFP) grant program, which allows individuals who qualify for Medicaid-funded nursing home or other institutional care to receive supports - such as in-home nursing and personal care services - while living in the community instead. In places where the MFP program is not available, services will be provided by a state-sponsored institutional transitional program comparable to MFP that includes dedicated supportive services.

As part of President Obama's Year of Community Living initiative, HUD and HHS launched a joint effort to provide housing support for non-elderly persons with disabilities who are currently receiving long-term care in institutional settings. The interagency collaboration is intended to allow persons with disabilities to live productive independent lives in their communities rather than in institutions.

"The Obama administration is committed to helping Americans with disabilities live independent lives. Housing is a critical piece of the equation when it comes to transitioning out of institutions," said Donovan. "Coordinating this effort with the Department of Health and Human Services is an important step in ensuring that more Americans with disabilities will have the housing and support they need to fully participate in community life."

"Through our collaboration with the Department of Housing and Urban Development, I know that we will be able to dramatically change peoples' lives," said Sebelius. "Individuals with disabilities can have a life in the community that serves their needs and supports them in leading productive, meaningful lives."

The funding announced today is being provided through HUD's Rental Assistance for Non-Elderly Persons with Disabilities Program. It is part of the $40 million HUD made available April 2010 to public housing authorities across the U.S. to fund approximately 5,300 rental assistance vouchers for non-elderly persons with disabilities to promote independent living for this community. Public housing authorities applied for funding under two categories.

Last October, HUD awarded $33 million to support a first round of 4,300 vouchers, making it possible for non-elderly individuals with disabilities and their families to access affordable housing in communities that meet their housing needs and so avoid potential institutionalization. Today's announcement is for the second round funding to provide 948 vouchers targeted for non-elderly individuals with disabilities currently living in institutional settings, such as nursing homes, but who could move into a community with assistance.

These vouchers will augment work already being done by HHS' Centers for Medicare & Medicaid Services (CMS) through its Money Follows the Person (MFP) rebalancing demonstration program. Now in its fourth year, the MFP program has made it possible for almost 12,000 individuals to live more independent lives by providing necessary supports and services in the community. Twenty-nine states and the District of Columbia are currently participating in the MFP program and CMS is expecting a new round of grant applications on January 7th.

State Medicaid agencies and local human service organizations will link eligible families to local public housing authorities that will administer voucher distribution. To improve the connections between the housing authorities and Medicaid agencies, HUD and HHS have launched the Housing Capacity Building Initiative for Community Living Project to assist seniors and individuals with chronic conditions who are at risk of institutionalization or who currently receive care in institutional settings, in finding appropriate housing in order to live more independent lives.

The Community Living Initiative is an outgrowth of the 1999 landmark Supreme Court ruling in Olmstead v. L.C. In that case, the Court ruled that the Americans with Disabilities Act (ADA) protects a person with a disability from being unnecessarily institutionalized. The Court said that such forced institutionalization can lead to isolation and segregation of individuals with disabilities and be a serious and pervasive form of discrimination.

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AHIMA Files Response to HHS Privacy Rules

/PRNewswire/ -- The following statement was released today by Rita K. Bowen, President, AHIMA Board of Directors:

"While AHIMA (American Health Information Management Association ) continues to applaud federal government support for the ideal of protecting patients' health information rights, the proposed rule-making for HIPAA privacy, security and enforcement by HHS has a number of requirements that we do not believe the industry is ready to undertake; especially as it gears up for Meaningful Use. Today AHIMA is releasing its recommendations to the HHS Office of Civil Rights (OCR) that speak to the issues we believe are most critical to the patients of America, the healthcare industry and the best practice of health information management.

"As staunch supporters of patients' health information rights, AHIMA agrees the single most contentious issue in the proposed regulation is the ability of individuals to restrict the information held by their healthcare providers from being shared with their health plan. While AHIMA believes an individual's control over this data flow is valid, data flow restrictions in the HHS proposal creates unintended repercussions for data integrity, data processing and other elements within the current US reimbursement system.

"Many AHIMA members are engaged in providing patients' individual and aggregate data for a variety of approved uses. There is a continued discussion within the profession on how to best cover the costs of the retrieval, analysis and release of information within the context of the privacy and security regulations, patient restrictions; and the need to verify the requesting individual as a means of keeping released information available to a necessary minimum. Additionally, we remain concerned the charges permitted by states or HIPAA do not cover all costs and ultimately raise the cost of health care.

"AHIMA also questions the sale of patient health information when an organization is being absorbed by a second organization. The OCR's approach, while practical, raises the issue of whether consumers have the right to determine if their health information should be transferred with the ownership of a health organization.

"Finally, AHIMA feels strongly that the OCR needs to provide greater clarification regarding the definition of 'agents' as it relates to covered entities and who should be covered by HIPAA, including its hybrid organizations."

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Sebelius Announces New $250 Million Investment to Strengthen Primary Health Care Workforce

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced a series of new investments worth $250 million to increase the number of health care providers and strengthen the primary care workforce. The new investments were made possible by the Affordable Care Act. Sebelius was joined for the announcement by U.S. Representative Lois Capps, Health Resources and Services Administration (HRSA) Administrator Dr. Mary Wakefield, and HHS Assistant Secretary for Health Dr. Howard K. Koh.

Communities across the country have long suffered from a shortage of primary care providers. Without action, experts project a continued primary care shortfall due to the needs of an aging population and a decline in the number of medical students choosing primary care. The Association of American Medical Colleges estimated that the nation would have a shortage of approximately 21,000 primary care clinicians in 2015. Building on the earlier investments made by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act, particularly for the National Health Service Corps, the investments announced today will support the training and development of more than 16,000 new primary care providers over the next five years.

"These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy," said Secretary Sebelius. "Primary care providers are on the front line in helping Americans stay healthy by preventing disease, treating illness, and helping to manage chronic conditions. These investments build on the Administration's strong commitment to training the primary care doctors and nurses of tomorrow and improving both health care quality and access for Americans throughout the country."

"The Affordable Care Act's goal of increasing access to quality, affordable care can only be accomplished if we train the next generation of health professionals to provide it," said Representative Capps. "This critical investment will help alleviate the current shortage of primary health care providers including physicians, physician assistants and nurses. Increasing the number of primary care professionals will allow us to place an increased emphasis on preventive care and wellness - something I've devoted my life to as a public health nurse -- making this country healthier in the long run. I applaud the President, Secretary Sebelius, Assistant Secretary Koh and Administrator Wakefield for swiftly working to roll out this important provision of health care reform."

