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Volume 27, Issue 473 |
August 7, 2006 |
MEDICAID
Funding for Nursing Home Alternatives
The Centers for Medicare & Medicaid Services (CMS) will now provide states with funds to support elderly and disabled Medicaid recipients who choose to live in the community rather than in institutions. Through the “Money Follows the Person” initiative, CMS will provide states with grants totaling $1.75 billion over five years. Part of the Deficit Reduction Act of 2005, the market-based approach is expected to produce cost-savings by allowing individuals to make more cost-effective choices based on the appropriate level of care. The federal grants will help states overcome the short-term costs of rebalancing Medicaid by paying the full cost of home- and community-based waiver services for one year, after which participating states must continue this care at the regular Medicaid matching rate. More information and applications for Money Follows the Person grants are available at this Web site. The deadline for applications is Nov. 1.
PRESCRIPTION DRUGS
Oregon and Washington will join forces to form a prescription drug buying cooperative, leveraging their combined purchasing power to lower prices for their uninsured residents. Both states currently have prescription drug plans that provide below-market-rate drugs to low-income seniors. The Northwest Prescription Drug Consortium will combine these two plans and will begin operations by the end of the year. The Consortium will not purchase drugs for Medicaid. This change comes on the heels of a report from the Heinz Family Foundation, which found that Oregon can save up to $17 million a year by reforming how it buys drugs. The report suggested steps such as consolidating drug purchases, increasing the attorney generals’ involvement in the process, seeking drug rebates and developing a preferred drug list for the state's Medicaid program.
Rx Errors
At least 1.5 million U.S. residents are harmed or killed each year because of medication errors, leading to at least $3.5 billion annually in added health-care expenses, according to a July 20 report released by the Institute of Medicine. After analyzing published studies and government data, and conducting public forums, the IOM’s 17-member panel concluded that medication errors cause at least 400,000 preventable injuries and deaths in hospitals, over 800,000 in long-term care facilities and more than 530,000 among Medicare beneficiaries treated in outpatient settings. The most common medication errors include nurses administering the wrong medications or wrong dose in an intravenous drip, physicians prescribing drugs that could cause dangerous interactions with other medications and pharmacists dispensing 100-milligram tablets when 50-milligram tablets were prescribed. Confusing drug labels and packaging cause one-quarter to one-third of all medication errors. The report also found that hospitals and long-term care facilities typically do not report medication mix-ups to patients or their families unless the errors result in injury or death. The panel recommends that all prescriptions be written electronically by 2010, and that drug labeling, naming and packaging of drugs be changed in order to prevent errors.
PUBLIC HEALTH
We’ll be Watching You
The State of Washington is getting up close and personal with its residents to learn more about their health. Beginning in late July, state health officials will conduct door-to-door surveys of 1,100 households from across the state, looking to learn more about Washingtonians’ health behaviors. Of particular interest are risk factors for cardiovascular disease and diabetes. Cardiovascular disease is currently the number one killer in the state, depriving Washington of 15,000 residents a year. Officials will choose households randomly, based on demographic data to ensure a representative mix. A nurse on each survey team will measure blood pressure, pulse, height, weight and waist size, and take blood samples to measure cholesterol and blood sugar. Women of childbearing age and participants 60 and older will also have hair samples taken to measure mercury levels. Participants will receive a $45 gift card for their troubles. The funding for the survey comes from an $800,000 grant from the Centers for Disease Control and Prevention (CDC). Arkansas and Kansas also are participating in the program, which is a part of the Healthy People 2010 initiative.
SUBSTANCE ABUSE
Alcohol Still Drug of Choice in Rural Areas
Despite the attention being given to meth, alcohol remains the primary substance of abuse in rural communities, according to a recent report by the Carsey Institute. This is particularly a problem with rural youth, as their rates of abuse have gone up in the past few years. Until the early 1990s, alcohol abuse rates among rural and urban youth were similar, and even declining. Since then, however, excessive drinking has increased in rural areas but declined in urban ones, with rural youth now the heaviest drinkers. Adding to the problem is the lack of treatment centers in rural areas. States that have the highest youth alcohol abuse rates also have the highest unmet need for treatment, with low population density and a growing population of low-skilled immigrants and fixed-income retirees further stretching resources. The study suggests that new treatment options be developed specifically for rural populations, building on community resources and reducing the stigma associated with treatment. The second most popular drug for both groups is marijuana. Stimulant use, meth in particular, remains higher in rural areas than in urban localities.
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