Last month, journalists from the New England Center for Investigative Reporting raised serious questions about prenatal genetic screening tests, saying physicians and patients may not fully understand the results of these tests for fetal abnormalities.
In their reporting, the journalists exposed a symptom of what may be a bigger problem: the proliferation of genetic tests without a full understanding about what such testing can and cannot do. Even health insurers have struggled to understand how to pay for new genetic tests.
The stories also pointed out that federal regulators are wrestling with how to classify genetic tests. Many of these tests fall into the category of what pathologists call lab-developed tests or LDTs. These tests are not regulated by the FDA, as the NECIR journalists reported. In October, the FDA proposed regulating these tests as medical devices and clinical laboratories are pushing back, saying such regulations could interfere with the practice of medicine.
We’ll address these issues one at time. Continue reading
AHCJ has just updated its easy-to-use Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey data to include the latest release of the data by the U.S. Centers for Medicare and Medicaid Services and reflect changes in the data by CMS.
The data include survey questions about how doctors and nurses communicate, how hospitals are controlling patients’ pain, how hospitals are keeping clean and quiet, and more. AHCJ also creates a spreadsheet file that contains a timeline of the overall ratings of hospitals, with results from October 2006 to September 2013.
Each data release now includes the beginning and ending dates covered in the survey. The latest hospital survey results cover Oct. 1, 2012, through Sept. 30, 2013.
AHCJ hosted a webcast
about the CMS data, featuring several CMS officials and Charles Ornstein, a senior reporter at ProPublica and member of AHCJ’s board of directors.
The federal government is expected Wednesday to release data on the services provided by – and money paid to – 880,000 health professionals who take care of patients in the Medicare Part B program. For 35 years, this data has been off limits to the public – and now it will be publicly available for use by journalists, researchers and others.
While the data offers a huge array of stories, which could take weeks or months to report out, it also has some pitfalls. Here are six things to be aware of before you dig in:
Have a strategy for storing and opening the data. This data set is big. About 10 million rows, from what I hear. Because of that, you won’t be able to analyze it in Microsoft Excel and you might not be able to open it in Microsoft Access. You’ll want to upload it onto a data server and analyze it in a more powerful program such as SQL or SPSS. This could well serve as a barrier to entry for smaller news organizations. You may want to partner with an academic institution or another news outlet to analyze the data. Continue reading
One of the most significant trends in health care over the past few years has been the merger of physician groups with hospitals. By acquiring physician groups, hospitals and health systems can develop accountable care organizations and gain a competitive advantage by requiring employed physicians to refer patients to them.
But last week a federal judge in Idaho ruled that St. Luke’s Health System in Boise had violated antitrust law by acquiring the 40-physician Saltzer Medical Group, in nearby Nampa, Idaho, in December 2012. At the time, Saltzer was the largest independent multispecialty group practice in the state. As result of the antitrust violation, the judge said the hospital had to unwind the acquisition.
Given that the Federal Trade Commission was a plaintiff in the case, the decision raises a question about whether the FTC will pursue antitrust cases in other cases when hospitals acquire physician groups. The decision on Friday by B. Lynn Winmill, chief judge of the U.S. District Court in Idaho, marked the first time a federal court had decided an FTC case against a hospital acquiring a physician practice, as Beth Kutscher explained in Modern Healthcare. Continue reading
The recent chemical spill in West Virginia, which contaminated the drinking water of 300,000 people, became another occasion when federal agencies shut the door on reporters seeking answers, fueling public anxiety with their silence.
But after complaints from journalism organizations, including AHCJ, the U.S. Centers for Disease Control and Prevention this week issued a mea culpa and a pledge “to work to reach that critical balance between accuracy and timely release of information the public expects and needs to protect their health.”
The CDC told West Virginia health officials on Jan. 15 that pregnant women should not drink the water until the chemical, called Crude MCHM, was at “nondetectable levels.” Reporters from the Charleston (W.Va.) Gazette had a lot of questions about this order – but could get no answers from the CDC press office. Continue reading
I’m not particularly tech savvy but, one month into the HealthCare.gov website mess, here’s some of what I think we do know now – and what we are still waiting to find out.
Traffic: Volume was high, and it was one reason for the system’s poor performance. But it was not the only reason, not by any means. Nor have I seen a convincing explanation for why the administration low-balled the traffic expectations.
Code: There are millions of lines of it and it’s a mess. It’s being rewritten/worked-around. We don’t know much more than that. Continue reading
With all the website woes, you are going to hear a lot more about “delaying” the Affordable Care Act.
But what “delay” means is in the eye of the beholder – or maybe in the political affiliation of the beholder. It’s helpful to think about “delaying” the whole law or the mandate (mostly but not only a Republican idea) versus “extending” the enrollment period – but keeping the mandate in force for 2014, although it could be even weaker than it already is for the first year. That’s an idea that we’re beginning to hear from more Democrats – including several senators up for re-election in red states in 2014. Continue reading
The 8th Circuit Court of Appeals held hearings yesterday on a 2011 lawsuit brought by the Argus Leader of Sioux Falls, S.D., over whether data about the payments made to businesses participating in the Supplemental Nutrition Assistance Program, formerly known as food stamps, should be publicly available.
As Josh Gerstein reports for Politico, an attorney for the newspaper argued that “a lower court judge misinterpreted the law by ruling that a confidentiality provision for retailer applications allowed the U.S. Department of Agriculture to withhold all data on payments to those retailers.” Continue reading
As one of my colleagues emailed me the other day: “Life’s a glitch.”
We know we’ll be hearing A LOT more about the health care marketplace glitches, including testimony at some upcoming Congressional hearings.
I have not read every article that has come out about the technical problems but here are some that I think are particularly useful right now; there are going to be a lot of developments in this story so whatever I write now will soon be outdated soon.
The Wall Street Journal, on Friday, had what is probably the most detailed description (in plain English) about what the “glitch” is. Continue reading
This week’s shutdown of the federal government has some very real and immediate impacts on the nation’s older adults. Money funneled through the Older Americans Act for meals, caregivers, legal help, and family caregiver training will soon dry up, according to a report in the Eureka (Calif.) Times-Standard.
Other programs, like energy assistance for low-income families, which help pay heating bills, Temporary Assistance to Needy Families (TANF), which provides cash to the impoverished, and Social Services Block grants, which help states fund initiatives like elder abuse programs and senior services, will be hit hard if the impasse continues for any length of time.
Money for many of these programs ran out at midnight on Sept. 30; because they are either discretionary, or require re-authorization, they’re at a standstill until an appropriations bill is passed. Some local programs which rely on partial federal funding for vital senior services like Meals on Wheels face the daunting prospect of temporarily halting operations. However, spokespersons for other organizations say they’re OK for now. Continue reading