The week in review, February 11–17, 2013
medwireNews: This week's stories include: a meaningful push to terminate Medicare's sustainable growth rate reimbursement formula; underage drinking trends showing that branding is not just influencing those of legal age; CHIP's adjustments in eligibility alone not being a game changer in overall coverage; experts and groups pushing the FDA to draw the line concerning sugary drinks; panel puts electronic health record program to task about fraudulent billing practices.
Pricey but vital termination
In 1997, a deficit reduction law intended to control federal health spending was created and labeled Medicare's sustainable growth rate (SGR) reimbursement formula. A large majority of medical experts and organizations have come to view the system as fundamentally flawed since payments hinge on economic growth as opposed to medical trends, such as an aging population or obesity rates.
In 2002, a backlash from doctors occurred when a 4.8% pay cut was set to kick in, which congress then delayed - and has been doing so ever since. All the while, the costs needed to fix this rule have risen while the payment formula has motivated exploitation of the fee-for-service system.
Now a congressional committee spearheaded by the new chair of the House Ways and Means Health Subcommittee is set to come up with a solution to replace SGR once and for all - especially when any more delay only means even costlier repercussions down the road.
Branding is undoubtedly important in how numerous alcoholic beverage companies build a relationship between youth and their product. Yet, until now, national surveys of alcohol use among underage youth have gauged preferences for beverage type (beer, spirits, wine) but not the brand (Bud Light, Bacardi rum, Coors Light).
To better gauge the nuances of brand preferences, researchers conducted an online survey that shed light on the specific tastes of underage drinkers and, perhaps, why underage drinking is still a public health concern in the USA; more than 70% of high school students have consumed alcohol while 22% engage in heavy episodic drinking.
The study, published in Alcoholism: Clinical and Experimental Research, found that much like cigarette brands, the marketing of which is currently much more regulated, underage drinkers prefer a disproportionally small number of beverage types - a trend that is likely due to branding.
Eligibility versus cost
Children's Health Insurance Program (CHIP) was a large step toward providing universal coverage to nearly 8 million children in families with incomes too high to qualify for Medicaid, yet still unable to afford private insurance in the USA.
Before the 2010 passage of the Affordable Care Act, states were already implementing CHIP programs that were more inclusive by extending eligibility to families with incomes above previous eligibility thresholds. Between 2002 and 2009, 13 states bumped up income eligibility thresholds for CHIP to between 200% and 400% of the federal poverty line.
Yet, according to a study in Health Services Research, eligibility alone is not going to significantly change children's coverage if the high premiums that will have to be paid are not also taken into account.
Describing sugary drinks as a "slow-acting but ruthlessly efficient bioweapon," the executive director of the Center for Science in the Public Interest along with leading health experts and health-advocacy organizations sent a petition to the Food and Drug Administration (FDA), demanding safe limits of high-fructose corn syrup and other sugars in widely consumed drinks.
The letter specifies to the FDA that their currently benign classification of these sugars is wrong, as the current level of consumption is actually unsafe.
The 54-page petition not only suggests phasing in limits but also encourages the use of alternative "sweetness enhancers," which are a possible reality within the next few years.
Medicare fraud check
Offsetting the arduous push for implementing electronic health records has been the rise in Medicare billing fees, which the Center for Public Integrity has attributed to medical billing abuses that are made easier to do by the digital system.
To get to the bottom of this, health policy experts gathered to discuss the scourge of questionable billing practices with various witnesses from various medical organizations testifying about the widespread nature of the problems that digital records have supposedly created.
While the National Coordinator for Health Information Technology, Farzad Mostashari, assured the panel that taxpayer money was not being fraudulently wasted on false billing he also admitted that there is much that is unknown about the appropriateness of the coding that is upping the reimbursement amounts.
By Peter Sergo, medwireNews Reporter