February 8, 2013

CLANCY STEPS DOWN AS DIRECTOR OF AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has announced Carolyn Clancy, MD is leaving the Agency for Healthcare Research and Quality (AHRQ) after serving as director for the past 10 years. Her departure will come less than a year after a House Labor, Health and Human Services Appropriations bill would have eliminated AHRQ completely.

In her announcement, Sec. Sebelius credits Dr. Clancy with overseeing the country’s first annual reports on quality, safety and disparities in care, as well as other efforts promoting patient safety. "Moreover, under Carolyn’s leadership, AHRQ has been instrumental in cross-cutting departmental initiatives, from the development of the Affordable Care Act National Quality Strategy to the launch of CHIPRA provisions on assessing children’s quality of care,” Sebelius wrote.

SEN. HARKIN INTRODUCES HEALTHY LIFESTYLES BILL

Sen. Tom Harkin (D-IA), Chair of the Health, Education, Labor and Pensions Committee, has introduced the "Healthier Lifestyles and Prevention America (HeLP) Act” that outlines multifaceted approaches to promote health in schools, communities, and the work place. First introduced by Sen. Harkin in 2007, the HeLP Act seeks to improve the health of kids in schools, facilitates healthier communities and workplaces, encourages responsible marketing and consumer awareness, and calls for expanded coverage of preventive services while providing increased research and surveillance programs that target breastfeeding, mental health and substance abuse.

For more information, please visit Sen. Harkin’s official website.

FDA SEEKS COMMENTS ON CHANGES TO SMOKELESS TOBACCO WARNINGS

As a result of its new tobacco regulation authority, the Food and Drug Administration (FDA) is seeking public comments on proposed changes to smokeless tobacco warnings. The "Family Smoking Prevention and Tobacco Control Act” requires that the FDA issue regulations that dictate new health warning labels that must appear on smokeless tobacco products to promote greater "understanding of the risks associated with the use of smokeless tobacco products.”

Comments supported by scientific evidence will be accepted through regulations.gov until April 1, 2013.

January 25, 2013

CDC VITAL SIGNS: BINGE DRINKING AMONG WOMEN/ADOLESCENT GIRLS

The January 2013 issue of the Centers for Disease Control and Prevention (CDC)Vital Signs features binge drinking as a women’s health problem. According to the CDC, 1 in 8 women aged 18 and older as well as 1 in 5 high school girls binge drink or consume four or more alcoholic drinks on a single occasion. High risk groups include high school girls and young women (aged 18-34), Whites and Hispanics, and women living in households with incomes above $75,000.

Further information about who is at risk, what can be done, and the science behind this issue can be found on the CDCVital Signs page.

FEWER THAN HALF OF AMERICANS VACCINATED AGAINST FLU IN 2010-2011

Fewer than half of Americans 6 months and older were vaccinated against the flu in the last two flu seasons, according to Trust for America's Health’s (TFAH)new review of flu vaccination trends and policies. Among TFAH’s recommendations: educating the public, especially at-risk groups, front-line workers, and clinicians, about the seriousness of the flu, need to be vaccinated and the safety of the vaccine; covering flu vaccines under public and private insurance without cost-sharing; investing in research for a universal flu vaccine to replace the annual shot; and sustaining investments, including through the Prevention and Public Health Fund, for immunization programs and to expand vaccination capacity in schools.

SPENDING DECLINES ON FOOD MARKETING TO CHILDREN

Total spending by food companies on marketing to children was down 19.5 percent in 2009 from 2006, according to the results of a Federal Trade Commission (FTC) comprehensive study of food and beverage industry marketing expenditures and activities directed to children and teens. The study found that most of that decrease comes from less spending on television ads to youth.

At the same time, food companies stepped up their spending by 50 percent to market to children and teens using online, mobile, and viral marketing strategies. Overall, food companies allocated $1.79 billion on marketing to youth ages 2-17 in 2009.

A Review of Food Marketing to Children and Adolescents: Follow-Up Report gauges the progress industry has made since first launching self-regulatory efforts to promote healthier food choices to kids. It serves as a follow-up to the Commission’s 2008 report on food marketing requested by Congress.Additional information and key findings about the nutritional quality of foods within the product categories most heavily marketed to children or teens is contained in the report.

January 13, 2013

ACPM JOINS LETTER ON ESSENTIAL HEALTH BENEFITS RULE’S IMPACT ON TOBACCO CESSATION

ACPM joined several of its public health and medicine partner organizations on a sign-on letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius regarding the impact of proposed regulations that define Essential Health Benefits (EHB) on coverage of tobacco cessation.

The letter, signed by 15 national organizations, notes that "We strongly urge HHS to clearly define which tobacco cessation treatments are required coverage as a preventive service under EHB. This definition should include—and require—all tobacco cessation medications approved by the FDA and individual, group and phone counseling. It should be based on and reference the most recent version of Treating Tobacco Use and Dependence, to ensure that if the guideline is updated, the benefit will be too.”

ACPM will continue to advocate for full coverage of tobacco cessation programs as implementation of the Affordable Care Act moves forward.

To view a copy of the letter, visit http://bit.ly/UMhws4.

ACPM JOINS AMA ET AL URGING ACTION TO AVOID SEQUESTRATION’S IMPACT

Just prior to the start of the New Year, ACPM joined its colleagues in the AMA Federation on a sign-on letter to Congress urging quick action to avoid the impact of the roughly 8 percent across-the-board cuts to all government programs that would have been required to implement the January 1 sequester. With mounting public pressure to avoid the sequester, Congress acted at the 11^thhour and passed legislation that delays the sequester by two months, providing additional time for Congress and the president to negotiate a broad deficit reduction package.

The AMA letter stated that Congress should act to "maintain funding levels for key research, public health, and prevention programs administered by such agencies as the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, and the Food and Drug Administration. Investment in public health and prevention programs promotes wellness, prevents disease, and protects against public health emergencies, as well as generates long-term benefits that promise to lower future health care spending. The long-term benefits in improved health status, including greater productivity, should not be sacrificed to meet short-term budget objectives.”

View a copy of the letter.

AHRQ RESOURCE FOCUSES ON USING INFORMATION SYSTEMS TO PROMOTE PREVENTION

The Agency for Healthcare Research and Quality’s Health Care Innovations Exchange now provides tools for Using Information Systems to Promote Prevention. The AHRQ tools focus on the many innovations in information technology and quality improvement that have emerged to promote prevention. These innovations are used to enhance preventive services by, for example, improving electronic health records to prompt and remind providers of recommended services, smart phone apps, and other interactive, electronic interfaces to promote preventive health services. For more information visit the Innovation and Quality Tools webpage.

December 17, 2012

COURT REFUSES GOVERNMENT’S APPEAL IN GRAPHIC WARNING LABELS CASE

The Federal U.S. Court of Appeals for the District of Columbia has denied a request by the government for a full-panel hearing on the Food and Drug Administration’s graphic tobacco warnings, upholding the decision by a three-member panel in August that the graphic labels violate the First Amendment rights of corporations.

The nine labels were created by the FDA as a means to implement the Family Smoking Prevention and Tobacco Control Act of 2009. They graphically illustrate the consequences of smoking, such as showing someone smoking through a tracheotomy via picture labels that cover half of the cigarette package. Their effectiveness, despite mounting evidence, is still unproven.

The law’s underlying provisions were upheld in March in the U.S. Court of Appeals for the 6^th Circuit and were supposed to be implemented this October. However, enforcement of the law has been subsequently blocked in the District of Columbia court circuit by five tobacco companies arguing that they should not have to pay for labels that have no proven effect. The Department of Justice has 90 days to decide whether to appeal the case to the Supreme Court, which many anti-tobacco groups support, given the contradictory finding from the 6^th Circuit that the law’s provisions are sound.

FDA APPROVES FIRST SEASONAL FLU VACCINE TO USE CELL CULTURE TECHNOLOGY

The Food and Drug Administration (FDA) has approved the first seasonal influenza vaccine licensed in the United States produced using cultured animal cells, instead of fertilized chicken eggs. The vaccine, Flucelvax, is approved to prevent seasonal influenza in people ages 18 years and older.

