Managed Care - August 2008 - (Page 8) NEWS AND COMMENTARY Investment in Prevention Can Save $16 Billion in Care small investment of $10 per person per year in disease prevention programs that increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the United States more than $16 billion annually within five years, according to a new report from the Trust for America’s Health (TFAH), a group that promotes prevention. According to the report titled “Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities,” this return amounts to $5.60 for every $1 spent. Out of the $16 billion, private insurers could save more than $9 billion, Medicare could save $5 billion, and Medicaid could save nearly $2 billion. “This study shows that with a strategic investment in effective, evidence-based disease prevention programs, we could see tremendous returns in less than five years,” says Jeff Levi, PhD, who is executive director of TFAH. The economic findings are based on a model developed by researchers at the Urban Institute and on a review of studies conducted by the New York Academy of Medicine. Implementing these programs in communities reduces rates of type 2 diabetes and high blood pressure by 5 percent within two years; reduces heart disease, kidney disease, and stroke by 5 percent within five years; and reduces some forms of cancer, arthritis, and chronic obstructive pulmonary disease by 2.5 percent within 10 to 20 years. federal legislation that reduced payments to oncologists, according to a study issued by the Duke University Clinical Research Institute (DCRI). Critics of Medicare Part D feared that if the payment schedule for oncologists were reduced and they weren’t being paid as much for the chemotherapy drugs they were giving their patients, “patient care might suffer if doctors had to close their practices or scale back, making it necessary for patients to travel farther or go to inpatient facilities for treatment,” says Kevin Schulman, director of DCRI’s Center for Clinical and Genetic Economics. “Our study showed that this, in fact, has not yet occurred.” Researchers at DCRI studied the treatment of patients with leukemia, lymphoma, breast, lung or colorectal cancer from 2003, before the act was passed, through 2006. “The distance patients traveled for chemotherapy treatments did not considerably increase after passage of the act,” says lead investigator, Lesley Curtis, a health services researcher at DCRI. “And despite concerns that patients would have to go to inpatient settings with longer wait times, we observed a small shift in the provision of initial chemotherapy from inpatient to outpatient settings,” says Curtis. The median amount of time between diagnosis and treatment was 28 days. This did not change significantly, regardless of treatment setting, says Curtis. A The findings were published in the Journal of the American Medical Association. Headlines On Deadline . . . A.M. Best has affirmed the financial strength ratings and issuer credit ratings of 32 health maintenance organizations, upgraded eight HMOs, and downgraded nine HMOs in its latest ratings. HMOs that have been upgraded include Athens Area Health Plan Select, El Paso First Health Plans, InterValley Health Plan, Mount Carmel Health Plan, and Upper Peninsula Health Plan. Downgraded plans include Columbia United Providers, Community Health Choice, Cook Children’s Health Plan, Inland Empire Health Plan, PreferredOne Community. These ratings are based solely upon public information. Updated ratings will be issued by the company over the next three months. . . . On 37 indicators of performance, the United States achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States in the “National Scorecard on U.S. Health System Performance, 2008,” a report issued by the Commonwealth Fund. One key patient safety measure — hospital standardized mortality ratios — improved by 19 percentage points from 2000 to 2002, and again from 2004 to 2006. The report says this sustained improvement was coupled with several high-profile local and national programs to improve hospital safety and reduce mortality. — Tony Berberabe Chemo Payment Cut No Harm to Patients Patients undergoing chemotherapy have not lost access to care, despite 8 MANAGED CARE / AUGUST 2008
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