Fort Washington, PA, United States (AHN) – McNeil Consumer Healthcare, a division of McNeil-PPC, Inc., is voluntarily recalling at the wholesale and retail levels seven lots, comprising approximately 574,000 bottles, of Infants’ Tylenol Oral Suspension, 1 oz. grape distributed nationwide in the United States.

Infants’ Tylenol is an over-the-counter product indicated as a pain reliever/fever reducer.

McNeil is initiating this voluntary recall as a precaution after receiving a small number of complaints from consumers who reported difficulty using the Infants’ Tylenol SimpleMeasure dosing system.

SimpleMeasure includes a dosing syringe that a parent or caregiver inserts into a protective cover, or “flow restrictor,” at the top of the bottle to measure the proper dose.

In some cases, the flow restrictor was pushed into the bottle when inserting the syringe. Children’s Tylenol products are intended for children two years of age and older and remain available.

No adverse events associated with this action have been reported to date and the risk of a serious adverse medical event is remote.

Consumers can continue to use Infants’ Tylenol provided the flow restrictor at the top of the bottle remains in place.

If the flow restrictor is pushed into the bottle, the parent or caregiver should not use the product.

Consumers can request a refund by visiting www.tylenol.com disclaimer icon or contacting McNeil at 1-888-222-6036 Monday-Friday from 8 a.m. to 8 p.m. Eastern Time; Saturday-Sunday 9 a.m. to 5 p.m. Eastern Time.

Parents and caregivers with any health questions or concerns should contact their healthcare provider and visit www.tylenol.com disclaimer icon for additional information.

View full post on All Stories

New Brunswick, NJ, United States (AHN) – Johnson & Johnson has been plagued by product recalls, and on Friday a unit of the pharmaceutical giant issued another one.

McNeil Consumer Healthcare said it is recalling some 574,000 bottles of a grape-flavored version of its liquid infant Tylenol because of problems with the device on the bottle that helps measure dosage.

The bottles come with a syringe and have a protective cover, or flow restrictor, at the top to help measure the right dose. McNeil says the restrictor has been pushed into the bottle in some cases when the syringe is inserted.

McNeil is one of three business segments for New Brunswick, NJ-based J&J. The latest recall is among about two dozen recalls issued in more than two years.

View full post on All Stories

Washington, DC, United States (KaiserHealth) – Across the national airwaves and on the Republican campaign trail, the Massachusetts health law that many now call “Romneycare” is routinely trashed. Here’s Texas Governor Rick Perry in a debate last October.

“Romneycare has driven the cost of small business insurance premiums up by- percent over the national average in Massachusetts.” And from former Senator Rick Santorum last month we heard, “it (Romneycare) was the basis of Obamacare and it was an abject failure.”

So you might think this drubbing would rub off on Massachusetts residents, about two-thirds of whom have consistently endorsed the state’s coverage plan since it passed in 2006. Not so.

In the latest WBUR poll, 62 percent support the law and 33 percent oppose it. Steve Koczela is president of the Mass, Inc. polling group, which conducted the poll.

“Even with all the attention the Massachusetts law has gotten nationally,” said Koczela, “it really hasn’t driven down support among voters here in Massachusetts.”

The difference between national and local opinions about the law is part politics, part misinformation, and partly a difference of experience, says Robert Blendon, a professor at Harvard Kennedy School. Massachusetts residents are living with the law. Opinions outside the state are based on speculation.

“A substantial share of Americans believe that the national law will fail and they assume that the Massachusetts law, which in their minds is related to this, is not working well either,” Blendon said.

That’s the case, said Blendon, even when he presents evidence to audiences outside Massachusetts that a strong majority of residents in the Commonwealth are happy with the state law.

“People are convinced,” laughed Blendon, that “[the poll] can’t be right.”

In Massachusetts, most residents in the WBUR poll (68 percent), see former Governor Mitt Romney’s opposition to the national law as an effort to win votes in his presidential campaign. Only 25% see his opposition as a disagreement based on principle.

“Taking that, in concert with the level of influence people thought the state law had on the national law, at least suggests there’s some difficulty distancing yourself from what happened nationally to what happened here at home,” says pollster Koczela.

That dynamic may translate into problems for Republican Sen. Scott Brown, who, like Romney, supports the state law but hopes to repeal the national law.

Robert D’Ambrosio is one of the WBUR poll respondents who said he likes the state health care law and is not sure whom he supports in the Senate race. D’Ambrosio finds Brown’s position confusing.

“I don’t understand why he doesn’t bother the same with the national as he does with the state,” says D’Ambrosio, who lives in Malden, a suburb just north of Boston. “If you like one, how can you not like the other?”