The manufacturing process for Flucelvax is similar to the egg-based production method, but the virus strains included in the vaccine are grown in animal cells of mammalian origin instead of in eggs. Cell culture technology has already been in use for several decades to produce other U.S. licensed vaccines. For more information, visit http://1.usa.gov/QX8O7p.

HHS SEEKING COMMENTS ON PROPOSED HEALTH INSURANCE RULES

The Department of Health and Human Services (HHS) is seeking public comment for several proposed health insurance rules. The first rule is related to health insurance market reforms. These reforms were designed to prevent discrimination against people with pre-existing conditions and protect patients from exorbitant premium increases. In addition, this rule would amend the standards for data reporting and collection by health insurance companies and state governments. The second rule is related to essential health benefits, actuarial value, and accreditation standards of health plans that will be listed on health insurance exchanges. Public comments on both of these rules will be accepted until December 26^th.

The final rule accepting public comment discusses employer or group health wellness program coverage. Specific amendments include increasing the maximum permissible reward for group health plans offering health-contingent wellness plans, wellness program design, and alternatives that could be offered to health plan members in order to avoid discrimination. Public comments on this rule will be accepted until January 25, 2013.

November 28, 2012

HHS ACCEPTING COMMENTS ON MID-COURSE UPDATE OFPHYSICAL ACTIVITY GUIDELINES

The federal Office of Disease Prevention and Health Promotion (ODPHP) is seeking public comment on the Physical Activity Guidelines for Americans Mid-course Report: Strategies for Increasing Physical Activity Among Youth until 9 AM EST Monday, December 10^th.

ODPHP, working with the President’s Council on Fitness, Sports, & Nutrition convened a subcommittee to review evidence-based strategies to increase physical activity in children and youth. These strategies form the basis of the mid-course report and are organized into five settings: Family and Home, Preschool and Childcare, School, Primary Care, and Community. The final report is expected to be released in 2013. Comments may be submitted via email or postal mail. Please see the link above for more information.

EMR USE IMPROVES AMONG PRIMARY CARE DOCS, BUT ACCESS TO CARE STILL A PROBLEM

U.S. physicians are increasingly adopting electronic medical records (EMRs), according to the Commonwealth Fund-sponsored 2012 International Survey of Primary Care Doctors, a 10-country survey of primary care physicians reporting progress in the use of Health Information Technology (HIT). Among U.S. physicians, the EMR adoption rate increased from 46% in 2009 to 69% in 2012. A similar increase was identified among Canadian physicians, yet both countries use HIT less often than U.K., New Zealand, or Australian physicians.

U.S. physicians also noted that treatment affordability and insurance restrictions can complicate care. Fifty-nine percent of U.S. primary care physicians reported that their patients cannot afford care regularly compared to less than 25% in other developed nations.

Among all countries surveyed, care coordination and communication between specialists and primary care providers remains problematic.

November 12, 2012

GAO DETAILS ACA PREVENTION FUND EXPENDITURES

Forty-three activities across five agencies received funding from the Affordable Care Act’s Prevention and Public Health Fund in fiscal years 2010 and 2011, according to a Government Accounting Office (GAO) report on expenditures from the Fund. Most of the $500 million available in 2010 went to Health Resources and Services Administration (HRSA) programs, while most of the $750 million available in 2011 went to the Centers for Disease Control and Prevention (CDC). Twenty-three of the activities, accounting for 72 percent of program funds over the two fiscal years, went to programs already receiving other funds. Officials at the Department of Health and Human Services (HHS) said it’s still too early to grade most activities receiving PPHF money.

The GAO report is available at http://1.usa.gov/R7ecSR.

WORLD’S SECOND-LARGEST CIGARETTE MARKET EYEING CRACKDOWN ON TOBACCO USE

Russia, the world’s second-largest cigarette market, is eyeing a severe crackdown on tobacco use that could have major implications for companies like Phillip Morris International, according to an article in theWall Street Journal. According to the article, a bill that would establish nationwide smoking restrictions, such as limits on advertising and smoking in restaurants, was expected to be submitted to parliament on November 1 for a vote early next year. A separate effort to raise excise taxes nearly 135% by 2015 has already passed a parliamentary committee.

Such measures pose a significant challenge to the world's big four tobacco companies that control 90% of the Russian market. The article notes that in Russia cigarettes are inexpensive, restaurants and bars are normally thick with smoke, and nearly 40% of the population and 60% of men smoke cigarettes.

To view the article, visit http://on.wsj.com/R1RmgT.

LONG-LASTING FLU VACCINE IN THE WORKS

Advances in influenza vaccine technology include the possibility of universal flu vaccination, according to an article published in Influenza and Other Respiratory Diseases. The article examines several ongoing research projects that address novel technology in influenza vaccines.

The authors are pursuing their own research in this field by attempting to develop a T-cell based vaccine that could attack the section of the virus that does not mutate on an annual basis.Vaccine clinical trials have already produced strong results with fewer vaccinated subjects developing influenza than control subjects; and shorter viral shedding in vaccinated subjects overall.

OBESITY AND OTHER PAY-FOR-PERFORMANCE MEASURES DRIVING QUALITY

The leading national group that evaluates health plans has released a study concluding that Medicare's program for making higher payments to health plans based on performance is reaping dividends, and that, prodded by quality measures, doctors are stepping up efforts to identify and counsel obese patients. The National Committee for Quality Assurance (NCQA) found that health plans have shown big improvements on its health quality measures, such as those for obesity and colorectal screening.

On average, PPOs in the Medicare Advantage program screened 55 percent of their enrollees for colorectal cancer in 2012, up from 41 percent in 2011, and Medicare HMOs improved from 57.6 percent to 60 percent. The report also showed that caregivers in health plans are more likely to screen enrollees for obesity, not only among the elderly but also among the young. In 2009, NCQA introduced adult BMI assessment to its quality measures, and by 2011 major improvements were observed on this measure across commercial, Medicaid and Medicare lines of business and for HMOs and PPOs, the report said. Medicare plans saw the greatest success, increasing rates by 18 and 26 percentage points, respectively in HMOs and PPOs. Measuring BMI "naturally leads to counseling," said NCQA’s President Margaret O’Kane.

Originally established by the insurance industry, NCQA has won a reputation for independence and promoting quality measurement that improves health care.

October 26, 2012

HORMONE THERAPY FOR PRIMARY PREVENTION NOT RECOMMENDED FOR POSTMENOPAUSAL WOMEN

The United States Preventive Services Taskforce (USPSTF) has issued a new recommendation against the use of hormone therapy for the primary prevention of chronic conditions in postmenopausal women. The "Grade D” recommendation applies to all postmenopausal women whether or not they have had a hysterectomy. However, it does not apply to women younger than 50 years who have surgical menopause or those using hormone therapies to treat menopausal symptoms like hot flashes.

Despite the protective effect of hormone therapy in preventing hip fractures, the USPSTF found adequate evidence that the use of combined estrogen and progestin is associated with an increased risk of stroke, dementia, gallbladder disease, and urinary incontinence. They also concluded that there was convincing evidence of a small increase in the incidence of invasive breast cancer as well as an increased risk of deep venous thrombosis and pulmonary embolism. As a result, they concluded that the disease prevention benefits of combined estrogen and progestin and estrogen alone do not outweigh the harms in most postmenopausal women.

The full recommendation statement can be found here.

October 15, 2012

FROM THE USPSTF: SCREENING FOR HEPATITIS B, ALCOHOL MISUSE

The United States Preventive Services Task Force (USPSTF) has published a new draft recommendation for alcohol misuse screening as well as a draft research plan for hepatitis B screening. Draft research plans and recommendations are released to give the public an opportunity to comment on the proposals.

In its draft recommendation, the USPSTF gave alcohol misuse screening and behavioral intervention by clinicians a "grade B” recommendation, concluding that there is moderate certainty of a moderate net benefit to screening and brief behavioral counseling interventions for alcohol misuse in adults. However, for adolescents, an "I statement” was issued as the evidence concerning alcohol misuse screening and behavioral counseling interventions in primary care settings was inconclusive.

The draft research plan addresses hepatitis B virus infection screening in nonpregnant adolescents and adults. The final research plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center, which will form the basis of the USPSTF Recommendation Statement on this topic.

Details of the hepatitis B research plan can be found here. The alcohol misuse draft recommendation can be found here.