The investments announced today in the primary care workforce are the first allocation from the new $500 million Prevention and Public Health fund for fiscal year 2010, created by the Affordable Care Act. Half of this fund - $250 million - will be used to boost the supply of primary care providers in this country by providing new resources for:

* Creating additional primary care residency slots: $168 million for training more than 500 new primary care physicians by 2015;

* Supporting physician assistant training in primary care: $32 million for supporting the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians;

* Encouraging students to pursue full-time nursing careers: $30 million for encouraging over 600 nursing students to attend school full-time so that they have better odds of completing their education;

* Establishing new nurse practitioner-led clinics: $15 million for the operation of 10 nurse-managed health clinics which assist in the training of nurse practitioners. These clinics are staffed by nurse practitioners, which provide comprehensive primary health care services to populations living in medically underserved communities.

* Encouraging states to plan for and address health professional workforce needs: $5 million for states to plan and implement innovative strategies to expand their primary care workforce by 10 to 25 percent over ten years to meet increased demand for primary care services.

"With these health care workforce investments, we have a unique opportunity to further strengthen our primary care workforce for the future," said Dr. Wakefield. "Today's announcement is a strong indication of our commitment and one of many steps in the right direction."

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New Study Shows That American Public is Willing to Accept Major Reforms in Medicare Program

/PRNewswire/ -- Although Americans see Medicare as a key part of the country's social contract and want to preserve it in some recognizable form, they are willing to consider significant changes in the program to hold down its costs as the U.S. population ages.

In day-long "Choice-Dialogues" in which Americans from all walks of life considered the pros and cons of a range of choices for reforming Medicare, common ground was found in several key areas:

-- Allow Medicare to negotiate prices for prescription drugs (94 percent
support).
-- Encourage hospice care instead of heroic end-of-life measures (85
percent support).
-- Only cover treatments that are scientifically proven to be effective
(68 percent support).
-- Emphasize preventive care and personal responsibility (89 percent
consider preventive care very important or essential).
-- Gradually increase the Medicare eligibility age from 65 to 67 (68
percent support).


If additional money is needed to maintain Medicare in a way that is familiar in the future, Americans would rather see the government raise taxes than increase the federal debt.

These are among the central findings in a report released today by The Concord Coalition and Viewpoint Learning, Inc. The report is entitled "Medicare: It's Not Just Another Program."

The report, which was written by Viewpoint Learning, also underscores public dismay at the health care system in general. It comes as Congress and the Obama administration are working on massive changes in the entire system.

"Participants repeatedly expressed concerns over what they saw as a Byzantine and unaccountable health care system," the Medicare report says. "Most felt that the medical industry (especially the pharmaceutical companies) puts profits before people."

Robert L. Bixby, executive director of The Concord Coalition, says the report shows that Americans are prepared to accept significant changes in the program that plays a central role in the federal government's long-term fiscal problems.

"Medicare is on an unsustainable path and must be reformed," Bixby said. "According to conventional wisdom, however, the public is not ready to accept any change in the status quo. The good news from these Choice-Dialogues is that the conventional wisdom is wrong; the public is ready and willing to consider some very fundamental Medicare reforms so long as the program is preserved as a vital part of the social contract."

"Politicians who are truly interested in saving Medicare should stop the scare tactics and start engaging the public in a dialogue on the real trade-offs that must be confronted," Bixby added. "Changes will still be difficult, but the results will be more acceptable."

Viewpoint Learning conducted the dialogues with randomly selected representative samples of 35-40 citizens in Oak Brook, Illinois; Columbia Maryland; Phoenix and Houston. This project builds on the findings of a broader two-year project, "The America We Want," that examined public opinion on a broader range of federal programs and budget issues.

The new report found that many Americans lacked a strong understanding of the Medicare program, how it is funded, and the severity of the fiscal challenges facing the United States in the years ahead.

Yet most participants in the dialogues, after studying these issues in depth and spending much of a day discussing the problems and possible solutions with others, were able to agree on a set of Medicare changes.

But to win public support, the report cautions, "proposals for major reform to Medicare need to recognize the extent to which Americans see Medicare as an essential part of the social contract and not just as another government program."

Steven Rosell, president of Viewpoint Learning, said "The findings from these daylong dialogues with Americans from very different backgrounds and perspectives reveal deep disconnects between how Washington talks about Medicare and health care reform and how the public talks about them. In case after case, the report shows how leaders and the public are talking past each other, and how this deep disconnect and misunderstanding lead to the heat and the rancor that have made advancing real reform so difficult."

When most people talk about the "cost of health care," for example, they are focused on what they pay in premiums, co-pays and drug expenses. When health care experts talk about costs, however, they usually focus on the costs to businesses, government and other institutions.

Rosell also noted that many Americans do not realize that they are essentially paying for the cost of care for the uninsured already.

The new report, he said, provides insight for leaders about how best to bridge such disconnects and begin to create a learning curve that could lead to public support for significant Medicare reform.

Some elements in the new report also echo the findings of The Concord Coalition's fiscal advisory councils that met in early December in Washington. Working in six different parts of the country on Concord's Fiscal Stewardship Project, these advisory councils called for sweeping reforms in the health care system and some changes in Medicare to put the government on a more sustainable fiscal path. More information on the advisory councils' work is available at:

http://concordcoalition.org/fiscal-stewardship-project/fiscal-stewardship- project.

The full report, entitled "Medicare: It's Not Just Another Program," is available at: http://www.concordcoalition.org/files/uploaded-pdfs/Medicare_Report_Dec09_PRIN T.pdf

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Care Management Improves Physical Health of Patients with Mental Illness

Connecting mental health patients with care managers responsible for coordinating their health care significantly improves their overall health and wellbeing, according to a study by Emory University public health researchers.

The study, the first of its kind, tested a population-based medical care management intervention aimed at improving medical care in community mental health settings. Recent studies show that people with severe mental illness die 25 years younger than the general population largely due to medical causes such as heart attacks.

