Carotid Stent Guidelines Released
A coalition of groups has released a set of guidelines for determining when physicians are qualified to perform carotid artery stenting. “This is a very rigorous set of standards,” said Kenneth Rosenfield, M.D., director of cardiac and vascular invasive services at Massachusetts General Hospital in Boston. “This sets the bar very high.” The standards call for physicians to first be proficient in other types of stenting, and then to perform a minimum of 30 diagnostic angiograms and 25 carotid stenting procedures under supervision. They also call for physicians to be skilled in risk assessment, diagnosis, and alternative therapies for the patients involved, and to report and analyze their outcomes. The document notes that physicians of many different subspecialties will seek the training; one of the issues in developing the guidelines had been whether to restrict training only to certain specialists.
Neuroscience Partnership at NIH
The National Institutes of Health is breaking down barriers between 14 of its institutes and centers to better coordinate research done on the brain and nervous system. Neuroscience is “one of the most important and dynamic scientific frontiers for biomedical and behavioral research in this century,” said NIH Director Elias A. Zerhouni, M.D. “Greater synergy and cross-fertilization across research disciplines will be needed for progress in our understanding of this complex system and new discoveries of benefit to our patients.” The partnership blueprint will allow resources established by one institute or center to be open to scientists supported by other centers. The blueprint is available at
http://neuroscienceblueprint.nih.gov
Site for Parkinson's Trials Launched
A consortium comprising patient groups, private foundations, government, and industry has launched a new Web site dedicated to clinical trials for Parkinson's disease. The site,
Health Care Spending by the Elderly
U.S. seniors spent an average of $11,089 on personal health care goods and services in 1999, but nearly half that amount was reimbursed by Medicare and another 15% was paid for by Medicaid, according to a report prepared by the Centers for Medicare and Medicaid Services' Office of the Actuary. The amount spent by seniors was almost four times the average of $2,793 for people under age 65. “What this report shows is the importance of our efforts to bring down the high cost of health care for America's seniors,” CMS Administrator Mark B. McClellan, M.D., said in a statement. Although people 65 and over made up only 13% of the population in 1999, they accounted for 36% of personal health care spending, according to the report.
Improper Payments Increase
Medicare made about $20 billion in improper payments in fiscal year 2004, a report from the Centers for Medicare and Medicaid Services found. The sum included $900 million in underpayments to providers due to errors made by insurers and $20.8 billion in overpayments to providers. CMS hopes to cut the rate of erroneous payments more than half, to 4%, in 2008 by conducting more extensive payment reviews and other quality controls. “We have made significant strides in how we measure the error rate in Medicare payments, and that will enable us to do even more to bring it down,” said CMS Administrator Mark McClellan, M.D. A recent report from the Congressional Budget Office suggested that some of Medicaid's reimbursement policies may have contributed to increasing markups by pharmaceutical manufacturers.
Patients Turn to CAM
Discouraged by costly conventional treatments, 6 million Americans turned to alternative medicines in 2002 for chronic pain and other conditions, the Center for Studying Health System Change reported. These alternatives “may be of questionable value,” said HSC President Paul Ginsburg, Ph.D. About 63% of 31,000 adults said they used herbal remedies, yet two of the most popular remedies—St. John's wort and kava—can have serious side effects. The conventional medical professional was rarely aware of their patient using an alternative treatment.