Many residents polled say they want to know how Brown and the leading Democratic contender Elizabeth Warren would control health care costs. Paula Zindler from Cummington in western Massachusetts, is another undecided voter. She says the state law, which both Brown and Warren support, has forced up the cost of her health coverage.

“We had to switch to a different carrier, because my insurance, I was told, was inadequate,” explains Zindler. “So I either had to change my insurance or pay a fine, and I’m not happy with that.”

While health care is expected to be a key issue in the U.S. Senate race in Massachusetts, there are at least two major, yet to be determined, factors that will shape this debate. One is whether the US Supreme Court will let all or part of the federal Affordable Care Act stand. Two is who the Republican presidential nominee will be. But health care will also play into the standard practice of US political races, says Professor Blendon.

“Even though they (Brown and Warren) have a truce on how each side will describe each other, there will be an effort to put one far on the left and one far on the right and health care examples will be very prominent in that effort,” explains Blendon.

By “truce,” Blendon refers to the agreement Warren and Brown reached a few weeks ago to donate half the cost of any political ad funded by an outside organization to charity. Several residents in the WBUR poll praise this deal and say watching whether it holds will be one of the most interesting parts of this year’s Senate race.

– Provided by Kaiser Health News.

View full post on All Stories

Boston, MA, United States (KaiserHealth) – Voters are hearing a lot about health care this year. Republicans want to make the 2012 elections a referendum on the health care law that President Obama signed two years ago.

That law was largely based on one that then-Gov. Mitt Romney signed into law nearly six years ago in Massachusetts.

Romney is now a GOP presidential contender, and that has made the Massachusetts universal health care law a political football. Romney’s rival Rick Santorum recently called it “an abject failure.”

But “Romneycare,” as Santorum and others call it, isn’t controversial in its home state. And a lot of people there don’t call it Romneycare because it took the support of a lot of other people — Democratic legislators, business leaders, insurers, hospitals and doctors, consumer groups — to get it passed.

But it’s true that Romney got the ball rolling. When I interviewed him in 2006, Romney said he got the idea from talking to Massachusetts business leaders.

“The key insight was this: People who don’t have insurance nonetheless receive health care — and it’s expensive,” Romney said.

Romney saw a state fund set up to provide free care — paid for by a growing surcharge on private insurance premiums — was spending a billion dollars a year.

“My question was, could we take that billion dollars and help the poor purchase health insurance — let them pay what they could afford? We’d subsidize what they can’t,” Romney said.

And he proposed a requirement that people buy private health insurance if they’re able. That’s the “individual mandate” that has become a curse word in Republican politics these days.

“We’re going to say, ‘Folks, if you can afford health care, then, gosh, you’d better go get it,’ ” Romney said back in 2006. ” ‘Otherwise you’re just passing on your expenses to someone else.’ That’s not Republican, that’s not Democratic, that’s not Libertarian — that’s just wrong.”

Flash forward to 2012. Romney’s successor, Democrat Deval Patrick, says the health plan Romney launched is no abject failure — it’s working.

“I think it’s just been a terrific success,” Patrick said in an interview. “And [it's] a statement of value — about our values here, about how people aren’t all on their own, that we are in this together.”

Patrick says no state can match Massachusetts’ record of getting more than 98 percent of its citizens insured for health care — and virtually every last child. And, he boasts, “It has cost the state about 1 percent in additional new state spending.”

The Massachusetts law has had strong and steady support — and little opposition. Last year, an attempt to repeal the “individual mandate” — the part that requires most people to have insurance — couldn’t get enough signatures. Last week, only 39 people had “liked” its Facebook page.

To get an idea of how it’s working at the ground level, I stopped by the office of Dieufort Fleurissaint, a self-employed Haitian-American businessman. He has a tax prep and insurance business. He’s also an evangelical minister who worked with the group Greater Boston Interfaith Organization, which helped get the health law passed.

“Close to 500,000 people didn’t have health insurance,” Fleurissaint says. “Now, because of the passing of the law, they have health insurance.”

And one of them, it turns out, is Fleurissaint. He used to be a mortgage broker, but his business crashed in 2008. He couldn’t pay his health insurance premiums.

But under the new law, Fleurissaint qualified for state-subsidized insurance.

“My premium … dropped from $1,200 on a monthly basis [to] $770 for the same coverage for the same family of four,” he says. And when his income dropped again during the recession, so did his health insurance costs.

“The law has been extremely good for me,” he says, but he admits that not all his business colleagues like the law.