"There is a growing concern about the epidemic of premature morbidity and mortality among persons with serious mental illnesses," says lead study author Benjamin Druss, MD, MPH, professor of health policy and management and the Rosalynn Carter Chair in Mental Health at Emory's Rollins School of Public Health. "This model provides one of the first evidence-based approaches for addressing that problem by helping patients access high-quality medical care."

A total of 407 people with severe mental illness at an urban community mental health center were randomly assigned to either the medical care management intervention or usual care. The patients were all ages 18 and older, considered economically disadvantaged, and experienced serious and persistent mental illness.

For individuals in the intervention group, care managers provided communication and advocacy with medical providers, health education and support in overcoming system-level fragmentation and barriers to primary medical care. Patients in the usual care group were given a list with contact information for local primary care medical clinics and were permitted to obtain any type of medical care or other medical services without the assistance of a care manager.

At a 12-month follow-up evaluation, researchers found that medical care management was associated with significant improvements in the quality and outcomes of primary care. The intervention group received an average of 58.7 percent of recommended preventive services compared with a rate of 21.8 percent in the usual care group.

In addition, patients in the intervention group received a significantly higher proportion of evidence-based services for cardiometabolic conditions (34.9 percent versus 27.7 percent) and were more likely to have a primary care provider (71.2 percent versus 51.9 percent). The group showed significant improvement in mental health functioning, and at one-year follow-up, had a substantially lower risk for heart disease than those in the usual care group.

These findings suggest that care management is a promising approach for improving quality and outcomes of medical care for patients with serious mental illnesses, says Druss.

The study titled, "A randomized trial of medical care management for community mental health settings: The Primary Care Access, Referral, and Evaluation (PCARE) study," was published in the Dec. 15 online edition of The American Journal of Psychiatry. It was funded by a grant from the National Institute of Mental Health of the National Institutes of Health.

In addition to Druss, study authors were: Silke Von Esenwein, PhD, director of research projects, Kimberly Rask, MD, PhD, associate professor of health policy and management, and Liping Zhao, MSPH, senior biostatistician, of the Rollins School of Public Health; and Michael Compton, MD, MPH, assistant professor of psychiatry and Ruth Parker, MD, professor of medicine, of the Emory School of Medicine.

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Health Reform Needs Enforceable National Workforce Strategy

/PRNewswire/ -- Congressional leaders must ensure that health reform includes a health workforce planning body with sufficient authority to ensure implementation of an integrated, coordinated national health workforce policy, according to Dr. Steven A Wartman, president and CEO of the Association of Academic Health Centers (AAHC). "With each step in the legislative process, the Congress has progressed toward a more effective health workforce planning process," Wartman said. "Still missing from both House and Senate bills is a mechanism -- such as national health workforce commission recommendations that automatically go into effect unless overridden by Congress -- to ensure timely implementation of the recommendations," added Wartman, urging Congress to address this concern before finalizing the legislation.

An updated analysis of the current House and Senate bills released today by the AAHC identifies additional strengths and weaknesses in the bills when measured against the AAHC's own health workforce recommendations:

-- The AAHC recommends that development and implementation of an
integrated, coordinated, strategic national health workforce policy be
the primary objective of any advisory committee or national
commission. The House bill contains a clear statement that the
purpose of its advisory committee is "to develop and implement an
integrated, coordinated, and strategic national health workforce
policy reflective of current and evolving health workforce needs,"
while the Senate bill only lists national health workforce policy as
one of several priorities.
-- The AAHC recommends the list of enumerated issues to be addressed by
the advisory committee or national commission include the
harmonization of conflicting national and state-based regulatory and
private self-regulatory standards (e.g., licensure, scope of practice,
accreditation). The Senate bill expressly directs its national
commission to "identify barriers to improved coordination at the
Federal, State, and local levels," but the House bill does not
expressly address the need for harmonization.
-- The AAHC recommends the creation of a permanent, independent advisory
committee or national commission that serves as a continuously
available policy research and consultative resource. The Senate bill
creates an independent national commission composed of members
appointed by the Comptroller General, while the House bill only
creates an advisory committee appointed by and reporting through the
Secretary.

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$10 Million in Grants Aimed at Enrolling American Indian, Alaska Native Kids in Health Care to be Awarded

HHS Secretary Kathleen Sebelius today announced the availability of up to $10 million in grants to help reach American Indian and Alaska Native (AI/AN) children who qualify for, but are not yet enrolled, in Medicaid and the Children's Health Insurance Program (CHIP).

These new grants are part of a broader effort to find and enroll uninsured children who are eligible for Medicaid or CHIP but not enrolled. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) set aside $100 million for fiscal years 2009-2013
expressly to help find and enroll eligible uninsured children, including $10 million specifically for Indian health providers.

As called for in CHIPRA, grants will be awarded by the Centers for Medicare & Medicaid Services (CMS) to applicants whose outreach, enrollment and retention efforts will target geographic areas with high rates of eligible but uninsured American Indian and Alaska Native
children, who often live in isolated areas and are uninsured at higher-than-average rates.

"American Indian children are often uninsured, although many are eligible for Medicaid and CHIP," Secretary Sebelius said. "These grants will help Tribes and Indian health providers reach out to children and families to ensure more children get the health care they need."

Grants will be awarded to applicants that will be able to demonstrate increases in enrollment and improved retention of children already in Medicaid and CHIP. Grantees will report to CMS the number of new enrollees and those who retained coverage that are directly attributable
to the grant activities. Grantees will also report activities they believe were the most effective in finding, enrolling and maintaining coverage for eligible children.

"States have been effective in enrolling over 28 million children in Medicaid and more than 7 million children in CHIP, but there are still millions of uninsured, low-income children who are not enrolled in these programs even though they are eligible" said Cindy Mann, the director of
the CMS Center for Medicaid and State Operations. "We are looking forward to innovative grant proposals that will put new outreach, enrollment and renewal systems in place to ensure that uninsured Indian children get enrolled and stay enrolled for as long as they are eligible."

Applications are due by Jan. 15, 2010, and the grants will be awarded on April 15. Grants will be available to:

* The Indian Health Service;
* Tribes and Tribal organizations operating a health program; and,
* Urban Indian organizations operating a health program.

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AHIP Statement on Affordable Health Care for America Act

/PRNewswire/ -- Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP), released the following statement today in response to the Affordable Health Care for America Act:

"The promise of health care reform has been that if you like your current coverage, you can keep it. We are concerned that this proposal will break this promise by increasing health care costs for families and employers across the country and significantly disrupting the quality coverage on which millions of Americans rely today.

