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Volume 3 Issue 1
| Fall 2012
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Dear Readers,
Welcome to the Fall / Winter 2012 issue of "Patient Navigator Notes," a quarterly newsletter to inform our readers about important health topics. If you are a new reader, we hope you'll take a look! For those interested in learning about patient advocacy, there is still time to register for the National Association of Healthcare Advocacy Consultants (NAHAC) fourth annual conference " The Leading Edge of Reform: Roles and Goals for Healthcare Advocates" to be held in Boston November 2-3, 2012. Founder and President Patient Navigator, LLC
Guiding your journey through illness and aging .... |
Medicare Open Enrollment Begins October 15
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Medicare's 2012 Open Enrollment Period will run from October 15 through December 7. During this period, people with Medicare can change their Medicare health and prescription drug plan coverage options without restriction. Changes that are made on or before December 7 will take effect on January 1, 2012.
However, we encourage patients to pay attention and to understand their coverage, particularly in light of changes that may be coming as a result of Federal budget negotiations.
A word of caution: Private Medicare Advantage Plans (Part C) can start marketing to you as of October 1. These are private HMO insurance plans that contract to Medicare to provide your services; they are not traditional Medicare. Before you make any decisions or changes to your Medicare, do your research. Don't let a fancy marketing brochure fool you. Here is a good explanation of the differences between traditional Medicare and Medicare Advantage.
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Acupuncture and Chronic Pain Study
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A meta-analysis published in the September 10 online edition of the Archives of Internal Medicine has concluded that, "Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option."
This conclusion comes from a fresh analysis of initial raw data that had been collected by 29 studies previously conducted in Germany, Spain, Sweden, the United States and the United Kingdom. Collectively, these past investigations had involved nearly 18,000 patients. The meta-analysis took six years to complete.
The meta-analysis included studies that compared acupuncture with usual care, like over-the-counter pain relievers and other standard medicines. It also included studies that used sham acupuncture treatments, in which needles were inserted only superficially, for example, or in which patients in control groups were treated with needles that covertly retracted into handles.
The researchers, led by Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study, found that acupuncture outperformed sham treatments and standard care when used by people suffering from osteoarthritis, migraines and chronic back, neck and shoulder pain.
"This has been a controversial subject for a long time," he told the New York Times. "But when you try to answer the question the right way, as we did, you get very clear answers. "We think there's firm evidence supporting acupuncture for the treatment of chronic pain."
The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health sponsored the study. You can learn more in the NCCAM Spotlight and its acupuncture information page.
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Institute of Medicine Report on U.S. Healthcare System Waste
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According to a report by the Institute of Medicine (IOM), an independent, nonprofit organization established in 1970 as the health arm of the
National Academy of Sciences, the U.S. healthcare system wasted more than $750 billion in 2009. Yes, billion.
What will $750 billion get you these days? For example:
- NASA's new Mars rover, Curiosity, cost $2.5 billion.
- The U.S. contribution to the International Space Station is about $50-$100 billion since 2001, including the Space Shuttle missions.
- $750 billion is about 1/5th (20%) of the 2013 U.S. Federal budget.
And again, it's important to emphasize that this $750 billion was wasted in just one year. It's probably safe to assume we have likely already wasted a comparable sum in each of 2010, 2011, and 2012. So what was the money wasted on in 2009? According to IOM's report, this is the breakdown:
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Unnecessary Services
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$210 billion
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Inefficiently delivered services
(Includes mistakes and unnecessary use of higher-cost providers)
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$130 billion
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Excess administrative costs
(Includes inefficiencies resulting form care-documentation requirements)
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$190 billion
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Too-high prices
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$105 billion
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Missed prevention opportunities
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$55 billion
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Fraud
(Committed by patients, providers, and payers)
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$75 billion
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Furthermore, it's clear this waste represents significant inconsistencies within the industry. If other industries adopted some of these same problems, we wouldn't tolerate it. The IOM says that: - If banking were like health care, automated teller machine (ATM) transactions would take not seconds but perhaps days or longer as a result of unavailable or misplaced records.
- If shopping were like health care, product prices would not be posted, and the price charged would vary widely within the same store, depending on the source of payment.
- If airline travel were like health care, each pilot would be free to design his or her own pre-flight safety check, or not to perform one at all.
So not only are we wasting a huge sum of money, we're not even getting a premium product in return; on the contrary, it's underperforming as we wrote about in our last issue. It is a largely held view that the healthcare system as we know it today is unsustainable long term, and this is just one measure that illustrates why. There are some important initiatives underway, not only in the context of the Affordable Care Act but in other important ways such as the "Choosing Wisely" campaign in which nine United States specialty societies representing 374,000 physicians developed lists of Five Things Physicians and Patients Should Question in recognition of the importance of physician and patient conversations to improve care and eliminate unnecessary tests and procedures. More on this in the next issue.
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