“They complained that they were forced, basically obligated to purchase health insurance,” Fluerissaint says. “So I explained to them that it’s much better to have health insurance than not having it.”

In fact, despite some initial grumbling, more Massachusetts businesses of all sizes have begun offering insurance.

When I called the Massachusetts Restaurant Association, it said it didn’t know of any members that don’t offer coverage. That was surprising, since restaurant owners have been among the most opposed to health laws like this one.

Similarly, Bill Vernon, who heads the Massachusetts office of the National Federation of Independent Businesses, says the law “works for Massachusetts.” The NFIB is a plaintiff in one of the lawsuits challenging the constitutionality of the Obama health plan that will be argued later this month before the U.S. Supreme Court.

But in Massachusetts, Vernon says, “my guess is that we would probably be pretty much split on the issue of whether to repeal the law or not. That suggests repeal is not something we would favor. And I don’t think it’s politically realistic, either.”

Likewise, the individual mandate has not met with nearly the resistance that many predicted.

“The sky did not fall,” says Andrew Dreyfus, president of Blue Cross Blue Shield of Massachusetts, the state’s largest insurer. “And by the way, we have much stronger penalties around the individual mandate than the national law has, and despite that, the sky did not fall.”

The penalty for not buying insurance can be on the order of $1,200 a year for a 37-year-old single person in Boston. But only about 1 percent of taxpayers end up paying any penalty.

Meanwhile, a new study in the journal Health Affairs shows that more Massachusetts citizens are seeing a doctor regularly, fewer are going to emergency rooms for care, and the percentage who rate their own health as “good” or “excellent” is going up.

But that doesn’t mean everything about Massachusetts health care is wonderful.

The 2006 law didn’t do anything about controlling the state’s health costs, which were already among the nation’s highest.

So now the conversation in Massachusetts has turned to cost control. And some very interesting things are beginning to happen.

They didn’t happen overnight. When Patrick took over the governor’s office in 2007, he called together top insurers, hospital executives and doctors to talk about controlling costs. He says it was an exercise in frustration.

“I finally lost my patience,” Patrick says. “Because they’d sit around the table and everyone would start their response the same way — ‘Well, governor,’ they’d say, ‘it’s complicated.’ “

Patrick says the insurers would point to the hospitals, the hospitals would point to the doctors, the doctors would say it’s malpractice suits or red tape or the imaging center down the street.

Patrick says he got fed up. “I understand it is complicated,” he says. “But the point is, we have to stop being defeated by that complexity.”

So, two years ago, the governor directed his insurance commissioner to exercise a little-used power to turn down a requested rate increase because it was excessive. Not every state has this power.

Insurance companies were outraged. But Dreyfus of Blue Cross Blue Shield now says it was a pivotal point.

“It sent a message to the entire health care community and the business community that we had to change,” Dreyfus says.

And change seems to be happening. Insurers have torn up their contracts with hospitals calling for annual reimbursement increases of 8 percent and 10 percent, and negotiated agreements providing for 3 percent, 2 percent and even zero percent increases.

Blue Cross Blue Shield has persuaded some of the state’s biggest hospitals, and thousands of doctors, to accept a new kind of payment. Instead of getting paid every time they do something — a venerable system called fee-for-service that encourages them to provide more and more services — they’re paid a fixed amount each month for each patient.

That was tried in the 1990s, and it failed, largely because of backlash over its incentive to stint on care. The new wrinkle is that this time hospitals and doctors have to meet 60-some different quality measures to show they’re not cutting back on care.

Dreyfus says a third of his company’s 2.8 million subscribers are now on these so-called “global payment” plans, and he’s hopeful that most of the state will be on this kind of reimbursement within the next two to three years.

The various steps seem to be working to moderate Massachusetts’ historically high health care inflation rates. “We’ve got some more work to do here,” the governor says, “but average premium increases were almost 17 percent two years ago. They are less than 2 percent right now.”

But he doesn’t trust that it will automatically go on that way. Patrick and many others, inside and out of government, say Massachusetts now needs some legislation to lock in these changes and go further — cut down on administrative costs, reform the malpractice system and other innovations.

The big idea you often hear these days is to hold total Massachusetts health spending to a target tied to the state’s overall economic growth.

“I want to assure … that it’s sustainable,” Patrick says, “that we don’t continue to have increases above the rate of growth in the economy.” Otherwise, he says, health care will “eat up everything else.”

Legislators, who are wary of tampering with a health sector that accounts for 20 percent of the state’s economy, are expected to come up with their own proposals this spring.