"The lack of system-wide cost containment is a missed opportunity. Without a greater focus on health care costs, families and employers will not be able to afford coverage and health care costs will rise at a rate much faster than the overall economy is able to sustain.

"We share the concerns that doctors, hospitals, employers, and patients have all raised about the significant disruption a new government-run plan would have on the current health care system. A new government-run plan would bankrupt hospitals, dismantle employer coverage, exacerbate cost-shifting from Medicare and Medicaid, and ultimately increase the federal deficit.

"Estimates show that a government-run plan would cause millions of people to lose their current coverage. Moreover, massive Medicare Advantage cuts would cause millions of seniors to lose their Medicare Advantage coverage altogether, while millions more would face benefit cuts and higher out-of-pocket costs.

"Health plans strongly support comprehensive, bipartisan health care reform and have proposed sweeping insurance market reforms and new consumer protections to ensure that every American has guaranteed access to affordable health care coverage. Experience in the states has shown that insurance market reforms must be paired with an effective personal coverage requirement for these reforms to work. While this legislation recognizes the key linkage of market reforms and a personal coverage requirement, more needs to be done to ensure coverage is affordable and our health care system is sustainable.

"As the process progresses, health plans will continue to work to advance bipartisan legislation this year that will cover all Americans, make coverage more affordable, and improve quality."

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HHS Awards $17 Million in a New National Initiative to Fight Health Care-Associated Infections

/PRNewswire/ -- HHS Secretary Kathleen Sebelius today announced the award of $17 million to fund projects to fight costly and dangerous health care-associated infections, or HAIs.

"When patients go to the hospital, they expect to get better, not worse," Secretary Sebelius said. "Eliminating infections is critical to making care safer for patients and to improving the overall quality and safety of the health care system. We know that it can be done, and this new initiative will help us reach our goal."

HAIs are one of the most common complications of hospital care. Nearly 2 million patients develop HAIs, which contribute to 99,000 deaths each year and $28 billion to $33 billion in health care costs. HAIs are caused by different types of bacteria that infect patients being treated in a hospital or health care setting for other conditions. The most common HAI-causing bacteria is methicillin-resistant Staphylococcus aureus, or MRSA. The number of MRSA-associated hospital stays has more than tripled since 2000, reaching 368,600 in 2005, according to HHS' Agency for Healthcare Research and Quality's (AHRQ) Healthcare Cost and Utilization Project.

Of the $17 million, $8 million will fund a national expansion of the Keystone Project, which within 18 months successfully reduced the rate of central-line blood stream infections in more than 100 Michigan intensive care units and saved 1,500 lives and $200 million. The project was originally started by the Johns Hopkins University in Baltimore and the Michigan Health & Hospital Association to implement a comprehensive unit-based safety program. The program involves using a checklist of evidence-based safety practices; staff training and other tools for preventing infections that can be implemented in hospital units; standard and consistent measurement of infection rates; and tools to improve teamwork among doctors, nurses and hospital leaders.

Last year, AHRQ funded an expansion of this project to 10 states. With additional funding from AHRQ and a private foundation, the Keystone Project is now operating in all 50 states, Puerto Rico and the District of Columbia. The new funding announced today will expand the effort to more hospitals, extend it to other settings in addition to ICUs, and broaden the focus to address other types of infections. Specifically, the new $8 million in funding will provide:

-- $6 million to the Health Research & Educational Trust for national
efforts to expand the Comprehensive Unit-Based Patient Safety Program
to Reduce Central Line-Associated Blood Stream Infections. The funding
will allow more hospitals in all 50 states to participate in the
program and expand the program's reach into hospital settings outside
of the ICU. The Health Research & Educational Trust will also use $1
million to support a demonstration project that will help fight
catheter-associated urinary tract infections.

-- $1 million to Yale University to support a comprehensive plan to
prevent bloodstream infections in hemodialysis patients.


AHRQ, in collaboration with the Centers for Disease Control and Prevention (CDC), also identified several high-priority areas to apply the remaining $9 million toward reducing MRSA and other types of HAIs. These projects will focus on:

-- Reducing Clostridium difficile infections through a regional hospital
collaborative.
-- Reducing the overuse of antibiotics by primary care clinicians
treating patients in ambulatory and long-term care settings.
-- Evaluating two ways to eliminate MRSA in ICUs.
-- Improving the measurement of the risk of infections after surgery.
-- Identifying national-, regional- and state-level rates of HAIs that
are acquired in the acute care setting.
-- Reducing infections caused by Klebsiella pneumoniae
Carbapenemase-producing organisms by applying recently developed
recommendations from CDC's Healthcare Infection Control Practices
Advisory Committee.
-- Standardizing antibiotic use in long-term care settings (two
projects).
-- Implementing teamwork principles for frontline health care providers.

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'Doc Buy' Fails as Physician Support for Health Care Overhaul Wanes - Shadow Bill Concealing $247 Billion in Health Costs Defeated

'Doc Buy' Fails as Physician Support for Health Care Overhaul Wanes - Shadow Bill Concealing $247 Billion in Health Costs Defeated in Critical Senate Vote

/Standard Newswire/ -- Patients First, A Project of Americans for Prosperity(tm) is praising the U.S. Senate's bipartisan rejection of the $247 billion so-called "Doc Fix" bill (S.1776) by a 53-47 margin.

Senate Majority Leader Harry Reid had attempted to hastily force the bill through the Senate to
simultaneously purchase the support of doctors in the larger health care legislative battle, while concealing the full cost of the health overhaul in a shadow bill.

Leader Reid had abruptly scheduled today's failed cloture vote to increase Medicare payments to doctors by $247 billion. The tricky tactic, which would also have required a vote to waive Senate budget rules, raised criticism since it would conceal the total cost of the health care plan being considered in Congress by splitting the overhaul into two separate bills. The Senate Finance Committee recently voted for a $904 billion plan, but the addition of this $247 billion bill would have pushed the total cost of the overhaul to well over $1.1 trillion, violating the White House's
pledge to keep the health care plan deficit neutral.