CDC CHANGES RECOMMENDATIONS FOR VACCINE STORAGE AND HANDLING

The Centers for Disease Control and Prevention (CDC) has published an interim guide on proper handling and storage of vaccines. Changes to previous recommendations come in light of new scientific evidence on equipment used for vaccine storage and improved understanding of best practices for the handling and storage of vaccines. The guidance is intended for all providers, and CDC will evaluate the most efficient and cost effective strategies to adhere to these new recommendations. The specific details of the recommendations can be found here.

VIDEO DESCRIBES NEED FOR INTEGRATION OF PRIMARY CARE AND PUBLIC HEALTH

The Institute of Medicine (IOM) has produced a new video highlighting its recent report about the integration of primary care and public health. The video identifies several instances where primary care and public health have coordinated to reduce disease burden and improve health outcomes. It provides examples of initiatives around the country where this kind of integration has been successful. Additionally, it offers actionable strategies to help achieve better integration between primary care and public health. The video is available to watch online or may be downloaded as slides.

October 1, 2012

CONTINUING RESOLUTION PASSES HOUSE OF REPRESENTATIVES

Prior to leaving town in advance of the November elections, members of Congress adopted a continuing resolution (CR) that will essentially extend FY 2012 funding levels for all government agencies through March 27, 2013. The 6-month CR buys Congress additional time to negotiate a FY 2013 funding package as it works to address other major fiscal issues, such as the impending sequester, tax extenders, and the Medicare physician payment fix.

For more information, contact Paul Bonta at pbonta@acpm.org.

ADMINISTRATION RELEASES REPORT DETAILING IMPACT OF SEQUESTRATION

The Obama Administration’s Office of Management and Budget has released a report detailing the potential effects of sequestration should Congress fail to put a halt to the automatic across-the-board cuts required by the Budget Control Act (BCA) of 2011. The Budget Control Act of 2011 contained a provision calling for sequestration—an across-the-board cut on January 2, 2013—if a $1.2 trillion deficit reduction deal was not reached by the end of 2012.

The report makes clear that sequestration would seriously impair the ability of government to carry out core functions including national security. The sequestration would result in a 9.4 percent cut in non-exempt defense discretionary funding and an 8.2 percent reduction in non-exempt nondefense discretionary funding. The sequestration would also impose cuts of 2.0 percent to Medicare, 7.6 percent to other non-exempt nondefense mandatory programs, and 10.0 percent to non-exempt defense mandatory programs.

The American Hospital Association, American Medical Association, and American Nurses Association also has released a report, "The Negative Impacts of the Medicare Cuts in the Budget Control Act of 2011,” that estimates a loss of 766,000 Medicare-related jobs by 2021 as a result of the impending sequester.

IOM GME COMMITTEE HOLDS FIRST PUBLIC MEETING

A newly formed Institute of Medicine (IOM) Committee on Governance and Finance of Graduate Medical Education (GME) held its first meeting as it embarks on an effort to assess current regulations, financing, content, and governance of GME and recommend how to modify GME to produce a physician workforce for a 21st century U.S. health care system that provides high quality preventive, acute, and chronic care. ACPM will communicate with the committee to highlight the challenges posed by the GME payment formula for preventive medicine residency training programs that train residents in community settings rather than in the typical teaching hospital setting. Furthermore, ACPM will position preventive medicine residency training programs as a critical component of efforts to improve the delivery of preventive services in a more streamlined and efficient health care system.

The committee is co-chaired by Donald Berwick, MD, MPP, former administrator of the Centers for Medicare and Medicaid Services, and Gail Wilensky, Ph.D., former administrator of the Health Care Financing Administration and chair of the Medicare Payment Advisory Commission.

For more information on the IOM Committee,visit http://bit.ly/HMpyZf.

 

September 7, 2012

USPSTF ISSUES STATEMENT ON SCREENING FOR CHRONIC KIDNEY DISEASE

The United States Preventive Services Task Force (USPSTF) has determined that there is insufficient evidence to recommend for or against routine screening of chronic kidney disease (CKD) in adults. The recommendation, which received an "I” rating, does not apply to those who already exhibit symptoms of CKD or are otherwise predisposed to it due to another medical condition such as diabetes. In its statement, the Task Force called for new studies to be conducted to help shed light on the pros and cons of a screening program.

The full recommendation statement can be found here.

COURT STRIKES DOWN GRAPHIC CIGARETTE WARNING REQUIREMENT

The U.S. Court of Appeals for the D.C. Circuit struck down the large, graphic cigarette warnings required by the landmark 2009 law that gave the Food and Drug Administration (FDA) authority over tobacco products stating that the government did not provide evidence that the new labels would reduce smoking rates. The court, in a 2-1 decision, said federal regulators fell short of meeting constitutional requirements for justifying the labeling rules.

"The First Amendment requires the government not only to state a substantial interest justifying a regulation on commercial speech, but also to show that its regulation directly advances that goal," Judge Janice Rogers Brown wrote in the majority opinion.

The only other appellate court to consider the issue, the U.S. Court of Appeals for the Sixth Circuit, upheld the graphic warnings requirement in March. The split decisions make it likely the U.S. Supreme Court will settle the issue.

To view the court’s opinion, visit http://1.usa.gov/OAg9WT.

HHS RELEASES FINAL RULE FOR STAGE TWO OF MEANINGFUL USE PAYMENTS

The U.S. Department of Health and Human Services (HHS) has released a final rule specifying the Stage 2 criteria that eligible providers must meet to qualify for Medicare/Medicaid electronic health record (EHR) incentive payments. The final rule stipulates 17 core objectives that eligible providers will be expected to meet in order to qualify for incentive payments. In addition, providers will be required to report on 9 clinical quality measures.

Eligible providers and hospitals that become EHR meaningful users in 2013 will be able to avoid Medicare payment penalties that are scheduled to take effect in 2015. For more information, please see the HHS publication located here.

August 16, 2012

COMMUNITY TASK FORCE UPDATES CANCER SCREENING RECOMMENDATIONS

The Community Preventive Services Task Force has released updated recommendations related to increasing community demand for breast and colon cancer screenings based on new systematic reviews conducted by Community Guide researchers and partners. The Task Force recommends use of group education for increasing breast cancer screening and one-on-one education to increase colorectal cancer screening with fecal occult blood testing (FOBT).

Previously there was insufficient evidence available to support these practices.Strongevidence also is now available to support the use of client reminders to increase colorectal cancer screening with FOBT; whereas, previously, there was onlysufficientevidence to recommend this intervention.

These recommendations are available inThe Community Guide: Increasing breast, cervical, & colorectal cancer screeningathttp://bit.ly/OYeZ6f.

ALMOST A THIRD OF PHYSICIANS UNWILLING TO ACCEPT MORE MEDICAID PATIENTS

A recent study published in the journalHealth Affairsfound that 31% of physicians are unwilling to accept additional Medicaid patients. However, this percentage varies significantly across the US. For example, in New Jersey, only approximately 40% of physicians are accepting new Medicaid patients, while in Wyoming nearly all physicians are willing to accept new Medicaid patients.

In contrast, only 17 percent of physicians refused new Medicare patients, and 18 percent were unwilling to accept new patients with private insurance coverage. These findings are particularly relevant in light of new provisions employed under the Affordable Care Act (ACA) to increase the number of patients covered by Medicaid and increase Medicaid payments to primary care doctors.

For additional information, visithttp://bit.ly/OHRZecandhttp://bit.ly/MfUNPX.

COALITION OFFERS GRASSROOTS TOOLKIT FOR PUBLIC HEALTH FUNDING ADVOCACY

The Coalition for Health Funding, a broad-based coalition of more than 70 national organizations working to increase overall funding for federal health programs, has released a grassroots toolkit aimed at increasing awareness among lawmakers of the negative impact sequestration will have on programs supported through discretionary funding. Federal discretionary dollars are used to fund activities that fall outside entitlements, defense, and homeland security programs. Unless Congress acts to reverse sequestration’s impact by the end of the year, most federal programs will face an across-the-board cut of roughly 8 percent starting January 2, 2013. Sequestration is a rigid budgetary tool originally included in the 2011 Budget Control Act as a measure to force bipartisan agreement on a broad deficit reduction package, which has not materialized.

