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Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

Student Posts Are Unprofessional

A majority of medical schools say they have experienced incidents of students posting unprofessional content online, researchers reported in the Journal of the American Medical Association. However, only 28 of the 78 schools surveyed said they had policies to address such postings, which typically occur on social networking sites, media-sharing sites, blogs, wikis, and podcasts, the authors said. Only six schools said they had encountered patient confidentiality violations, such as online descriptions of identifiable patients, and issues of conflict of interest were rare. But posts using profanity, discriminatory language, depictions of intoxication, and sexually suggestive material were common. Two-thirds of the schools gave students informal warnings, while three schools said they dismissed the students involved.

EHRs Improve Care Quality

Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies do, according to a new study from RAND Corp. Researchers looking at 305 groups of physicians in Massachusetts found that EHR-equipped practices were more likely to deliver better care for diabetes and to provide some health screenings, as long as the EHR systems were used routinely and included advanced functions such as reminders to physicians. The quality differences were small, but the authors said they were surprised at how few strategies to improve quality actually were linked to better performance. The study was published in the Annals of Internal Medicine.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. Announced at a press conference by President Obama, the grants come from the American Recovery and Reinvestment Act passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, the department said.

Medicaid Funds More Home Care

Annual Medicaid spending for assisted living and community-based services ballooned by more than 80% in the past 7 years as states sought alternatives to costly nursing home care, a report from the National Center for Assisted Living found. Over the same period, Medicaid's nursing home spending grew only about 10%, and the number of nursing home beds dropped nearly 1.6%, the report said. The program's bills for nursing home care, at $47 billion in 2007, were still far higher than the nearly $17 billion states spent on alternative services such as home care and assisted living. But “consumer preferences for options to institutional care and the states' interest in reducing Medicaid-expenditure growth rates have created a shift in the supply and utilization of nursing homes over the past several years,” the assisted living group concluded in its report.

Resistance Cuts Antibiotic Sales

Antibacterial drugs will soon see a slump in sales, partly because of declining effectiveness and partly because of generic competition, according to the market research company Kalorama Information. The segment had sales growth of just over 3% in 2008 and 2009, but sales will rise only 1.1% in 2010 and will decline by 0.6% in 2011, Kalorama estimated in its report “Worldwide Market for Anti-Infectives (Antifungals, Antibacterials and Antivirals).” The company pegged the 2009 world market for antibacterial drugs at $24.5 billion. It forecast global sales of all classes of anti-infectives to hit $53.3 billion, up from $45.3 billion in 2006.

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