"The 53 Senators that voted against this hastily-crafted backroom health care deal deserve credit," said Phil Kerpen, policy director of Patients First. "Leader Reid's attempt to use outright deception and trickery to conceal the true costs of the attempted Washington takeover of health care has failed. Americans have the right to know the details of how government-forced health care would impact their access to quality affordable health care. Transparency and open debate, not backroom deals and legislative gimmicks, offer us a way forward towards real health care
reform."

The "Doc Fix" bill's defeat spells further trouble for the Obama Administration and Congressional Democrats as they court critical support from doctors for the controversial health care overhaul. A recent IBD/TIPP Poll of nearly 1,400 doctors found that two-thirds of
physicians oppose the reforms proposed by Congress. 45 percent of doctors said that enactment
would force them to consider retiring or abandoning their practice, and 67 percent anticipated fewer medical school applicants. Meanwhile, 65 percent of doctors believed that the plan would lead to lower-quality care for seniors and 71 percent said that it was impossible for government to insure 47 million more Americans while cutting costs and providing better quality care.

"America's doctors cannot be bribed into supporting legislation that will restrict patient choice, increase bureaucracy, defund Medicare for seniors, and drive costs so high that middle class taxpayers suffer," said Phil Kerpen. "Our nation's physicians want to care for their patients, and government should not stand in the way of the sacred doctor-patient relationship."

Patients First, A Project of Americans for Prosperity(tm), is focused on real health care reform--reform that puts patients first. Patients First believes that Americans want and need more health insurance options--not just a costly, government-defined plan paid for by American taxpayers.

Patients First is a project of Americans for Prosperity® (AFP), a 501(c)(4) non-profit organization recognized by the IRS. AFP is the nation's premier grassroots organization committed to advancing every individual's right to economic freedom and opportunity. AFP has more than 700,000 members, including members in all 50 states, and 25 state chapters. Patients First is not affiliated in any way with Patient First health clinics. For more information on Patients First, go to www.JoinPatientsFirst.com (http://rs6.net/tn.jsp?et=1102780163328&s=13633e=001ZT5NIGsO3Sm71FnQxFM7c909urFNCe1BrHFUUxAchDovoi3PcvaYNpHK1T8
3srDskHtH9Wp_AWd5JxMhq2QGU6eumkYedekDD05_3N4yT1ANSouKAwNgOyU__ZtAVjIv).

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Secretary Sebelius Releases $27.8 Million in Recovery Act Funds to Expand the Use of Health Information Technology

HHS Secretary Kathleen Sebelius today announced awards totaling $27.8 million to health center-controlled networks and large multi-site health centers to implement electronic health records (EHR) and other health information technology (HIT) innovations. The funds are part of the $2 billion allotted to HHS' Health Resources and Services Administration (HRSA) under the American Recovery and Reinvestment Act of 2009 (ARRA) to expand health care services to low-income and uninsured individuals through its health center program.

"The increased use of health information technology is a key focus of our reform efforts because it will help to improve the safety and quality of health care generally while also cutting waste out of the system," Secretary Sebelius said.

"These funds to expand and upgrade electronic health records systems will make a huge difference for health centers struggling to provide health care to the growing number of people in need," said HRSA Administrator Mary Wakefield, Ph.D., R.N.

"Broad use of health information technology has the potential to improve health care quality, prevent medical errors, and increase the efficiency of care provision," added National Coordinator for Health Information Technology David Blumenthal, M.D., M.P.P. "This program supports the department's overall efforts to assist physicians and hospitals in adopting and becoming meaningful users of health information technology."

Eighteen grants totaling more than $22.6 million will support HER implementation. Grants totaling more than $2.6 million will help four grantees implement a variety of HIT innovations, including the creation of health information exchanges among different providers and the
incorporation of HIT at dental delivery sites. Another five grants totaling over $2.5 million will help health centers devise plans to use existing EHRs to improve patient health outcomes.

HRSA received $2 billion through the Recovery Act to expand health care services to low-income and uninsured individuals through its health center program. To date, more than $1.3 billion of these funds have been awarded to community-based organizations across the country.
HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance.

In addition, HRSA received $500 million in Recovery Act workforce funds --$300 million to expand the National Health Service Corps (NHSC) and another $200 million for other health care workforce programs. The NHSC funds will pay for student loan repayments for primary care medical, dental, and mental health clinicians who will practice for a minimum of two years in NHSC sites that treat underserved and uninsured people. Recently, awards totaling $33 million -- part of the $200 million total were announced to expand the training of health care professionals.

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Senate Introduces Bill to Boost Participation in Clinical Trials for Rare Diseases

/PRNewswire-/ -- Four members of the United States Senate introduced legislation today to allow patients with rare diseases to participate in clinical drug studies without losing their eligibility for public healthcare coverage, echoing a move by the House of Representatives last month.

The "Improving Access to Clinical Trials Act" is co-sponsored by Senators Ron Wyden (D-OR), Chris Dodd (D-CT), James Inhofe (R-OK) and Richard Shelby (R-AL).

Researchers who develop drugs to treat rare diseases such as cystic fibrosis often struggle to recruit participants for clinical trials because of limited patient populations. To compound the problem, current law prevents many people who receive Supplemental Security Income (SSI) from accepting research compensation because it would make them ineligible to continue receiving government medical benefits. This financial penalty prevents significant numbers of people with rare diseases from participating in clinical studies.

"For many suffering from rare diseases, access to clinical trials is their best hope for treatment," said Senator Wyden. "This legislation will make sure the small financial incentives these people receive will not be counted against them if they are on SSI or Medicaid. Patients suffering from rare diseases should not have to choose between their best hope for treatment or losing benefits, nor be denied the access more financially fortunate patients receive."

"For those living with a rare disease, clinical drug studies can offer a ray of hope: access to cutting-edge medical technologies that may help treat or even cure a serious illness," Senator Dodd said. "Currently, individuals who receive public assistance often do not participate in compensated clinical trials for fear of losing their Medicaid or Supplemental Security Income. This legislation will remedy this inequity by ensuring that more Americans, including those who receive public assistance, have access to these potentially life-saving clinical drug studies."

"This bill allows patients with a rare disease to disregard up to $2,000 of compensation received for participation in a clinical trial in their SSI and Medicaid income calculations," said Senator Inhofe. "Though it will have a negligible impact on the federal budget, it will make a dramatic difference in the lives of those who will gain access to potentially life-saving treatments by enrolling in clinical trials as well as all those in the future whose lives will be improved by the medical advances that arise from this research.