The toolkit is tailored for use during the August congressional recess and includes:

• A short video presentation to help grassroots understand the current debate, and the consequences of inaction;
• Tips on participating in "Town Halls,” writing editorials for local papers, and engaging lawmakers through social media; and
• Frequently asked questions about "sequestration.”

ACPM, a long-time member of the Coalition for Health Funding, recently joined nearly 3,000 national, state, and local organizations on a sign-on letter to Congress urging that they avert sequestration by "adopting a balanced approach to deficit reduction that does not include further cuts to NDD (non-defense discretionary) programs.” Please consider utilizing the toolkit and communicating with your elected officials about the impact sequestration will have on state and federal public health programs in your community. To access the toolkit, please visithttp://bit.ly/NdUVPo.

August 3, 2012

CBO LOWERS COST ESTIMATE OF ACA TO REFLECT SUPREME COURT DECISION

The Congressional Budget Office has released an analysis of the impact of the Supreme Court decision on the Affordable Care Act, finding that the Court’s decision would result in a net reduction of $84 billion over 10 years. These savings are reflective of the significant reductions in spending from lower Medicaid enrollment, which are expected to more than offset the increase in costs from greater participation in the newly established insurance exchanges.Read the CBO analysis at http://www.cbo.gov/publication/43472.

FDA APPROVES SECOND NEW WEIGHT MANAGEMENT DRUG

The FDA has approved a second new weight management drug, Qsymia, less than a month after approving another weight management drug, Belviq. Qsymia, formerly known as Qnexa, is an extended-release formulation of a combination of two FDA-approved drugs, phentermine and topiramate. Qsymia is indicated for obese people or for overweight people who also have at least one weight-related comorbidity, such as hypertension, dyslipidemia, or diabetes.

Read the FDA press release at http://1.usa.gov/LWJVHH.

PHYSICIANS DISPUTE NEW GUIDELINES FOR PEDIATRIC LIPID SCREENING

Three physician-researchers at University of California San Francisco dispute recent National Heart Lung and Blood Institute (NHLBI) guidelines recommending cholesterol screening for children. In a commentary published online in Pediatrics, the group calls the new guidelines "overly aggressive” and suggests that the recommendations fail to appropriately weigh health benefits against potential harms and costs. The group further questions the credibility of the guidelines because they were based largely on expert opinion, and a majority of the expert panel members disclosed ties to companies making lipid-lowering drugs and lipid-testing instruments.

The new pediatric lipid screening recommendation report was released by the NHLBI late last year and was endorsed by the American Academy of Pediatrics. The report recommends universal screening of 9- to 11-year-old children with a non-fasting lipid panel and targeted screening of high risk 2- to 8-year-old and 12- to 16-year-old children with two fasting lipid profiles.

July 20, 2012

ACPM OPPOSES EXEMPTION OF CIGARS FROM FDA’S AUTHORITY

ACPM joined with its medical and public health partner organizations on a sign-on letter to the House of Representatives "to express our strong support for the Food and Drug Administration’s (FDA) oversight over tobacco products and to share with you our organizations’ deep concern that amendments that weaken the FDA’s authority over tobacco products may be offered to the Agriculture, Rural Development, Food and Drug Administration and Related Agencies” FY 2013 appropriations bill.

Cigar manufacturers have been advocating for an exemption from FDA’s authority claiming the 2009 Family Smoking Prevention and Tobacco Control Act limited FDA’s authority to cigarettes only. ACPM has been a staunch proponent of FDA’s authority over all tobacco products and will continue to oppose efforts that seek to limit or weaken FDA’s oversight capabilities. To view a copy of the letter, visit http://bit.ly/Prz5se.

PREVENTIVE MEDICINE CAUCUS URGES AMA COMMITMENT TO PUBLIC HEALTH

The American Medical Association (AMA) Section Council on Preventive Medicine (SCPM), which recently met during the AMA annual House of Delegates (HoD) meeting, sent a letter to AMA Board Chair Steven Stack, MD urging that the AMA maintain its commitment to public health. The letter was sent in response to the release of a new AMA strategic plan that does not provide explicit support for public health. Rather, the strategic plan is driven by the following three pillars that will define the AMA organizational structure and future activities: improving health outcomes, accelerating change in medical education, and enhancing physician satisfaction.

The letter, signed by Glenn Merchant, MD, MPH, FACPM, chair of the SCPM, noted that members of SCPM are "particularly interested in learning more about your focus on improving health outcomes as we feel this presents a unique opportunity to promote the practice of population-based medicine. While physicians play an important role in improving the health outcomes of their patients, they also play a vital role in improving the health of their communities. Measuring health outcomes at the population level drives improvements in both public health and clinical medicine. Employers, insurers, state governments and others focus their efforts at the population level because they understand that yields the greatest impact. The AMA must recognize the effectiveness of population-based health outcomes by developing measures that extend beyond the clinical environment.”

To view a copy of the letter, visit bit.ly/LyfCkz.

FUND SAYS U.S. WOMEN AT A DISADVANTAGE WITH INSURANCE COVERAGE

A new report by The Commonwealth Fund found that women in the U.S.—both with and without health insurance—are more likely to go without needed health care because of cost and have greater difficulty paying their medical bills than women in 10 other industrialized countries. The report found an estimated 18.7 million U.S. women ages 19 to 64 were uninsured in 2010, up from 12.8 million in 2000. An additional 16.7 million women had health insurance but had such high out-of-pocket costs relative to their income that they were effectively underinsured in 2010.

"Forty-three percent of women in the U.S. reported they went without recommended care, did not see a doctor when sick, or failed to fill prescriptions because of costs in the past year,” noted the report. To view a copy of the report, visit http://bit.ly/MovlmX.

July 6, 2012

TASK FORCE ISSUES FINAL RECOMMENDATIONS ON OBESITY SCREENING AND BEHAVIORAL COUNSELING

 

The United States Preventive Services Task Force (USPSTF) has released two final recommendations on obesity screening and behavioral counseling. The first recommends (Grade B) that clinicians screen all adults for obesity, and individuals with a body mass index of 30 kg/m2 or higher should be referred for intensive, multicomponent behavioral interventions. The task force has suggested that these programs include a comprehensive weight loss and behavior management program with 12-26 sessions in the first year. The new obesity screening recommendation does not address screening in overweight adults (BMI of 25 to 29.9 kg/m2).

The second recommendation indicates that clinicians should selectively offer behavioral counseling to patients rather than providing counseling to all general adult patients (Grade C). The task force found that medium- or high-intensity behavioral counseling interventions in the primary care setting to promote a healthful diet and physical activity have a small net benefit in adult patients with a low risk of cardiovascular disease. The task force suggested that clinicians may choose to selectively counsel patients for behavioral counseling based on individualized factors such as patient readiness to change, social support and community resources, as well as other health care priorities. The updated recommendation replaces the USPSTF's previous separate recommendations (both I statements) on behavioral counseling to promote a healthful diet (2003) and physical activity (2002) in adults without preexisting CVD or its risk factors.

To view the USPSTF statement on obesity screening, visit http://bit.ly/iVsiDW, and for behavioral counseling, visit http://bit.ly/L2tvvL

NATIONAL PREVENTION COUNCIL RELEASES ACTION PLAN TO IMPLEMENT NATIONAL PREVENTION STRATEGY

The National Prevention Council, led by U.S. Surgeon General Regina Benjamin, has released the National Prevention Council Action Plan: Implementing the National Prevention Strategy, providing next steps in the implementation of the National Prevention Strategy. The action plan describes actions being undertaken to realize the vision, goal, recommendations, and actions of the nation's first ever National Prevention Strategy in order to increase the number of Americans who are healthy at every stage of life.

Established by the Affordable Care Act, the National Prevention Council comprises 17 federal departments and agencies and aims to help move the nation's health care focus from one based on sickness and disease to one based on prevention and wellness. Last year the National Preventive Council released its comprehensive plan, the National Prevention Strategy, to address such issues as obesity, tobacco use, health disparities and chronic disease through the integration of recommendations and actions across multiple sectors. The action plan details commitments and outlines more than 200 specific prevention and wellness actions that federal agencies are already taking or plan to take to implement the National Prevention Strategy.

View the National Prevention Council Action Plan at http://1.usa.gov/tBmQ7y.

