Top Research Advances
Using a heart attack patient's own bone marrow to repair their heart was among the Top 10 research advances in heart disease and stroke last year, according to the American Health Association. This process, known as cell recycling, showed improvement in the heart's ability to pump, compared with placebo, in a randomized controlled trial. Other highlights of 2005 include promising results in using varenicline to help smokers quit, the American Heart Association's scientific statement on childhood obesity, benefits from treatment with drug-eluting stents compared with bare metal stents, and efforts to highlight disparities in cardiovascular disease. The American Heart Association also highlighted a finding from the Framingham Heart Study that showed a prehypertensive patient is more likely to have a heart attack and heart disease than a person with normal blood pressure.
Cardiac Rehab Coverage Expanded
Medicare is proposing to expand national coverage for cardiac rehabilitation services to three additional groups of beneficiaries: those who have had heart valve repair or replacement, percutaneous transluminal coronary angioplasty (PTCA), or heart or combined heart-lung transplant. “With this proposed coverage decision, [the Centers for Medicare and Medicaid Services] seeks to expand coverage to a greater number of beneficiaries with cardiac illness,” said administrator Dr. Mark B. McClellan. “But just as importantly, we hope that our proposed decision will raise the public's awareness regarding cardiac rehabilitation services in general.” The agency further proposed that cardiac rehabilitation services be comprehensive and include medical evaluation, education, and nutrition services. Medicare has covered cardiac rehabilitation services for beneficiaries following heart attack, coronary artery bypass surgery, and angina since the 1980s and this coverage will continue.
Treatment Awareness
Only about 55% of women over age 35 years said they believe they understand how to treat heart disease, according to a survey sponsored by the Cordis Corp., maker of the CYPHER sirolimus-eluting coronary stent, and the National Women's Health Resource Center. For example, 43% of women surveyed said they did not know if stent placement was a good option for women even after the technology was explained. Hispanic and African American women were more likely than white women to say that they did not know any treatments for heart disease. These findings are in contrast to survey respondents' greater awareness of heart disease prevention: 73% of respondents said that they knew how to prevent heart disease.
Medicare Patients Welcome
Most physicians have kept their doors open to Medicare patients despite previous reductions in their pay, according to the reults of a study from the Center for Studying Health System Change (HSC). The proportion of U.S. physicians willing to treat Medicare patients stabilized during the last half of 2004 and the first half of 2005, with nearly 75% reporting their practices were open to all new Medicare patients. In 2004–2005, 73% of physicians reported accepting all new Medicare patients, an increase from 71% in 2000–2001, but not statistically different. Physicians' willingness to treat Medicare patients remained high, despite a 5.4% payment cut in 2002 that was not fully offset by smaller increases in subsequent years. Only 3.4% of physicians reported closing their practices to new Medicare patients in 2004–2005, also statistically unchanged from 2000–2001. Moreover, the proportion of primary care physicians accepting all new Medicare patients increased significantly from 62% in the period 2000–2001 to 65% in the period 2004–2005. “While concerns about Medicare beneficiary access have focused on physician payment, policymakers should recognize that Medicare fees are only one factor in physician decisions to accept new patients,” commented HSC President Paul B. Ginsburg, Ph.D.
Targeting Health Disparities
The Department of Health and Human Services' National Center on Minority Health and Health Disparities (NCMHD) is awarding more than $56 million in grants to advance the elimination of health disparities among racial and ethic minorities and in medically underserved communities. The grant awards include $12 million that will go to 25 institutions for community-based research programs and $10.7 million that will go to 244 health professionals in the form of loan repayment. The grants will also support research into cancer, cardiovascular diseases, child health improvement, diabetes, HIV/AIDS, and obesity.