But significantly, no one is talking about repealing the 2006 law. Not even businessmen like Fred Difinis, who runs a small business selling parts for playground equipment. He’s unhappy with the Massachusetts health plan because it requires him to buy coverage for prescription drugs, which he says he doesn’t need.

“I’m not sure I necessarily want to see the law repealed,” he says. “What I want to see is some balance on the cost side of the equation.”

If Massachusetts can do that, it might become a national model — again.

– Provided by Kaiser Health News.

View full post on All Stories

Washington, DC, United States (KaiserHealth) – This fact sheet was released by the White House in advance of President Barack Obama’s Feb. 10 comments about mandated health insurance coverage for contraception.

THE WHITE HOUSE

Office of the Press Secretary

____________________________________________________________________

FOR IMMEDIATE RELEASE

Feb. 10, 2012

FACT SHEET: Women’s Preventive Services and Religious Institutions

Thanks to the Affordable Care Act, most health insurance plans will cover women’s preventive services, including contraception, without charging a co-pay or deductible beginning in August, 2012. This new law will save money for millions of Americans and ensure Americans nationwide get the high-quality care they need to stay healthy.

Today, President Obama will announce that his Administration will implement a policy that accommodates religious liberty while protecting the health of women. Today, nearly 99 percent of all women have used contraception at some point in their lives, but more than half of all women between the ages of 18-34 struggle to afford it.

Under the new policy to be announced today, women will have free preventive care that includes contraceptive services no matter where she works. The policy also ensures that if a woman works for religious employers with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide contraception coverage, but her insurance company will be required to offer contraceptive care free of charge.

The new policy ensures women can get contraception without paying a co-pay and addresses important concerns raised by religious groups by ensuring that objecting religious employers will not have to provide contraceptive coverage or refer women to organizations that provide contraception. Background on this policy is included below:

Section 2713 of the Affordable Care Act, the Administration adopted new guidelines that will require most private health plans to cover preventive services for women without charging a co-pay starting on August 1, 2012. These preventive services include well women visits, domestic violence screening, and contraception, and all were recommended to the Secretary of Health and Human Services by the independent Institute of Medicine of the National Academy of Science.

Today, the Obama Administration will publish final rules in the Federal Register that:

Exempts churches, other houses of worship, and similar organizations from covering contraception on the basis of their religious objections.

Establishes a one year transition period for religious organizations while this policy is being implemented.

The President will also announce that his Administration will propose and finalize a new regulation during this transition year to address the religious objections of the non-exempted religious organizations. The new regulation will require insurance companies to cover contraception if the non-exempted religious organization chooses not to. Under the policy:

Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.

Religious organizations will not be required to subsidize the cost of contraception.

Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception.

Insurance companies will be required to provide contraception coverage to these women free of charge.

Covering contraception saves money for insurance companies by keeping women healthy and preventing spending on other health services. For example, there was no increase in premiums when contraception was added to the Federal Employees Health Benefit System and required of non-religious employers in Hawaii. One study found that covering contraception lowered premiums by 10 percent or more.

###

—–

– Provided by Kaiser Health News.

View full post on All Stories

Philadelphia, PA, United States (AHN) – Three U.S. women born with a rare inherited eye disease that impairs vision have improved their sight after normal genes were injected in their retinas to replace mutant genes that cause the disorder.

The gene therapy performed by Jean Bennett of the University of Pennsylvania’s Mahoney Institute of Neurological Sciences and her colleagues shows promise in treating Leber’s congenital amaurosis (LCA), wherein mutant genes prevent photoreceptors or light-sensitive cells in the retina from functioning properly to produce vision.

In their study published in the Feb. 8 issue of Science Translational Medicine, Bennett and her team described the therapy as the use of virus to carry normal RPE65 genes in an area of the retina to make eyes more sensitive to light and the brain more responsive to optical input.

The RPE65 produces an enzyme that breaks down retinol into a substance that photoreceptors need to function properly. However, a mutant RPE65 prevents production of such enzyme.

When the researchers injected normal RPE65 into the LCA-affected eye of three women, their vision improved two weeks after the surgery. The improved vision was known after the women successfully navigated an obstacle course in dim light, recognize people’s faces and read large signs.

Treatment of the other eye of the women further improved their vision, according to Bennett.

The initial study involved the treatment of 12 adult patients who are legally and six of them regained their sight. Bennett’s team plan to conduct the gene therapy on more patients to bolster their study.

View full post on All Stories

St. Paul, MN, United States (KaiserHealth) – Minnesota lawmakers are grappling with a new question: How close can they get to setting up a health insurance exchange without passing a new state law?