 

June 22, 2012

LATEST FROM THE USPSTF: DRAFT RECOMMENDATIONS FOR PUBLIC COMMENT

The United States Preventive Services Task Force (USPSTF) has posted a draft recommendation on vitamin D and calcium supplementation to prevent cancer and osteoporotic fractures. The USPSTF recommends against daily supplementation with ≤400 IU of vitamin D₃ and 1,000 mg of calcium carbonate for the primary prevention of fractures in non-institutionalized postmenopausal women (Grade D). The task force also found evidence currently is insufficient to assess the balance of benefits and harms of vitamin D supplementation (with or without calcium) for the primary prevention of cancer in adults, combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women or in men, or daily supplementation with >400 IU of vitamin D₃and 1,000 mg of calcium for the primary prevention of fractures in non-institutionalized postmenopausal women (Grade I). Public comments for these recommendations will be accepted through July 10th. To view the draft recommendation and submit comments, visit http://bit.ly/q0Lkyv.

HEALTH SPENDING WILL CLIMB TO NEARLY ONE FIFTH OF GDP

A report from the Center for Medicare and Medicaid Services’ (CMS) Office of the Actuary found that the health share of the gross domestic product (GDP) is projected to grow from 17.9 percent in 2010 to 19.6 percent by 2021. Published in the journal Health Affairs, the authors note that health spending will grow at 4.0 percent between 2011 and 2013 due to sustained effects of the recent recession and modest recovery, but accelerate to 7.4 percent in 2014 as major coverage expansions from the Affordable Care Act (ACA) begin. Overall, between 2011 and 2021, health spending growth is projected to be 5.7 percent. According to the report, while health care spending is expected to rise roughly 2 percentage points faster than the overall economy during the projection period, this rise has been consistent over the past 30 years.

 

To view this article, visit: http://bit.ly/KqZDdo.

June 1, 2012

CDC RECOMMENDS BABY BOOMERS TEST FOR HEPATIS C

In draft recommendations the Centers for Disease Control and Prevention (CDC) proposes one-time testing for all adults born between 1945 and 1965 (baby boomers) for identification of persons with hepatitis C virus (HCV) chronic infection. More than 2 million U.S. baby boomers are infected with HCV. Many infected baby boomers do not realize they are infected, as HCV can damage the liver with few noticeable symptoms over many years. The CDC believes that expanded screening efforts will help slow or halt disease progression and transmission, especially since new treatments can cure up to 75% of infections.

The CDC is accepting public comments regarding its recommendation through June 8, 2012. To review the recommendations and/or submit a comment, visit http://1.usa.gov/LU1Hb3.

OMB ISSUES FY 2014 BUDGET GUIDANCE TO GOVERNMENT AGENCIES

The Office of Management and Budget (OMB) has issued the FY 2014 budget guidance to leaders of government departments and agencies. The guidance notes that FY 2014 budget requests should reflect a five-percent decrease in funding from FY 2013. Information technology costs must be reduced by ten percent. OMB also requests that agencies and departments refrain from the use of across-the-board cuts, cuts to mandatory spending, or cost shifts from other parts of the budget to reach 2014 spending level limits.

To view the OMB guidance visit http://1.usa.gov/LbgPOi.

NEW GUIDELINES RECOMMEND AGAINST SCREENING LOW-RISK PATIENTS FOR LUNG CANCER

New lung cancer screening guidelines recommend annual CT scans for a select group—current or former smokers between ages 55-74—and against routine screening among other groups. These guidelines, published online in the Journal of the American Medical Association (JAMA), are the result of a systematic review by an expert panel from several medical groups—the American Cancer Society (ACS), the American College of Chest Physicians (ACCP), the American Society of Clinical Oncology (ASCO), and the National Comprehensive Cancer Network (NCCN)—with input from the American Thoracic Society (ATS). It forms the basis for the clinical practices guidelines of the ACCP and ASCO.

 

May 22, 2012

TASK FORCE RECOMMENDS TEAM-BASED CARE TO IMPROVE BLOOD PRESSURE

The Community Preventive Services Task Force has recommended team-based care for improving blood pressure control. Team-based care is provided by a team of health professionals—a primary care provider supported by a pharmacist, nurse, dietitian, social worker, and/or community health worker—rather than a single physician. The Task Force found strong evidence to support the effectiveness of team-based care in improving the number of patients with controlled blood pressure and in reducing systolic (SBP) and diastolic (DBP) blood pressure. The greatest improvement in blood pressure was observed when the team members could change medications independently, or with the approval of the primary care provider. Complete findings of the review are expected to be published by May 2013.

To view the Task Force Finding and Rationale Statement, visit http://bit.ly/K7S6wg.

HOUSE GOP PASSES SEQUESTER REPLACEMENT WITH MORE HEALTH CARE CUTS

House Republicans moved ahead with their plan to replace the January 1, 2013 budget cuts "sequester" with a heavier round of health care cuts that would spare the defense industry from the impending budget cuts. The sequester was agreed to as part of last year’s Budget Control Act and requires an across-the-board cut to federal defense and non-defense programs necessary to secure at least $1.2 trillion in savings.

These cuts passed the House as part of the chamber’s budget reconciliation bill that would defund parts of the Affordable Care Act, impose more stringent eligibility reviews for Medicaid enrollees, and cap damages on medical malpractice awards. Senate Democrats and the White House have voiced their opposition to the House bill.

HOUSE SUBCOMMITTEE APPROVES LANGUAGE SUPPORTIVE OF VA AND CDC COLLABORATION ON NVDRS

The House Military Construction and Veterans Affairs (VA) Appropriations Subcommittee adopted its FY 2013 appropriations bill with language provided by ACPM. The chair of the National Violence Prevention Network called on the VA and Centers for Disease Control and Prevention (CDC) to collaborate "to improve the nation’s capacity to prevent veteran suicides. By linking VA claims data and systems with other public health surveillance data, less lag time, more complete tracking and a richer set of data will help inform targeted prevention strategies.” ACPM requested the inclusion of this language to build awareness of the National Violent Death Reporting System (NVDRS) and advance data sharing discussions between the CDC National Center for Injury Prevention and Control and the VA. The CDC National Center for Injury Prevention and Control administers the NVDRS program.

FDA PANEL BACKS PREVENTIVE USE OF HIV DRUG

An advisory panel to the Food and Drug Administration (FDA) has recommended that a drug currently used to treat HIV infection also be approved for prevention. The recommendation marks the first time government advisers have advocated administering antiviral medicine to healthy individuals who might be exposed to the virus through sexual activity.

After evaluating studies and hearing scientific presentations, the panel recommended that Truvada, a once-a-day treatment pill, be prescribed for people at higher risk of infection, such as individuals involved in a sexual relationship with someone who is HIV positive and homosexual men with multiple partners. The drug would also be recommended for other high-risk groups.

Voting was not unanimous. Some members of the 22-member panel voted no or abstained because of their belief that data is insufficient to prove the drug safe and effective in women and African-Americans. Preventive use costs approximately $14,000 annually. However, FDA approval may increase the likelihood of coverage under health insurance plans.

FDA ADVISORS RECOMMEND NEW WEIGHT LOSS DRUG

A panel of advisors to the Food and Drug Administration (FDA) has recommended that the agency approve Lorcaserin, a new weight loss drug, developed by Arena Pharmaceuticals. The recommendation comes despite concerns over cardiac risks. The panel concluded that the benefits of Lorcaserin "outweigh the risks when used long term” in overweight and obese patients. The FDA has set a target date of June 27 for deciding whether to approve sales of the drug. Earlier this year, an FDA advisory panel recommended approval of weight loss drug Qnexa, developed by Vivus Pharmaceuticals. If ultimately approved, these drugs would be the first new prescription weight loss drugs available in the U.S. in 13 years.

May 4, 2012

HOUSE AND SENATE SPENDING ALLOCATIONS FOR HEALTH PROGRAMS SET

The House and Senate Appropriations Committees have approved their spending allocations, setting overall spending targets for FY 2013. The House Appropriations Committee set an overall spending cap of $1.028 trillion, which is $19 billion less than the level set by its counterpart in the Senate, which used the $1.047 trillion benchmark set forth in last year’s debt limit law. Among the differences between the House and Senate allocations is a $7.7 billion difference in funding for the Labor, Health and Human Services and Education Appropriations bills, with the House proposing to allocate $150 billion to these programs compared to $157.7 billion in the Senate.