"Scientists and researchers across our nation continually produce new therapies that have the potential to save the lives of countless Americans who suffer from life-threatening rare illnesses," said Senator Shelby. "These patients should not be forced to choose between the health benefits they desperately need and the opportunity to participate in a clinical trial that could improve their medical condition. I am confident that this legislation will open a pathway for more patients to receive life-saving treatments."

Fifty years ago, there were no drugs for people with CF and those with the disease rarely lived to attend elementary school. Today, because of the Cystic Fibrosis Foundation's focus on innovative and aggressive research, there are more than 30 potential therapies in development, and the median life expectancy is higher than 37 years.

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MHA Director McIlwain Prepared for the Challenges of the Health Care System

As health care remains on the front burner of political debate, the Master of Health Administration (MHA) program at Clayton State University is prepared to continue its mission of developing well-rounded competent individuals for administrative positions in varying types of health care organizations. The new director of the MHA program, Dr. Thomas F. McIlwain, is prepared for the challenges in a changing health care system.

“Change is inevitable, and the health care system is no exception,” he says. “In my 25 or so years of working and teaching in health services administration, I have seen the problems, issues, health policies, and health policy outcomes debated. Each new policy change is a tweak of the existing system, but each has been designed to make it better. I have no doubt of the outcome of the current debate. The system will get a little better.”

McIlwain comes to Clayton State with a wealth of prior industry and teaching experience. In the 80s, he served as an administrative associate at University Hospitals of Alabama while teaching in the MSHA program at the University of Alabama at Birmingham, where he received his Ph.D. in Health Services Administration. His administrative residency was with a for-profit system, American Medical International, which eventually merged with National Medical Enterprises to form what is now know as Tenet Health Care.

His immediate teaching position after UAB was at Appalachian State University in the Walker College of Business’ Department of Management. He served as director of the undergraduate health care management program for eight of the 10 years he was in Boone, N.C. He then moved to Mount Pleasant, S.C., where he served as MHA program director for three of the 10 years he was on faculty at the Medical University of South Carolina.

For the past four years he was associate professor of Public Health and vice-chair in the Department of Community Health Sciences in the College of Health at the University of Southern Mississippi in Hattiesburg. While there, he developed the graduate emphasis in health administration in the CEPH-accredited Master of Public Health program. He was also involved in the development of the cohort-based Executive Master of Public Health in Health Services Administration program.

McIlwain has consulted with health care organizations in the area of strategic planning including medical group practices, nursing homes, and hospitals. His research interests are in health care marketing, including direct-to-the-consumer pharmaceutical advertising, and health care strategic management.

“The main goal of the MHA program at Clayton State is to become CAHME (the Commission on Accreditation of Health Management Education) accredited. CAHME is dedicated to promoting, evaluating, and improving graduate healthcare management education. I was responsible for the re-accreditation of the MHA program at MUSC where the program received the highest awarded number for seven years,” McIlwain says. “My goal is to move this program to that level of quality education. This process will involve making sure that we have quality admissions, support, and outcomes in teaching, service, and research. We are moving the program to competency based outcome measurement also.

“I was attracted to Clayton State because of its proximity to the health care industrial complex of the Metro Atlanta area. This program is poised to become a premier provider of graduate health care management education in the Atlanta and Georgia region. My experience with accreditation and program management provides me with a perspective of what this University can accomplish in this type of program”McIlwain is looking forward to accomplishing many goals within MHA program.

“The goals of the program are to prepare students for positions of increased responsibility within healthcare organizations. It also provides individuals with clinical backgrounds the management skills needed to assume leadership positions,” he says. “We are also interested in attracting individuals who have experience in other industries but want to begin careers in health care management.

“Of course the goal of all health administration programs is to improve the quality of care and resource use in health organizations by graduating individuals with the skills and competencies to achieve this goal.”
McIlwain is married to Margaret, a family nurse practitioner, and is the father of two sons.

A unit of the University System of Georgia, Clayton State University is an outstanding comprehensive metropolitan university located 15 miles southeast of downtown Atlanta.
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Secretary Sebelius Releases $33 Million in ARRA Funds to Train Health Professionals

HHS Secretary Kathleen Sebelius today announced awards totaling $33 million to expand the training of health care professionals. The funds are part of the $500 million allotted to HHS' Health Resources and Services Administration (HRSA) to address workforce shortages under the American Recovery and Reinvestment Act (ARRA).

"President Obama is committed to passing health insurance reform and we're closer to reform than ever before," said Secretary Sebelius. "The Recovery Act will help ensure we grow our health care workforce and give our aspiring doctors, nurses and health professionals the tools and training they need to provide top-quality care to more Americans."

"As we mark 200 days since President Obama signed ARRA, HRSA has moved quickly to distribute most of the $2.5 billion assigned to us," said HRSA Administrator Mary Wakefield, Ph.D., R.N. "These funds are helping us rebuild the infrastructure needed to produce more skilled health professionals, and they are expanding essential primary care services to hundreds of thousands of additional Americans through our health center system."

The grants announced today, with funding totals, are distributed through six HRSA programs:

* Scholarships for Disadvantaged Students, $19.3 million. This
program funds health professions schools and training programs which, in
turn, provide scholarships to full-time health professions students,
with priority given to those with financial need.

* Centers of Excellence, $4.9 million. This program funds health
professions schools to establish or expand programs for minority
individuals. Funds may be used to improve student academic performance,
recruit and retain minority faculty, and expand opportunities to train
at off-campus, community-based health care sites.

* Public Health Traineeships, $3 million. This program funds
schools of public health to support traineeships that pay tuition, fees,
and stipends for students in biostatistics, epidemiology, environmental
health, toxicology, nutrition, or maternal and child health.

* Nursing Workforce Diversity, $2.6 million. This program
increases nursing education opportunities for individuals from
disadvantaged backgrounds through student scholarships or stipends,
pre-entry preparation, and retention activities.

* Health Careers Opportunities, $2.5 million. This program funds
schools and health professions training sites to establish or expand
programs that help individuals from disadvantaged backgrounds enter and
graduate from a health professions program.

* Dental Public Health Residency Training, $810,925. This program
funds residency programs in dental public health, including financial
aid to residents.