The state, which has a Democrat in the governor’s mansion and Republicans in control of both houses of the legislature, saw exchange legislation fail in the last session. And prospects for a law’s passage are not much better in the current session.

The exchanges are online marketplaces, established by the federal health law, that will allow consumers and small businesses in a given state to buy health insurance based on detailed comparisons of competing plans.

Minnesota’s Democratic Gov. Mark Dayton said last week that at some point — not necessarily this year — authorization will be needed from the state legislature to open a Minnesota exchange for business. But he also suggested that much work could be done ahead of legislative action.

“We probably don’t have the ability to implement the whole thing but we can get to the starting gate by Dec. 31st,” he said.

Dayton referred to the federal deadline of Jan. 1, 2013, when all states are supposed to present their exchanges to the federal government for certification. Certification means that the exchange is adequate under the law and the federal government won’t impose its own exchange on a state.

Minnesota Commerce Commissioner Michael Rothman said nothing in the federal health care law requires states to pass legislation to set up their state health insurance exchanges. He said the federal review will be based on other benchmarks.

“It will look at how far along we’ve built the exchange, the operations, the IT, how far Minnesota is ready and prepared to have its own Minnesota-made exchange, rather than having the federal option imposed on us and certification does not require legislation,” Rothman said.

Several other states — including Indiana, Iowa, Alaska and Mississippi –are moving forward with exchange planning without authorizing legislation.

But a key Republican lawmaker pushed back against the notion that exchange legislation is optional in Minnesota. Sen. David Hann, chair of the Health and Human Services Committee, said the governor shouldn’t move forward on an exchange unless the legislature passes a bill authorizing one.

“If we fail to do that, that does not then result in the default position of the governor writing the law,” Hann said. “That there’s no provision under our constitution to do it and I can’t believe, and don’t accept the view that the federal government can set aside the requirements with the respect of the Minnesota constitution to lawmaking.”

The Dayton Administration has repeatedly said it wants the Republican-controlled legislature’s input on creating and designing a state insurance exchange.

Last year the legislature defeated an exchange bill, even though it was sponsored by Republicans. As this session gets underway, Republicans still appear divided. When Dayton created an advisory exchange task force last fall, Republicans refused to fill their two seats on the panel.

That offer fell short, said Rep. Steve Gottwalt, R-St. Cloud, chair of the House health and human services reform committee.

“Let’s have a meaningful negotiation. We’re going to bring our people, you bring your people, and we’ll start talking about it. That’s not happening,” Gottwalt said.

But all that the feds require under proposed rules is that states submit an exchange plan that satisfies four broad criteria: The exchange must be consistent with provisions of the health care law, help low-income users obtain tax credits toward buying insurance; it must serve the entire geographical area of Minnesota; and must have reinsurance — essentially a protection against catastrophic losses for insurers that sell their policies on the exchange.

The Dayton administration could meet most of those criteria without authority from the legislature, said Fred Morrison University of Minnesota law professor and an expert on Minnesota constitutional law.

“You could establish an exchange, it’s rather like an insurance brokerage; you could create the information systems that are necessary to work that exchange; and you could operate that over the state as a whole,” Morrison said. “Those three are easy.”

What is not easy, Morrison said, is the reinsurance program. That would require some taxing authority and he doubts an executive order by the governor would be enough.

There could be a way around that, however. Last year the Obama administration said state exchanges that don’t meet all the law’s requirements could win conditional certification well into next year. In addition, the federal government would help those states fill in the blanks of what they couldn’t accomplish through a state-federal partnership.

That scenario could buy some time for the Dayton administration to work with a potentially friendlier legislature in 2013, after this year’s elections.

– Provided by Kaiser Health News.

View full post on All Stories

United States (KaiserHealth) – When the oversized postcard arrived last August from Provena St. Joseph Medical Center promoting a lung cancer screening for current or former smokers over 55, Steven Boyd wondered how the hospital had found him.

Boyd, 59, of Joliet, Ill., had smoked for decades, as had his wife, Karol.

Provena didn’t send the mailing to everyone who lived near the hospital, just those who had a stronger likelihood of having smoked based on their age, income, insurance status and other demographic criteria.

The nonprofit center is one of a growing number of hospitals using their patients’ health and financial records to help pitch their most lucrative services, such as cancer, heart and orthopedic care. As part of these direct mail campaigns, they are also buying detailed information about local residents compiled by consumer marketing firms — everything from age, income and marital status to shopping habits and whether they have children or pets at home.