The funding disparity all but guarantees that the FY 2013 Labor, Health and Human Services and Education Appropriations bill will not pass prior to the start of the new fiscal year on October 1.

For more information, contact Paul Bonta at pbonta@acpm.org or 202-466-2044.

ACPM SENDS LETTER OPPOSING CUTS TO PREVENTION FUND TO PAY FOR STUDENT LOAN BILL

ACPM sent a letter to House leaders urging they not tap funds from the Prevention and Public Health Fund to pay for maintaining low student loan rates for college students who receive federal support.

In the letter ACPM President Miriam Alexander stated, "While ACPM supports efforts to stabilize our nation’s economy, the College will not support any proposal that diverts funds away from disease prevention programs for short-term economic savings. The Prevention and Public Health Fund represents a critical investment in public health and a historic commitment towards efforts that will help shift the focus of our health care system from disease treatment to disease prevention and health promotion.” ACPM has been a vocal proponent of the Prevention and Public Health Fund and will continue to voice opposition to efforts aimed at weakening or eliminating this important source of revenues for prevention and health promotion programs.

To view a copy of the letter, visit http://www.acpm.org/resource/resmgr/Policy-Files/2012_LTR_OpposePPHFcutsE&C.pdf.

NATION’S LARGEST PHYSICIAN SPECIALTY ORGANIZATION CALLS FOR IMPROVEMENTS TO U.S. PUBLIC HEALTH SYSTEM

The American College of Physicians (ACP), the largest medical-specialty organization in the U.S. representing 132,000 internists, internal medicine subspecialists, and physicians in training, has released a policy paper calling for an improved public health infrastructure that works collaboratively with physicians to ensure the public's safety and health. "Strengthening the Public Health Infrastructure" makes the case for adequate investments in public health, noting that strengthening the public health infrastructure is imperative to ensuring that appropriate health care services are available to meet the population's health care needs and to respond to public health emergencies.

The paper calls for adequate funding for the public health infrastructure, but recognizes that the tight budget environment requires that funding be prioritized. It makes the case that the consequences of underfunding essential and effective programs that prevent diseases and promote good health within groups of people would be an unwise, and ultimately very costly, use of limited resources. The paper recommends that funding priority be based on assessment of which programs have demonstrated effectiveness in achieving key public health objectives.

ACP presents seven public policy positions in the paper to strengthen the public health infrastructure.

ADENOVIRUS VACCINES REINSTATED AFTER LONG ABSENCE

The adenovirus vaccine, 18 years after its sole manufacturer discontinued its use, is once again available for U.S. military trainees. The adenovirus vaccination program resumed in October 2011, with enlisted soldiers receiving the vaccine during basic training. The re-licensure of the vaccine required significant investment by the U.S. government and long years of testing and regulatory review, during which rates of adenovirus illness in the military rose. The history of the vaccine’s disappearance illustrates the precarious position of the lesser-used vaccines in the military. For more on this story, including quotes from ACPM Fellow Joel Gaydos, MD, MPH, FACPM, visit http://ow.ly/aHLGz.

April 23, 2012

EVIDENCE REVIEW ON CHRONIC KIDNEY DISEASE PUBLISHED

The Annals of Internal Medicine has published a review of the evidence on screening for, monitoring, and treatment of chronic kidney disease stages 1 to 3. This review is based on a report that was posted for public comment from March 22 to April 6, 2011, through a partnership with the Agency for Healthcare Research and Quality’s Effective Health Care Program. The evidence review will inform the U.S. Preventive Services Task Force’s forthcoming draft recommendation statement on screening for chronic kidney disease. The evidence review is available at http://bit.ly/JrVA9X.

COMMUNITY GUIDE TASK FORCE ISSUES RECOMMENDATION ON DEPRESSIVE DISORDERS

The Task Force on Community Preventive Services (Task Force) has issued a recommendation on collaborative care to improve the management of depressive disorders. Based on strong evidence of effectiveness in improving depression symptoms, adherence to treatment, response to treatment, and remission and recovery from depression, the Task Force recommends collaborative care for the management of depressive disorders. The Task Force also finds that collaborative care models provide good economic value based on the weight of evidence from studies that assessed both costs and benefits.

To read the full Task Force recommendation visit http://bit.ly/HWqdtQ.

FDA TAKES STEP TOWARD PHASE OUT OF ANTIBIOTICS IN FARM ANIMALS

The Food and Drug Administration (FDA) recently published draft guidance aimed at the drug and livestock industry to voluntarily phase out the routine use of medically important antibiotics from farm animal feed. The action comes on the heels of a U.S. District Court ruling in New York that ordered the FDA to take action to stop use of penicillin and tetracyclines in livestock feed because they threaten human health.

ACPM, as an active member of the national Keep Antibiotics Working coalition, has been a strong proponent of new measures to thwart the use of antibiotics in farm animals.

To read the draft guidance visit http://bit.ly/Isn1AZ.

April 8, 2012

CMS RELEASES PROPOSED REGULATION TO CREATE "ACCOUNTABLE CARE ORGANIZATIONS”

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed regulation creating the Medicare Shared Savings Program, commonly referred to as the Accountable Care Organization (ACO) program, mandated by the Affordable Care Act. The 60 day public comment period for the proposed regulation runs through June 6.

In its press release, CMS states "ACOs create incentives for health care providers to work together to treat an individual patient across care settings, including doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care.”

ACPM will submit formal comments to CMS in response to the proposed regulation strongly urging ACOs rely on the expertise of preventive medicine physicians to ensure these new networks meet the dual goal of improved care and improved quality.

To view a draft of the proposed regulation, please visithttp://bit.ly/f3bq8S.

ACPM joined 54 public health stakeholder organizations in a sign-on letter to President Obama urging he "strongly oppose” efforts to eliminate the $15 billion Prevention and Public Health Fund mandated by the Affordable Care Act. The Fund has become a target for increasing attacks by congressional Republicans who question the Fund’s intent and are eager to siphon the funds for non-public health uses. Legislation recently approved by the House Energy and Commerce Committee, HR 1217, would repeal the Fund by striking Section 4002 of the Affordable Care Act, the section authorizing and funding the Prevention and Public Health Fund.

To view a copy of the letter, please visithttp://bit.ly/fXvhmi.

VIDEOS FEATURING ACPM MEMBERS UNVEILED DURING CAPITOL HILL BRIEFING

Videos by ACPM President Miriam Alexander, MD, MPH, FACPM, FellowDeborah Porterfield, MD, MPH, FACPM, and Preventive Medicine resident Charlie Preston, MD, MPH, were highlighted during a Capitol Hill briefing hosted by the Health Professions and Nursing Education Coalition (HPNEC). The briefing explored how federal support for the Health Resources and Services Administration (HRSA) Title VII and Title VIII programs strengthens workforce development activities across the country. Title VII of the Public Health Service Act authorizes HRSA to fund Preventive Medicine residency training programs. ACPM has been an active member of HPNEC working to secure support for enhanced HRSA funding to expand support for Preventive Medicine residency training.

To view the videos, please visithttp://www.youtube.com/user/HPNEC1.

March 26, 2012

GUIDELINES FOCUS ON NEWLY DIAGNOSED HIV PATIENTS

Infectious diseases experts have issued guidelines calling on physicians to ensure that newly diagnosed HIV patients start treatment and adhere to life-long drug regimens. The recommendations were developed by a panel of 31 HIV experts on behalf of the International Association of Physicians in AIDS Care. The guidelines urge health professionals to monitor the entry of patients they diagnose with HIV into treatment programs. The guidelines are available online in the March 5 issue of Annals of Internal Medicine athttp://bit.ly/GENqQs.

TASK FORCE ISSUES RECOMMENDATIONS ON ALCOHOL RETAIL SALES AND ADOLESCENT HEALTH

The Community Preventive Services Task Force (Task Force) recently issued findings on the Effects of Alcohol Retail Privatization on Excessive Alcohol Consumption and Related Harms. The Task Force recommends against the further privatization of alcohol sales in settings with current government control of retail sales. The finding is based on strong evidence that privatization results in increased per capita alcohol consumption, a well-established proxy for excessive consumption and related harms.