Today's grants follow an Aug. 12 announcement by HHS Deputy Secretary Bill Corr of $13.4 million in ARRA funds for loan repayments to nurses who agree to practice in facilities with critical shortages and for schools of nursing to provide loans to students who will become nurse
faculty.

To date, HHS has announced the availability of nearly $200 million in ARRA workforce funds, of a total $300 million, to expand HRSA's National Health Service Corps. The funds will pay for student loan repayments for primary care medical dental and mental health clinicians who wish to practice, for a minimum of two years, in NHSC sites that treat underserved and uninsured people.

In addition, HRSA received $2 billion through ARRA to expand health care services to low-income and uninsured individuals through its health center program. To date, more than $1.3 billion of these funds have been awarded to community-based organizations across the country. HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance.

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Dr. 'Smith' Comes to Washington: Angry Physicians From All 50 States Rally in DC on Sept. 10

/PRNewswire/ -- More than 1,000 physicians from all 50 states will converge on the Capitol in scrubs and lab coats this week to bring an angry message to Congress: "Stop meddling in medicine!"

The doctors, all traveling as individuals and at their own expense, will hold a rally at the Capitol, lobby their Members of Congress, and meet with the doctors of Congress, including Tom Price, MD (GA) and Sen. Tom Coburn (OK).

The event, co-sponsored by the Association of American Physicians and Surgeons (AAPS) and Tea Party Patriots, was prompted by the American Medical Association's misguided endorsement of House Bill HR 3200, a bill that would turn more control over to the government, rather than restore it to patients and doctors.

"The AMA's endorsement was bought and sold, at the expense of patients, and the expense of the profession of medicine," said Dr. Michael Schlitt, who is traveling from Seattle. "I couldn't stand by without telling Congress and the public that they don't represent me, or most of the doctors I know. And that it's time Congress listens to real doctors from the frontlines."

The doctors' rally is the first public event of the 9.12.09 March on Washington.

SPEAKERS INCLUDE:
Rep. Tom Price, MD (R-GA)
Rep. Phil Gingrey MD (R-GA)
Members of Congressional Doctors Caucus
Mark Kellen, MD, President, AAPS, IL
Michael Schlitt, MD, neurosurgeon, WA
Peter Lavine, MD, President, Washington DC Medical Society
Joyce Lovett, MD, pediatrician, GA
Scot Barbour, MD orthopedic surgeon, GA
Hal Scherzo, MD, pediatric urologist, GA
Clare Gray, MD, internist, NC

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New National Poll Finds Americans Strongly Opposed to Cutting Medicare Payments for Nursing Home Care as a Means of Financing Health Care Reform

/PRNewswire/ -- As federal lawmakers continue to sound out constituents over the August recess on health care reform, and how best to finance a broad-based overhaul, a new Mellman Group (D) national survey (1000 Registered Voters, 8/21-24, +/- 3%) finds Americans, by significant margins, strongly oppose cutting Medicare-funded nursing home care over other funding options. Underscoring the unpopularity of cutting Medicare-financed nursing home care - now proposed by Congress - the data finds a full 66% of voters less likely to support their local member of Congress for reelection if they voted to cut seniors' Medicare-funded care to finance health care reform, believing that cutting such payments would reduce quality of care.

Says the new Mellman Group poll analysis:

"Voters overwhelmingly oppose cutting Medicare payments to nursing homes as a means of financing healthcare reform, expressing their distaste for this approach in several ways during our brief survey.

First, it is the least popular of the funding options being considered.

Second, cutting Medicare payments to nursing homes is far and away the least acceptable method of financing reform.

Finally, a large majority of voters would feel less favorable toward a Member of Congress who supported such an approach. Voters say they will take out their anger on Members who vote for such nursing home cuts at the ballot box. The reason is straightforward--most Americans believe that cutting such payments will reduce the quality of care seniors receive in nursing homes. While healthcare reform is important to many Americans, Medicare funds for nursing homes are considered off limits as a way to finance reform."

When asked "If Congress cut $32 billion in Medicare payments to nursing homes to care for seniors, do you think the quality of care seniors receive in nursing homes would get better, stay about the same or get worse?" the analysis indicates that, "Seniors are equally concerned, as 78% of those over 65 believe nursing home care will get worse because of such cuts and a majority believe care will get much worse (58%)."

The following are the poll questions and results:

1. Congress is now considering ways to pay for healthcare reform. Which one of the following do you think is the most acceptable way to pay for healthcare reform?

Cutting Medicare payments to nursing homes to care for seniors 3%
Raising taxes on people who make over $250,000 per year 45%

Requiring people to pay taxes on generous healthcare benefits they receive from their employers 6%

Taxing health insurance companies 14%
None 26%
Don't know 6%


2. And which one of the following do you think is the least acceptable way to pay for healthcare reform?

Cutting Medicare payments to nursing homes to care for seniors 49%
Raising taxes on people who make over $250,000 per year 8%

Requiring people to pay taxes on generous healthcare benefits they receive from their employers 14%

Taxing health insurance companies 9%
None 14%
Don't know 6%


3. If Congress cut $32 billion in Medicare payments to nursing homes to care for seniors, do you think the quality of care seniors receive in nursing homes would get better, stay about the same or get worse? [IF BETTER/WORSE ASK]. And is that much [BETTER/WORSE] or only somewhat [BETTER/WORSE]?

Much better 4% 7%
Somewhat better 3%
Stay about the same 11%
Somewhat worse 19%
Much worse 59% 78%
Don't know 4%


4. If your Member of Congress voted to fund healthcare reform in part by cutting $32 billion in Medicare payments to nursing homes to care for seniors would you be __more likely to vote to reelect them, __less likely to vote to reelect them or would it not make much difference to your vote? [IF MORE/ LESS LIKELY ASK:] Is that much [MORE/LESS] or somewhat [MORE/LESS] likely?

Much more likely 5% 7%
Somewhat more likely 2%
No difference 20%
Somewhat less likely 17%
Much less likely 49% 66%
Don't know 6%


"From the results of this objective, timely and highly significant national survey, it is abundantly clear the public, to its credit, harbors strong antipathy to slashing Medicare beneficiaries' nursing home benefits to finance any broader reform package," stated Bruce Yarwood, President and CEO of AHCA. "We strongly support the laudable objective of the Obama Administration and Congress to expand Americans' access to care, and help bring down health care costs. However, we will continue to warn both on Capitol Hill and at the local level how and why the $32 billion Medicare cuts now under consideration will not only harm seniors' ongoing access to quality nursing home care, but also jeopardize the jobs of the key frontline caregivers who make a significant difference in patients' care outcomes."

