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03-03-2013 | Article

The week in review, February 25 – March 3, 2013

medwireNews: This week's stories include: framework details to fund safe research of dangerous strains of influenza; the evolving landscape of health insurance that empowers the consumer; drop in insurers seeking a rate hike of 10% or more; American Academy of Neurology choosing five tests and procedures to second-guess; a study that stresses the importance of communication between doctors and patients.

Setting protocol

In 2011, researchers developed a form of highly pathogenic avian influenza (HPAI) H5N1 virus that could be transmissible by respiratory droplets between mammals. The work created an uproar due to concerns that the release - either accidental or purposeful - of such an infectious form of influenza could lead to a global pandemic.

A voluntary moratorium was imposed until a report that was recently released by the Department of Health and Human Services proposed a finalized framework that spells out the protocol for funding dual research of concern.

While some will be displeased that researchers can continue producing and studying a lethal virus, the National Institutes of Health communicated the importance in understanding what can be manufactured naturally.

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Informed health shopping

Health plans are undergoing a serious overhaul in the USA with many deadlines for partaking in health exchanges coming and going, while more and more states are accepting federal help to expand Medicaid.

Commenting on this evolving landscape, the CEO Avalere Health, an advisory company that is a leader in healthcare business strategy and public policy, pointed out how payers will have to engage more with individual customers while health providers consolidate and become more efficient as their payments become based more on quality of care.

Altogether, consumers will be much more empowered as informed purchasers of insurance as they can gain insight from other consumers about their experience.

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Rate hike disclosure

The Department of Health and Human Services (HHS) was more than pleased to see that the number of health insurance companies requesting to raise their rates by 10% or more dropped from 75% in 2010 to 14% in 2013.

The HHS explained that the observed drop is a result of the prohibitive affect of an Affordable Care Act (ACA) law requiring companies in every state to publicly justify wanting to raise their rates by double-digits.

The HHS also issued a final rule that further protects consumers according to the ACA by guaranteeing eligibility and disallowing higher premiums hitting higher risk enrollees.

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Cutting off the fat

The Choose Wisely campaign is a movement to inform patients about the evidence that underlies health recommendations so that they can better communicate with doctors to make wiser decisions.

This has become increasingly important to control skyrocketing medical costs - a large portion of which is fueled by doctors prescribing - as well as patients demanding - tests and procedures that are either excessive or flat out inappropriate.

To contribute to making sure that one-quarter of the USA's GDP does not end up consumed by medical costs by 2025, the American Academy of Neurology released a list of five treatments and procedures that doctors and patients should question.

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Broader responsibility

The complexity of the healthcare system and the extent of technical information that is churned out to guide patients might explain why 88% of Americans are not competent enough to know how to properly make use of it to make healthy decisions.

That is why an HHS senior health communication advisor stated in a Health Affairs study that medical advisors should assume that all patients are at risk for neither understanding their health conditions nor knowing how to deal with them.

The study suggests that the onus should not solely fall on doctors but rather the entire health organization to ensure that the patient's severe lack of health literacy does not become a disconnect that leads to mistakes and in turn wasteful costs.

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By Peter Sergo, medwireNews Reporter