Hospitals say they are promoting needed services, such as cancer screenings and cholesterol tests, but they often use the data to target patients with private health insurance, which typically pay higher rates than government coverage. At an industry conference last year, Provena Health marketing executive Lisa Lagger said such efforts had helped attract higher-paying patients, including those covered by “profitable Blue Cross and less Medicare.”

Strategy Draws Fire

While the strategies are increasing revenues, they are drawing fire from patient advocates and privacy groups, who criticize the hospitals for using private medical records to pursue profits.

Doug Heller, executive director of Consumer Watchdog, a California-based consumer advocacy group, says he is bothered by efforts to “cherry pick” the best-paying patients.

“When marketing is picking and choosing based on people’s financial status, it is inherently discriminating against patients who have every right and need for medical information,” Heller says. “This is another example of how our health system has gone off the rails.”

Deven McGraw, director of the health privacy project at the Center for Democracy and Technology in Washington, says federal law allows hospitals to use confidential medical records to inform patients about things that may help them.

“You want health providers to communicate to patients about health options that may be beneficial to their health,” McGraw says. “But sometimes this is about generating business for a new piece of equipment that the hospital just bought.”

Using such information for marketing “creeps closer to the line,” between what is legal and what is not, she says.

Hospital officials such as Denise Beaudoin of Detroit’s Henry Ford Health System say what they do is legal and that the sophisticated targeting approach-called “customer relationship marketing”-simply helps them deliver information to the people most likely to use it.

They say hospitals are adopting strategies used for decades by the retail, travel and communications industries, which have flourished with the growth of online companies such as Amazon and Google. Buy a book on Amazon and it will suggest a title with similar subject. Search for information on Alaskan vacations on Google, and an ad pops up for a cruise line.

HCA, Trinity Use Approach

At a time when government and private insurers are tightening reimbursements, more hospitals are turning to the same approach to drive admissions. An estimated 20 percent of them, including large academic medical centers and large chains, such as Nashville-based HCA and Novi, Mich.-based Trinity Health, now use the strategy. And the trend is expected to accelerate as more hospitals adopt electronic health records, says Guy Miller, a Chicago health care consultant.

Tess Niehaus, vice president of marketing at St. Anthony’s Medical Center in St. Louis, says the approach has been quite successful and makes no apologies for going after the most lucrative business.

“We are here to serve everybody but we market for good paying patients because it preserves our ability to serve everyone,” she says.

St. Anthony’s marketers use patient data to personalize mailings with an individual’s name and a picture of someone of similar age or gender. It is more expensive, but the strategy results in better response rates, she says. From October 2010 through July 2011, St. Anthony’s spent $25,000 on a targeted mailing to 40,000 women for mammogram screenings. The letters led 1,000 women to get the test, which generated $530,000 in revenue from screenings, biopsies and other related services, she says.

To help devise the campaigns, hospitals like St. Anthony’s share patient data with marketing staff and outside consultants. Anyone with access to patient records is required by federal law to sign nondisclosure agreements.

‘I Am Really Bothered’

While the practice is legal, most people would be shocked to know their records may be shared with nonmedical personnel and outside firms to help hospitals attract business, says Pam Dixon, executive director of the World Privacy Forum, an advocacy group based in California. “I am really bothered by the overabundance of information that is flowing that is unnecessary and risky,” she says.

While hospitals may profit from offering cholesterol tests and mammograms, the big payoff is in what those screenings may lead to – additional tests and procedures, including surgery.

“It’s all about downstream revenue,” says Patrick Kane, senior vice president of marketing at Cape Cod Healthcare in Massachusetts who used such approaches at Wellmont Health System in Kingsport, Tenn. “The old adage in business is that it’s easier to sell an existing customer new services, rather than find a new customer.”

Provena’s six hospitals in Illinois embraced targeted marketing in 2010, mailing information about screenings and educational events to 293,000 people. The mailings led to more than 50,000 patient visits – a 17 percent response rate, several times that typically seen in direct mail efforts, according to the industry presentation hospital officials made last year in Orlando. After accounting for marketing costs, those visits netted the system $595,000.

Some of its individual hospitals, made much higher returns. Provena St. Mary’s Hospital in Kankakee, Ill., made a $22,000 profit from a school physicals campaign, for instance, after spending $2,000 in marketing, according to the presentation.

Provena’s Lagger says the approach boosted the system’s bottom line so it could serve people regardless of insurance status. “This is a means to an end,” she says.

Tracking The Results

One of the biggest pluses for hospital executives is that they can track a campaign’s financial success by comparing the amount of services used by targeted consumers against those in a control group with the same demographic and economic characteristics, but who are not sent mailings.

