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Diabetes and Hypertension Often the Gateway to CKD
More than 70 percent of new cases attributable to these conditions.
Diabetes accounts for 44 percent of new CKD cases, followed by hypertension for another 27 percent. As rates of these conditions in the U.S. population continue to escalate, incidence of kidney disease is keeping pace as well, according to the U.S. Renal Data System's 2008 data report.
Based on findings from Medicare data and the National Health and Nutrition Examination Survey results, the report states CKD has "emerged as a major public health issue" due to these sharp inclines. Recognized CKD more than tripled in the Medicare population between 1995 (1.8%) and 2006 (6.4%), with a marked increase of 65 percent between 2002 and 2006.
March Is National Kidney Month
Health groups nationwide are urging patients to "get the test."
The National Kidney Foundation, in partnership with state and local stakeholders across the U.S., has announced March is National Kidney Month, an occasion to highlight the importance of urine microalbumin screenings for at-risk patient groups. People considered at risk are those with diabetes or hypertension, a family history of kidney disease, or who are 60 years or older. Public service announcements in print and broadcast media are urging patients to "love your kidneys" and get screened for kidney disease.
Proteinuria Can Elevate Kidney Disease Risk for Healthy People
Simple urine test shows promise for early identification of disease.
Measuring the amount of protein lost in urine can identify individuals at risk for developing kidney disease. According to a study appearing in the Journal of the American Society of Nephrology, a simple urine screen can address the epidemic of kidney disease.
Researchers concluded that individuals with high urinary protein levels are at high risk for losing their kidney function and needing dialysis or a kidney transplant. The higher the level of proteins in the urine, the higher the risk of needing dialysis or a kidney transplant and the more rapid the rate of kidney function decline.
Kidney Disease in African-Americans Often Goes Undetected
New study finds five in six with the disease are unaware they have it.
African-Americans may have a disproportionate rate of kidney failure--approximately four times higher than Caucasians--because awareness of necessary screening is low among patients and their providers alike, according to findings from the Jackson Heart Study reported in the February issue of the American Journal of Kidney Diseases. This study included 3,400 African-American patients who were screened for kidney disease and other illnesses. About 20 percent had kidney disease, but very few were aware of it. For every six individuals with kidney disease, about only one person knew it. Researchers cite this lack of awareness of the disease in its early stages--when early treatment could prevent damage from progressing to kidney failure--as a key issue in improving outcomes for African-American patients.
"Much of the problem of patient awareness is due to a lack of awareness of medical practitioners" who continue to adhere to out-dated standards of kidney function, Dr. Michael F. Flessner, at the University of Mississippi Medical Center in Jackson, said in a prepared statement. "Most physicians were trained in an era in which serum creatinine was used as an absolute indicator of kidney disease."
Updating clinicians' knowledge of the clinical standards for kidney disease screening and diagnosis could improve rates of early diagnosis, researchers say. Currently clinical standards call for screening patients with diabetes, hypertension or high cholesterol for protein in their urine with an annual microalbumin test.
Keep Up to Date with Latest on CKD and Treatment
Earn free CME/CE with online educational events.
Visit TMF's Campaign for Kidney Health Web site for a list of physician and staff Web-based educational seminars that cover a range of timely CKD-related topics, including identification, interventions and improving outcomes. Continuing education credits vary by seminar sponsor.
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HIMSS and EHR Association Welcome Stimulus Package Funds for HIT
Enhanced standards and privacy protections will accelerate adoption.
The Healthcare Information Management Systems Society (HIMSS) in partnership with the Electronic Health Records (EHR) Association supports the federal legislation
that will direct funds toward health information technology, standards and enhanced privacy regulations.
"We have worked closely with the U.S. House of Representatives, U.S. Senate and industry partners to provide information on the practical application of HIT throughout the development of this important economic recovery package," said Justin Barnes, EHR Association Chairman. "It's not just about greater adoption of electronic health records, which, of course, are an important infrastructure component of the stimulus package, but, more fundamentally, we want to ensure Americans are afforded the real benefits of interoperable health IT and EHRs, which are proven to save lives, reduce costs and increase access to quality care."
What the Stimulus Package means for physician EHR users.
On February 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act of 2009. This legislation contains over $25 billion for use in developing health information technology infrastructure and promote EHR use by physicians and other health care providers. Money is appropriated for national initiatives, grants to states and creation of regional extension centers to provide resources and support for selection, adoption, implementation and connectivity of HIT technology. Specifically this legislation allocates approximately $17 billion in incentive payments through Medicare and Medicaid reimbursement programs to assist physicians in adopting electronic health record technology.
To receive incentive payments a provider must already have purchased an electronic health record and be using it to a level of "meaningful use." The term "meaningful use" is defined broadly in the bill. Providers must meet three criteria: (1) use a "certified" product that has the capability of ePrescribing; (2) the EHR product must be interoperable and connected to exchange relevant health information; and (3) providers will be required to submit data on selected quality measures. Further details on these requirements will be provided by the Secretary of Health and Human Services before the incentive program begins.
Under the Medicare reimbursement program individual providers may be eligible for incentive payments (distributed over five years) up to a maximum of $44,000. Providers are eligible to apply for incentive payments as soon as they can demonstrate "meaningful use" of their EHR. Physicians operating in a hospital environment (ED, anesthesiology, hospitalists, etc.) are ineligible for incentive payments.
Incentive payments are paid over a multiyear schedule ending in 2016. Providers who apply in 2011 will receive a total of five payments totaling $44,000. The five-year incentive payments schedule would include $18,000 in 2011, $12,000 in 2012, $8,000 in 2013, $4,000 in 2014 and $2,000 in 2015. Providers who apply in 2012 would receive a similar five-year payment schedule ending in 2016. For providers applying for the first time in 2013 total payment is reduced to $39,000, and for those applying in 2014, the total incentive payment is $24,000. There are no incentive payments for those applying after 2014.
Beginning in 2015 physicians not showing "meaningful use" will have their Medicare fee schedule reduced by 1% followed by an additional 1% for each subsequent year to a maximum reduction of 5%.
Only 39 Percent of CRC Caught in Early Stages
Increased screening rates could dramatically improve survival rates for colon cancer.
The American Cancer Society estimates 50,000 Americans will die from colorectal cancer (CRC) in 2009, and many of these deaths could be avoided if routine screening rates increased among those most at risk.
When CRC is detected early, the five-year survival rate is 90 percent. However, only 39 percent of new cases are diagnosed at an early stage. The Centers for Disease Control and Prevention estimates that if everyone aged 50 years old or older were screened regularly, as many as 60 percent of deaths from this cancer could be avoided.
Beginning at age 50, all men and women should be screened for CRC, according to American Cancer Society recommendations. Medicare will pay for either 100 percent or 80 percent of the screening test, depending on which one is performed. |
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