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8/12/09 Statement from the American College of Surgeons Regarding Recent Comments from President Obama

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President’s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world.

Web site: www.facs.org
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Process Begins to Define "Meaningful Use" of Electronic Health Records

Building on the historic $19 billion investment provided through the
American Recovery and Reinvestment Act of 2009 (Recovery Act), efforts
continued today to further the national adoption and implementation of
health information technology (HIT) -- an essential tool to modernize
the health care system and bring about improved health for all
Americans. The Health Information Technology (HIT) Policy Committee, a
Federal Advisory Committee (FACA) to the U.S. Department of Health and
Human Services (HHS), met today to begin the process of defining
"meaningful use" of electronic health records (EHRs). This meeting is a
first step for the department, as it investigates possible definitions
for meaningful use.

"We are moving fast to achieve the President's goal to improve the
health and well-being of every American through the on-going use of
health information technology," stated HHS' National Coordinator for
Health Information Technology David Blumenthal, M.D., M.P.P. "The work
of the policy committee is a first step toward assuring that technology
-- the electronic health record -- is used in a meaningful way to
provide better patient care."

The Recovery Act provides Medicare and Medicaid incentive payments to
eligible providers, such as physicians and hospitals, in order to
increase the adoption of EHRs. To receive the incentive payments,
providers must demonstrate "meaningful use" of a certified EHR.
Building upon the work done by the HIT Policy Committee, the Centers for
Medicare & Medicaid Services (CMS), along with the Office of the
National Coordinator for Health Information Technology (ONC), will be
developing a proposed rule that provides greater detail on the incentive
program and proposes a definition of meaningful use. CMS expects to
issue the proposed rule in late 2009, which will be followed by a
comment period.

The recommendations discussed today represent extensive work by the
Committee's Meaningful Use Workgroup to review and evaluate diverse
ideas and contributions from Workgroup members along with information
from a public hearing on meaningful use convened in April by the
National Committee on Vital and Health Statistics (NCVHS). The NCVHS
hearing brought together key healthcare and information technology
stakeholder groups. The workgroup also reviewed written comments from
additional diverse stakeholders.

A public comment period on today's recommendations will be open through
the close of business on Friday, June 26, 2009. Instructions on how to
submit public comment can be found at http://healthit.hhs.gov.

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HHS Issues Special Report on Health Reform and Launches New healthreform.gov Web Site

Americans expressed serious concerns regarding health care in a new
report released today by the Department of Health and Human Services.
The report, Americans Speak on Health Reform: Report on Health Care
Community Discussions, summarizes comments from the thousands of
Americans who hosted and participated in Health Care Community
Discussions across the country and highlights the need for immediate
action to reform health care.

The report is available on a new Web site dedicated to health reform:
www.healthreform.gov. Unveiled today, the Web site will allow Americans
to view today's White House Health Forum, share their thoughts about
health reform with the Obama Administration and sign a statement in
support of President Obama's commitment to enacting comprehensive health
reform this year.

"This new Web site, www.healthreform.gov and report ensure that when we
discuss health reform, the American people will have an equal stake in
the health reform efforts," said HHS Spokeswoman Jenny Backus.
"Sky-rocketing health care costs are creating enormous pressure on
families, on businesses and our fiscal future. The Obama Administration
is committed to taking action this year on health reform and is calling
on government, business, health care stakeholders and everyday Americans
to come together to make it happen."

In December, then President-elect Obama called on the American people to
host Health Care Community Discussions to assess the seriousness of the
problems and identify solutions. In the last eight years, health
insurance premiums have grown four times faster than wages and one
million more Americans have lost their health insurance each year.
Health care costs have forced small businesses to close their doors and
compelled corporations to ship jobs overseas.

Over 9,000 people signed up in all 50 states and the District of
Columbia to host a discussion, and thousands more participated in these
gatherings. After each Health Care Community Discussion, guests and
hosts were asked to fill out a Participant Survey and submit a group
report to the Presidential Transition Team's Web site summarizing the
group's concerns and suggestions. Group reports from 3,276 Health Care
Community Discussions as well as Participant Surveys from 30,603
participants were collected, analyzed, and are summarized in the report.

The cost of health care services and health insurance was the top
concern about the health care system for 55 percent of discussion
participants. Participants also cited lack of emphasis on prevention,
pre-existing conditions limiting insurance access, and the quality of
care as key concerns. A qualitative analysis found that the Health Care
Community Discussions focused on concerns about a "broken" health
system, access to health insurance and services, rising premiums and
drug costs, medical mistakes and the system not being "for them."

Health Care Community Discussion group participants agreed on the values
and direction that should guide reform. They called for a system that
is fair, patient-centered and choice-oriented, simple and efficient, and
comprehensive. Participants also offered a wide range of specific
solutions, including making health insurance more accessible through an
insurance "exchange" or a public plan option, creating scorecards on
quality and cost, improving the nutritional content of school lunches,
implementing electronic medical records and creating an AmeriCorps for
health workers.

Today's report also includes a series of personal testimonials from
Health Care Community Discussion participants who expressed their
concern about the state of health care in America. A farmer from Enid,
Okla., explained, "I have spent my life's savings on [health care], and
now I am refused care at our local hospital because I cannot pay. I may
have to file bankruptcy due to this." A report from Missoula, Mont.,
commenting on policies that allow insurers to deny coverage to Americans
with pre-existing conditions said, "No mother should have to say her
daughter is 'uninsurable.'"

President Obama has committed to reforming health care this year and has
already acted to make health care more affordable and accessible.
President Obama signed a law to provide and protect health insurance for
11 million American children through the Children's Health Insurance
Program. The President also signed into law the American Recovery and
Reinvestment Act which includes investments in electronic health
records, prevention, comparative effectiveness research, and health
workforce training -- foundations for a 21st century health care system.
Additionally, the President's Budget Blueprint also includes an historic
commitment to comprehensive health care reform.

A copy of Americans Speak on Health Reform: Report on Health Care
Community Discussions, group reports filed by participants and hundreds
of submitted photos are available at www.HealthReform.gov.

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