The Task Force also issued a recommendation in support of person-to-person interventions intended to modify adolescents’ risk and protective behaviors by improving their caregivers’ parenting skills. Such interventions could be conducted either face-to-face or by telephone and occur outside of clinical settings.

To view the Task Force statement on alcohol retail sales visit http://bit.ly/geEste.

To view the Task Force statement on adolescent health visit http://bit.ly/w9cK9C.

CDC PUBLIC EDUCATION CAMPAIGN AIMS TO MAKE TOBACCO HISTORY

In an effort to help stem the national tobacco epidemic, the U.S. Centers for Disease Control and Prevention (CDC) has launched a new multi-channel advertising campaign, "Tips from Former Smokers.” The CDC is following evidence-based science by investing in one of the most important components of an effective comprehensive tobacco control program: a hard-hitting paid national tobacco education campaign that bolsters existing work being done at the state and local levels.

For more information on the campaign, please visit: http://www.cdc.gov/tobacco/campaign/tips/

To view the campaign videos click here: http://bit.ly/xpb1aH

PUBLIC HEALTH AND TWITTER: COMING TOGETHER FOR HEALTH IMPROVEMENT

Do you practice public health? Do you use Twitter? I suspect many of you will answer yes to the first question. I doubt many of you will answer yes to the second. However, this is a gap that should be, if not already, closing, as Twitter and other forms of social media are becoming important tools for health improvement at both individual and population levels. Dubious? Read this physician’s blog from KevinMD.com.

Already a Twitter user? Follow ACPM at http://twitter.com/ACPM_HQ.

March 9, 2012

COURT BLOCKS IMPLEMENTATION OF NEW GRAPHIC CIGARETTE WARNING LABELS

A final ruling by U.S. District Court Judge Richard Leon in Washington, DC blocking implementation of the new, graphic cigarette warning labels could hamper continued efforts to implement effective cigarette warning labels. The U.S. Department of Justice has already appealed an earlier ruling by Judge Leon and is working to preserve this critical requirement of the landmark 2009 law giving the Food and Drug Administration (FDA) the authority to regulate tobacco products. Judge Leon concluded in his summary statement that the warnings are "neither factual nor accurate” about cigarette smoking.

A federal judge from the Sixth Circuit earlier upheld the new, graphic warning labels and that decision is now under appeal by the tobacco industry. The next rulings on this issue will come from the two appellate courts, and the issue could end up before the U.S. Supreme Court.

COMMUNITY GUIDE PUBLISHES EVIDENCE REVIEWS ON PREVENTING ADOLESCENT PREGNANCY, HIV, and STIs

The Community Preventive Services Task Force has published its findings on two types of interventions to prevent teen pregnancy, HIV, and other sexually transmitted infections—comprehensive risk reduction and abstinence education delivered to groups of teens in school or community settings. Based on a systematic review of scientific evidence, the Task Force recommends comprehensive risk reduction interventions based on sufficient evidence that they reduced several self-reported risk behaviors, increased self-reported use of protection against pregnancy and sexually transmitted infections (STIs), and reduced the incidence of self-reported or clinically-documented sexually STIs.

A related review looked at group-based abstinence education to prevent pregnancy, HIV and other STIs among adolescents. Due to inconsistent results among reviewed studies, the Task Force found insufficient evidence to support this intervention and noted that more research is needed to determine whether or not the intervention works.

These findings and the Community Guide evidence reviews on which they are based are published in the March 2012 American Journal of Preventive Medicine. See http://ow.ly/9xCE0 for more information.

CMS ISSUES PRELIMINARY RULE FOR STAGE 2 MEANINGFUL USE

The Centers for Medicare and Medicaid Services (CMS) has released the preliminary rules for Stage 2 Meaningful Use. "Meaningful Use” is the federal standard for eligible physicians and hospitals to receive incentives through Medicare and Medicaid for adopting and using an Electronic Health Record. Stage 1, finalized about two years ago, was meant to start getting providers to move key clinical data into electronic format. Stage 2 is meant to tie health information technology (HIT) adoption more closely to driving improvements in care, and to show that electronic health records are beginning to make a difference.

A few of the notable changes that will be underway once the Stage 2 rule is finalized are:

• The "optional” measures included under stage 1 now would be "core” measures and would be added to the original stage 1 core measures.
• Under stage 1, an electronic connection for exchange of health information between providers had to be successfully "tested.” Under stage 2, actual patient health data would be exchanged with another healthcare provider.
• Under stage 1, patients had to have electronic access to their health records. Under stage 2, doctors would need to demonstrate that a percentage of their patients have accessed and downloaded their information.

Public comments on the preliminary Stage 2 rule will be accepted through March 23. The Stage 2 rule is expected to be finalized this summer. To view and comment on the preliminary Stage 2 rule, visit http://bit.ly/hL99Yo.

February 14, 2012

ACPM SENDS COMMENTS TO FDA ON ANTIBIOTIC RESISTANCE

In response to the growing public health threat posed by misuse and overuse of antibiotics in farm animals, ACPM, as an active member of the Pew Charitable Trusts workgroup on antibiotic resistance, applauded recent Food and Drug Administration (FDA) action to ban the extra-label use of cephalosporins in food-producing animals.

ACPM President Miriam Alexander wrote, "Banning the extra-label use of cephalosporins represents an important first step towards addressing the growing public health threat posed by antibiotic resistance. However, we urge the FDA to continue this important work by issuing guidance to thwart the use of antibiotics to promote growth and compensate for the effects of unsanitary and overcrowded conditions among livestock.”

To view a copy of the letter, visit http://bit.ly/ywOHl4.

ACPM OPPOSES USE OF PREVENTION FUND TO PAY FOR TAX EXTENDERS PACKAGE

ACPM sent a letter to House and Senate conferees working to negotiate a long-term extension of the "doc fix” in the Medicare physician fee schedule urging they not tap funds from the Prevention and Public Health Fund to pay for higher reimbursements for physician services.

In the letter ACPM President Miriam Alexanderstated, "While ACPM has been a staunch supporter of efforts to fix the broken sustainable growth rate formula used to calculate Medicare physician reimbursement levels, the College will not support any proposal that diverts funds away from disease prevention programs in order to increase payments for disease treatment.” ACPM has been a vocal proponent of the Prevention and Public Health Fund and will continue to voice opposition to efforts aimed at weakening or eliminating this important source of revenues for prevention and health promotion programs.

To view a copy of the letter, visit http://bit.ly/zg0Vz6.

FEBRUARY IS AMERICAN HEART MONTH

February has been declared American Heart Month, a time intended for all to "recommit to better heart health for all Americans.” As the leading cause of death in the UnitedStates, heart disease claims more than half a million American lives a year and costs the nation more than $444 billion in health care expenses and lost productivity.

For more information, please visit: http://www.cdc.gov/features/heartmonth/

January 27, 2012

CDC LAUNCHES NATIONAL WORKPLACE WELLNESS ASSISTANCE PROGRAM (NHWP)

CDC has launched a new workplace wellness assistance program called the National Healthy Worksite Program (NHWP). NHWP is designed to assist employers in implementing science and practice-based prevention and wellness strategies leading to specific, measureable health outcomes to reduce chronic disease rates. Seven counties have been selected to participate in the program: Somerset County, ME; Shelby County, TN; Marion County, IN; Harris County, TX; Buchanan County, MO; Kern County, CA; and Pierce County, WA.

For more information on the NHWP visit, http://1.usa.gov/tgMkpp.

The healthier meal requirements are a key component of the Healthy, Hunger-Free Kids Act, which was signed into law by President Obama and championed by the First Lady as part of her Let’s Move! campaign.

For more information on the new standards visit, http://www.letsmove.gov/

JEFFREY ZEINTS NAMED ACTING DIRECTOR OF OMB

President Obama recently announced current Office of Management and Budget (OMB) Deputy Director for Management and Chief Performance Officer Jeffrey Zients will serve as the Acting Director of the Office of Management and Budget. Jack Lew, the former director of OMB, was named White House chief of staff.

