Tag Archives: iom

Friday brings IOM’s report on defining essential health benefits

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

On Friday, Oct. 7, the Institute of Medicine plans to release its essential health benefits report – those are the benefits that plans for individuals and small businesses will have to cover per the Patient Protection and Affordable Care Act.

The benefits fall under 10 general categories including emergency services, behavioral health treatment, preventive services and chronic disease management.

There may be a bit of confusion about what IoM’s task is: It isn’t defining the benefits – it is producing some methodology that the U.S. Department of Health and Human Services can use when it defines the benefits (which will generate all kinds of stories, with outrage/glee from assorted disease advocates, drug makers, medical groups, etc., not to mention another round of debate about government role in determining such things and maybe some good reporting about the evidence base for decision-making.)

Anyhow, the IoM  had some preliminary meetings, naturally, and in August it published a summary of one of its workshops. It gives an interesting glimpse into what the experts are weighing and thinking about as you prepare to cover this issue in the coming months (and it will also generate some stories about what states are going to do about their insurance coverage mandates, if they aren’t wrapped into essential benefits)

Here’s the two-page version of the workshop summary. Probably no reason to read the whole report as it’s going to be overtaken in a couple of days, but if you are interested in the path the IoM took, here’s the link.

  • Balancing generosity and affordability – the package needs to be comprehensive but not ridiculously expensive.
  • How to define a “typical” employer plan-the starting point for EHB determinations.
  • Which state mandates to include (States can maintain those rules even if not in federal EHB but they have to pay costs in subsidized programs)
  • Specificity versus flexibility in the guidelines (how much plans/states can differ and still be roughly comparable)
  • Determining medical necessity – and how to apply it to individual patients. But also setting rules in ways that don’t discourage innovation and progress.
  • Protecting patients – i.e. making sure that people get what they need even if they are old, sick, disabled, etc. (My translation, not the IoM’s words: no fuel for another round of “death panel” charges).
  • Ensuring fair processes – “public engage­ment, independence of decision makers, and transparency of information used”

The report is embargoed until 12:01 a.m. EDT on Friday, Oct. 7, but reporters can get an advance copy after 2 p.m. EDT on Thursday, Oct. 6. Members of the committee will discuss their findings and recommendations in a briefing at 11 a.m. EDT on Friday. The briefing will be webcast and questions can be submitted via a link on the National Academies website.

To get the report in advance, arrange interviews with committee members, or register to attend the public briefing, contact the National Academies’ Office of News and Public Information at 202-334-2138 or news@nas.edu.

Report links Gulf War, illness; calls for more study

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Institute of Medicine has released a report, sponsored by the Department of Veterans Affairs, on certain health issues in Gulf War veterans.

gulf
Photo by woody1778a via Flickr

The committee behind the report wrote that insufficient data from immediately before and after deployment made drawing clear conclusions difficult, but called for a commitment to monitoring and caring for what the release called “persistent, unexplained symptoms” in Gulf War veterans. It also said that interaction between genes and the environment was likely a factor in veterans’ “multisymptom illness.”

The key paragraph from the press release (emphasis mine):

Military service in the Persian Gulf War is a cause of post-traumatic stress disorder in some veterans and is also associated with multisymptom illness; gastrointestinal disorders such as irritable bowel syndrome; substance abuse, particularly alcoholism; and psychiatric problems such as anxiety disorder, says a new report from the Institute of Medicine, the latest update in a series of reports on the Gulf War and veterans’ health. There is some evidence that service during the conflict is linked to fibromyalgia and chronic widespread pain, amyotrophic lateral sclerosis, sexual difficulties, and death due to causes such as car accidents in the early years after deployment, but the data are limited, said the committee that wrote the report.

IOM report details H1N1 resources

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Like many organizations, the Institutes of Medicine had an eye on pandemic influenza (and related pandemic diseases) well before H1N1 started making some such fears a reality.

Now, the IOM has assembled relevant flu pandemic research from the past few years in one handy guide (PDF) that focuses on issues that would be particularly useful when preparing for a fast approaching pandemic, including public communication, physical and medical prevention measures, school closings and other ‘outbreak mitigation’ measures, and monitoring.

Institute of Medicine prescribes ethics overhaul

Scott Hensley

About Scott Hensley

Scott Hensley runs NPR's online health channel, Shots. Previously he was the founding editor of The Wall Street Journal's Health Blog and covered the drug industry and the Human Genome Project for the Journal. Hensley serves on AHCJ's board of directors. You can follow him at @ScottHensley.

A pillar of the medical establishment criticized industry freebies for doctors in a wide-ranging report that calls for an end to practices that threaten to corrode physicians’ independent judgment and public trust in the profession.

The Institute of Medicine, an arm of the National Academy of Sciences, released a long-awaited report Tuesday that says disclosure of potential conflicts is a necessary first step but isn’t enough to safeguard medicine.

Some of the recommendations, if adopted, would eliminate longstanding practices, such as doctors’ use of free samples of brand-name drugs for all but the poorest patients, industry funding of continuing medical education and company ghostwriting of studies published or presented by doctors.

questions-and-moneyColumbia University’s David Rothman bluntly told the New York Times, “With the I.O.M.’s endorsement, issues that were once controversial now are indisputable. Conflicts of interest in medicine are no longer acceptable.”

You can read the report free online or download the executive summary. Reporters can get the report free from the National Academies press office, according to a news release.

Though many of the recommendations have already gained traction with universities, law makers and companies, some criticized the report as being short on facts to support its recommendations. Thomas Stossel, a Harvard Medical School professor, told The Wall Street Journal, “There is no evidence for the need of these regulation. It’s high-end welfare for the ethicists and maybe job security for the academic administrators.”

Bio Bonus: The report includes bios of committee members, including Peter Corr, formerly a research executive at Pfizer, who still holds stock and options in the drug maker. See the lineup starting on page 331.

Reports on health indicators, HIPAA released

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

The Institute of Medicine has proposed 20 specific health indicators to measure the overall health and well-being of Americans. These 20 indicators will “help Americans track the nation’s progress on improving our health and the effectiveness of public health and care systems,” the report says.

The indicators include things like life expectancy, mortality, unhealthy days, chronic disease and psychological distress.

Stakeholders and Public Should Use 20 Specific Health Indicators to Measure and Track Health and Well-Being of Americans” is available as a free download from the National Academies Press.

HIPAA privacy rule is inadequate

The National Academies Press also has published “Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research,” a report that concludes the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.

From the report: “The HIPAA Privacy Rule is difficult to reconcile with other federal regulations governing research involving people and their personally identifiable information. Moreover, organizations that collect and use health data vary greatly in how they interpret and follow the rule, and the rule does not apply uniformly to all health research. The committee’s review of published reports, testimony from patient and privacy advocates and the health research community, and other sources of information led it to conclude that the way the rule is currently interpreted does not adequately protect privacy and impedes important health research.”

The report notes that security breaches are a growing problem for health information databases and that encryption should be required for all laptops, flash drives, and other portable media containing such data.

A report brief is available as a four-page PDF. Journalists can get PDF or printed copies of the full report by contacting the National Academies Office of News and Public Information at 202-334-2138 or news@nas.edu.