When the Henry Ford Health System promoted mammograms last year in mailings to 30,000 women aged 40 or older, more than 5,700 responded — 304 more than in the control group. The mailings generated $268,000 more in profit than the control group — a return of more than four to one on the cost of the campaign, says Denise Beaudoin, vice president of customer engagement.

“Some doctors used to be leery about the effectiveness of these marketing campaigns, but not when we can show them data like this,” she says.

Beaudoin acknowledges that “it’s kind of scary how much data we have on people, but from our perspective, it’s good because we are reaching the right people at the right time for the service they need.”

Mercy Health Partners in western Michigan, part of the 47-hospital nonprofit Trinity Health system, sent a targeted cardiac screening mailing last year to 7,450 people. That resulted in 1,729 patient visits, or 7 percent more than in a control group. The campaign, which cost about $10,000, generated about $1 million in revenue and about $50,000 in profit.

“It’s a much more efficient use of marketing dollars,” says Preston Gee, Trinity’s senior vice president of strategic planning. “People like having information tailored to their own needs.”

‘Glad I Had The Test’

Much of the expertise for such campaigns is provided by three consulting firms — CPM Marketing of Madison, Wis., Medseek of Birmingham Ala. and New York-based Thomson Reuters. They typically charge hospitals $100,000 a year or more.

CPM, which merged in November with Denver, Colo.-based HealthGrades, a health ratings firm, added 100 new hospitals last year to give it a total of 400. Medseek works with more than 250 hospitals and Thomson Reuters, with 150.

“There are a lot of very rich data in health care beyond just age and gender that help steer or guide people to health services,” says John Hallick, president of CPM. “All of these things impact health, and some are better than others and you pick and choose.”

Boyd, the Joliet man who works as a home inspector, was not upset that Provena Health used information about him and his wife — both former patients — to pitch screening tests. “We lost our privacy long ago and I don’t like to think about all the information that’s out there about us.”

Provena Marketing Manager Richard Matula would not say why the Boyds were included in the mailing, citing patient privacy laws. Patients’ smoking status was not used to develop the mailing list, he says.

The targeting worked in the case of Boyd, who called the number on the back and scheduled the CT scan a few days later. The $169 test showed his lungs were clear, but found potential blockages in coronary arteries that his Provena-affiliated doctor is monitoring.

“In hindsight, I’m glad I had the test,” he says.

– Provided by Kaiser Health News.

View full post on All Stories

London, England, United Kingdom (AHN) – Malaria may be killing twice as many people as experts previously thought, and it could also be affecting older children and adults, long considered to be the least susceptible, according to a study published Friday in the journal Lancet.

The World Health Organization reports that malaria cases and deaths have been falling since 2004. The decline is largely attributed to large campaigns to distribute bednets, spray homes with insecticides and make better drugs available.

In December, the WHO reported about 655,000 had died from the disease in 2010.

However, using new available data and modeling tools, researchers put the 2010 figure at about 1.2 million, and note about 90 percent of the deaths were in Africa.

The new findings also challenge the belief that children who grow up in areas with malaria develop immunity to the disease as they get older.

Doctors have long believed that children under 5 years old and pregnant women were the most susceptible to the mosquito-borne disease. However, new findings contradict that notion.

The researchers analyzed data on malaria deaths from 1980 to 2010, including information not used in prior studies. The research was funded by the Bill & Melinda Gates Foundation.

Complicating the ability to come up with an accurate number is that most people killed by the disease are not hospitalized, so tracking their deaths is difficult.

WHO stands by its estimates.

Data from both the WHO and new Lancet study do show the same overall trend, that malaria has been dropping since 2004.

The study’s authors project malaria deaths will fall below 100,000 some time after 2020, thanks to campaigns to eradicate the disease. Experts caution that if health officials let their guard down, malaria could come roaring back.

View full post on All Stories

United States (KaiserHealth) – The health law’s biggest changes don’t take effect until 2014, when states and insurers must be ready to begin signing up an estimated 32 million people in Medicaid and private insurance. But a successful rollout in two years hinges on critical decisions that states must make – and take quick action on – this year.

It will be difficult for many states to meet fast-approaching deadlines, and some may not make it, says Brett Graham, a managing director at Leavitt Partners, a consulting firm working with states on implementation of the law.

Time is short, and states are missing key pieces of how-to guidance from the federal government about everything from what various insurance exchange options will look like to which benefits must be included in health plans, he says. To make matters worse, states are competing for a limited pool of information technology vendors to help them get started.

“It’s a pressure cooker,” said Graham. States are “in a position where they have to act with imperfect information.”