JANUARY 13, 2013

The new FDA labels would have covered the entire top half of each pack, front and back, contained written warnings and a telephone number for a smoking cessation hotline, and displayed graphic color images of dead or diseased smokers. Judge Richard Leon concluded the size and graphic nature of the FDA-approved labels went beyond conveying factual information and into the realm of advocacy, which is a crucial factor in a case about freedom of speech. If this ruling is upheld, it could have significant consequences for future warning labels. The government will be appealing this decision.

ACPM SIGNS LETTER URGING CONTINUED SUPPORT FOR HEALTH PROFESSIONS TRAINING PROGRAMS

As an active member of the Health Professions, Nursing, and Education Coalition (HPNEC), ACPM joined a sign-on letter to leaders of the House and Senate Labor, Health and Human Services, and Education Appropriations Subcommittee urging continued support for all Title VII Health Professions programs at no less than their FY 2011 funding levels. The Title VII health professions programs include the Health Resources and Services Administration (HRSA) program providing support to preventive medicine residency training programs.

To view a copy of the letter, visit http://www.acpm.org/resource/resmgr/Policy-Files/2011_Ltr_HPNCEC_Funding.pdf

PRESIDENT ISSUES EXECUTIVE ORDER ON PRESCRIPTION DRUG SHORTAGES

President Obama, along with HHS Secretary Kathleen Sebelius and FDA Commissioner Margaret Hamburg, signed an Executive Order directing the FDA to take specific actions to maximize their ability to reduce and prevent drug shortages. Over a recent period of 5 years, the number of reported prescription drug shortages tripled from 61 to 178. Drug shortages pose a significant public health concern because they lead to delays in treatment or force the utilization of second-choice products.

For more information, visit the web site on the Review of FDA’s Approach to Medical Product Shortages at: http://1.usa.gov/sI7uG8. To download the FDA’s Approach to Medical Product Shortages Report, go to: http://1.usa.gov/twGndx.

CDC AWARDS $9 MILLION TO EMPLOYERS FOR WELLNESS PROGRAMS

ACPM JOINS LETTER TO CONGRESS IN SUPPORT OF STRONG FDA OVERSIGHT

ACPM joined several public health organizations in a letter to Congress speaking out against language included in a draft House appropriations bill intended to weaken the Food and Drug Administration’s (FDA) ability to address public health issues such as tobacco control, antibiotic resistance, and obesity. The letter urged such language be stripped prior to formal consideration and passage of the bill. The language was included in a draft of the House FY 2012 Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations.

Click to view a copy of the letter.

ACPM SENDS LETTER TO HRSA ADMINISTRATOR URGING STRONGER SUPPORT FOR PMR PROGRAMS

ACPM President Miriam Alexander, MD, MPH, FACPM, sent a letter to Health Resources and Services Administration (HRSA) administrator Mary Wakefield urging a more equitable distribution of funding under HRSA’s "preventive medicine and public health” line-item. After release of HRSA’s FY 2011 spending plan, it was revealed that while funding for the "preventive medicine and public health” line-item increased from $10 million to $30 million, no new funding would be allocated to preventive medicine residency (PMR) training programs. The $20 million increase was a result of funds made available from the Prevention and Public Health Fund mandated by the Affordable Care Act.

In her letter, Dr. Alexander noted "While we are excited to see nearly $30 million appropriated to this line (by far the largest increase across all health professions programs), we are deeply disappointed that less than 10% of that amount will be allocated to support preventive medicine residency training programs.” Current HRSA funding supports 17 PMR training programs.

Click to view a copy of Dr. Alexander’s letter.

JUNE 3, 2011

NUMBER OF MEASLES CASES MARKS 15 YEAR HIGH

The Centers for Disease Control and Prevention (CDC) reported 118 measles cases across the United States in 2011, the highest number of cases reported for any January-May period since 1996. The report, from the most recent Morbidity and Mortality Weekly Report (MMWR),indicates the median annual rate of measles was 56 cases between 2001-2008.

Transmission occurred in households, child care centers,schools, emergency departments, and at large community events. The largest outbreak occurred in Minnesota among children unvaccinated due to parental concerns about the safety of measles, mumps and rubella vaccine (MMR). At least seven infants were too young to receive MMR vaccine.

Health care providers should be on alert for potential cases due to ongoing importations of measles to the United States, including persons with a febrile rash illness (symptoms of cough, coryza, and/or conjunctivitis), who have recently traveled abroad or have had contact with travelers.

To read the full MMWR report, please visit http://1.usa.gov/jKsK2z.

NEW HEALTH BENEFIT TO ADDRESS CHILDHOOD OBESITY

With nearly 1 in 3 children and teens in the United States overweight or obese, the Alliance for a Healthier Generation is working to enhance the prevention, assessment and treatment of childhood obesity in doctors’ offices across the country. The Alliance for a Healthier Generation, a non-profit founded by the American Heart Association and William J. Clinton Foundation, launched the Healthier Generation Benefit enabling families to work with their primary care physicians and registered dietitians to achieve lifelong health.

Through the Healthier Generation Benefit, eligible children have access to at least four follow up visits with a primary care provider and four visits with a registered dietitian annually, without the requirement of a co-morbidity.

More than two million kids are already covered by the Healthier Generation Benefit, with a goal of covering more than six million young people by the end of 2012. Providers are encouraged to contact the Alliance for a Healthier Generation to learn how they can get involved. To learn more about this effort please visit www.healthiergeneration.org.

HOUSE APPROPRIATIONS COMMITTEE SETS FY 2012 SPENDING CAP FOR HEALTH SUBCOMMITTEE

The House Appropriations Committee has released its subcommittee allocations for FY 2012 providing the Labor, Health and Human Services, and Education Appropriations Subcommittee with $139.2 billion, a $18.2 billion (11.6 percent) decrease from FY 2011 levels. The Labor, Health and Human Services (HHS), and Education Appropriations Subcommittee is charged with developing the FY 2012 budget for HHS, which includes the Health Resources and Services Administration’s "preventive medicine and public health” line-item supporting preventive medicine residency training programs.

ACPM JOINS PUSH TO SET STRONG STANDARD FOR OZONE AIR POLLUTION

ACPM joined other leading public health organizations in a sign-on letter to President Obama on ozone air pollution urging that he "direct the Environmental Protection Agency (EPA) to issue a strong standard to protect public health.” The letter was sent in response to EPA Administrator Lisa Jackson’s January 2010 commitment toreconsider the 2008 decision regarding the National Ambient Air Quality Standards for ozone air pollution.

The letter specifically notes that the, "ozone health standard must protect those who are most vulnerable from the negative health impacts of ozone, including children, older adults, and those with chronic diseases. To safeguard the health of the American people, help to save lives, and reduce health care spending, we support the most protective standard under consideration: 60 parts per billion (ppb) averaged over eight hours.”

Click to view a copy of the letter.

SENATORS ASK COMMITTEE TO INCREASE FUNDING FOR PMR PROGRAMS

Ten Senators, led by Sen. Tom Udall (D-NM), delivered a letter to the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies urging $10 million be made available in the FY 2012 budget to the Health Resources and Services Administration’s (HRSA’s) "Public Health and Preventive Medicine account to support preventive medicine residency training programs.” Currently, the "Public Health and Preventive Medicine” account is funded at $9.6 million and is divided between preventive medicine residency (PMR) training programs, public health training centers, and public health traineeships. The portion of funding provided to PMR programs is $2.3 million.

ACPM greatly appreciates Sen. Tom Udall’s (D-NM) efforts in leading the charge to build support for preventive medicine residency training programs in the Senate and for his broader efforts in support of the entire public health community. This is the second year in a row that Sen. Udall (D-NM) has led this effort.

Click to view the letter.

HILL BRIEFING HIGHLIGHTS ACPM TIME TOOLS ON MEDICATION ADHERENCE AND ABUSE

The Partnership to Fight Chronic Disease (PFCD), a broad-based national coalition organized to promote the prevention of chronic disease, recently held a Capitol Hill briefing where ACPM’s Time Tools on Medication Adherence and Use, Abuse, Misuse and Disposal of Prescription Pain Medications were highlighted as models of targeted programs that must be developed to help address the growing epidemic of prescription drug use and other medication use problems. ACPM has long been an active member of PFCD and maintains a seat on its Advisory Board.

Click to view the ACPM Time Tools.