One of the most pressing tasks for states this year has to do with the creation of exchanges, through which individuals and small businesses can buy insurance starting in 2014.

On Jan. 1, 2013, the Department of Health and Human Services will certify which states will be ready to run exchanges on their own. To win certification, a state must enact laws to fund the continuing operations of an exchange. While the federal government is providing financial help up front for the creation of exchanges, states will assume the cost once they are underway. HHS can issue a conditional certification for those states that are making progress but need more time.

Only- states plus the District of Columbia have made legislative progress toward creating an exchange, according to a Jan. 22 Robert Wood Johnson Foundation report prepared by the Urban Institute. Another 21 states have demonstrated interest, and 15 have made little headway.

While some states are aggressively moving forward, “at the other end are states that say, ‘no way, no how, we’re not doing it.’ Montana, Texas, Louisiana, Florida, they are not going to build it and they’re playing a game of chicken,” said Graham. “They’re waiting for the Supreme Court,” hoping it will effectively kill the health law in June when it rules on challenges to its constitutionality.

Most states, though, are undecided about whether to build their own exchanges and are moving forward in varying degrees. Even some states that are part of the Supreme Court challenge are moving forward: Colorado, Washington and Nevada have created exchanges.

Originally, the only alternative to a state exchange was a fully federal entity. HHS has since offered to partner with states. That way, a state could retain overall control of an exchange while passing certain responsibilities to the federal government.

But creating a full or partial federal exchange also could be problematic: Some health care analysts question whether the task will be any easier for the federal government. It faces the same short timeline as states this year, and while Obama administration officials say they have the money to fund exchange activity, some health care analysts say they aren’t so sure.

Most state legislatures are scheduled to adjourn for the year by March or April, before the Supreme Court rules, according to the National Conference of State Legislatures. Reconvening after the ruling would be difficult in an election year.

Insurers Need Long Lead Time

Insurers, which will offer coverage to individuals and small businesses through the exchanges, also are worried about the timetable. Until they know more about required benefits, for example, health plans say it’s difficult to develop new products, negotiate with doctors and hospitals and invest in information technology.

“Open enrollment has to be ready to go by Oct. 1, 2013, so in January of 2013 we have to submit our products and rates for [state] approval,” said Alissa Fox, senior vice president of the Blue Cross and Blue Shield Association. If health plans make changes before the federal government issues its specific requirements, they might have to start over, and that can be costly and time consuming, she says. “We want to change our claims processing system once, our enrollment system once.”

Last fall, Blue Cross urged HHS to release all outstanding regulations by the beginning of 2012 to give states and insurers sufficient time to make decisions.

That hasn’t happened. Among other things, states urgently need guidance on how the federal government would partner with states on exchanges or run its own exchanges, says Joy Johnson Wilson, health policy director for the National Conference of State Legislatures. “No rule, no concept,” she said. “Soon is good.”

Chiquita Brooks-LaSure, director of coverage policy at HHS, said that working with states is a “top priority … As we get similar questions from states, we will put out guidance to answer general questions. We’re going to continue to be responsive.”

On Jan. 25, HHS provided more details about the kinds of benefits insurers will be required to offer consumers and small businesses beginning in 2014. The agency had been under pressure to provide more information after releasing a general “bulletin” in December giving states broad flexibility to design benefits.

State legislators are particularly eager to learn how they can divvy up responsibilities with the federal government in the case of a federal or partnered exchange. One of the most important questions is who decides whether low-income people are eligible for Medicaid or federal subsidies to buy insurance in an exchange. The Medicaid program is being expanded to include people with income higher than currently allowed.

Graham sees a possible clash of federal and state budget interests over Medicaid, which states help fund. For the first two years Washington will pay 100 percent of the costs for the newly eligible, but the federal contribution will taper off to 90 percent beginning in 2020.

“If the federal government wants someone to be covered, it may say that person is eligible for Medicaid,” Graham said. “A state that already has a significant budget crisis won’t want to expand Medicaid. Who owns the process?”

Krista Drobac, director of the health division at the National Governors Association, says states want authority over eligibility. “It’s hard to control your program design if you’re not responsible for determining eligibility and enrolling people,” she said.

That’s why states are beginning to lay the groundwork for information technology, she says. They’re scrambling to sign technology vendors, who are in short supply.

Drobac says states have enough information to get started, even while missing details. But officials are worried.

“We’re down to the wire,” said Wilson. “When the bill passed in 2010, 2014 seemed a long way away. But when you back into what it takes to get the program up and running, it’s a very short timetable.”

– Provided by Kaiser Health News.

View full post on All Stories