|ACPM Headlines 7/10/15|
July 10, 2015
In this Issue
Policy and Practice
Research and Reports
1. OP-ED TOUTS PREVENTIVE MEDICINE AS ANSWER TO HEALTH CARE CRISIS
A recent op-ed published in the Huffington Post touts preventive medicine as the answer to our ailing health care system. “A Hidden Solution to America’s Health-Care Crisis,” authored by Deepak Chopra, MD, FACP, Daniel Blumenthal, MD, MPH, ACPM president, ACPM Fellow Linda Hill, and others write “At present, the most effective way to reduce health care costs is by reducing the rate of illness. We have a mechanism in place to do this -- preventive medicine. Prevention and health education don't drain the national treasury but provide a strong return on the dollar.
The op-ed also calls for the expansion of the preventive medicine training pipeline, noting “Physician training in preventive medicine as a specialty is currently in a fiscal crisis due to the lack of training dollars. Medical Centers are reluctant to divert their graduate medical education Medicare training dollars from acute care to prevention, and the federal government's Health Resources Service Administration funds only a fraction of preventive medicine training programs. Despite the gains in access to health care achieved with the Affordable Care Act, including an emphasis on quality of care and improved outcomes, prevention training funds have not followed.”
ACPM thanks Linda Hill, MD, FACPM, director of Preventive Medicine Residency Department of Family and Preventive Medicine at the University of California San Diego, for coordinating the op-ed with Dr. Chopra. ACPM has circulated the op-ed to all congressional offices and will include it in its growing arsenal of advocacy tools.
ACPM has released a new Time Tool™ focused on HIV screening. Routine HIV Screening: The Difficult but Essential Path to Ending the HIV Epidemic outlines the problem of HIV in the United States and the challenge of encouraging screening, synthesizing current HIV screening and treatment recommendations into crisp, clear advice for clinicians.
Nearly 1.2 million Americans are estimated to live with HIV infection; however, nearly 20% are unaware of it. In addition, the incidence of HIV is actually increasing slightly in adults under 30—especially African-Americans and Latinos. Clinicians are not regularly conducting comprehensive assessments that include HIV screening. As such, ACPM’s Time Tool™, consistent with its position statement, recommends ‘opt-out’ screening and clinician education to address HIV risks with patients.
This tool, which offers continuing medical education (CME), will assist clinicians with initiating a discussion on HIV as well as encouraging testing and appropriate treatment for the disease.
The Senate Appropriations Committee recently approved its FY 2016 Labor, Health and Human Services, and Education Appropriations bill including an amendment offered by Sen. Tom Udall (D-NM) to restore funding for preventive medicine residency training programs.
The original draft of the bill contained language directing the Health Resources and Services Administration (HRSA) to allot all funding under the “public health and preventive medicine” line-item to public health training center programs only, effectively eliminating funding for PM training. Recognizing the destructive impact this would have on the preventive medicine training pipeline, Sen. Udall, working with ACPM, acted quickly to build support for his amendment, which calls for an equal allocation of the nearly $10 million provided in the bill between the public health training centers and preventive medicine training programs.
ACPM deeply appreciates Sen. Udall’s steadfast support of preventive medicine and his efforts to build support among appropriators for the preventive medicine training pipeline.
4. ACPM PRESENCE FELT AT LIFESTYLE MEDICINE MEETING
ACPM President Elect, Bob Carr, MD, MPH, and ACPM Associate Executive Director, Dani Pere, MPM, recently traveled to Boston to represent ACPM at the Harvard Institute for Lifestyle Medicine 2015 Annual Conference. The two-day conference, attended by over 400 clinicians, covered topics related to stress management, weight loss, mediation, prescribing physical activity, obesity and sleep, nutrition, health coaching, and many case studies and practical applications.
ACPM hosted an exhibit table during the conference and spoke with attendees about its Lifestyle Medicine Curriculum, Weight Management Certification program, and upcoming Lifestyle Medicine Curriculum Symposium, August 23-24th in Baltimore, MD.
ACPM’s executive director Michael Barry, CAE joined CEO colleagues from several national organizations June 24 on Capitol Hill to advocate for the Prevention and Public Health Fund. The group of public health leaders met with several U.S. Senators and/or their staff to thank them for their support of public health, encourage new Senate champions for the Fund and the programs it supports, and identify additional champions.
The Prevention and Public Health Fund, created by the Affordable Care Act (ACA), is the nation’s largest single investment in prevention, having invested over $5 billion in resources to states, communities, and tribal and community organizations in support of community-based prevention, including tobacco use prevention, healthy eating and active living, childhood immunizations, and clinical prevention. However, many congressional legislators are unaware of the program’s importance to improved health systems, health care, and, most importantly, health. As such, the Fund has been targeted numerous times for cuts and as an offset (or “pay for”) for other legislative initiatives not relating to public health.
ACPM has been a leader in championing the Fund within the organized medicine community, including successfully leading the charge in 2013 in the AMA House of Delegates to adopt policy to support and protect the Fund. Such policy recently drove the AMA to oppose a bill in the House that would repeal the Independent Payment Advisory Board (IPAB), a key priority for the AMA, because of a last-minute provision to offset its estimated $7 billion cost through reduced funding for the Prevention and Public Health Fund.
As an ACPM Member, you are eligible for a 20% membership discount with the European Society of Lifestyle Medicine (ESLM), an ACPM affiliate organization. Simply visit ESLM’s member website and enter the promo code ACPM15 to obtain the discount. This discount code is good for both new members and membership renewals.
The American Journal of Preventive Medicine (AJPM), the official journal of ACPM and Association for Prevention Teaching and Research, has achieved its highest Impact Factor, according to the 2014 Thomson Reuters’ Journal Citation Report released in mid-June. The AJPM Impact Factor for 2014 is 4.527, an increase over the 2013 Impact Factor of 4.281, which was the previous high-water mark.
A journal’s Impact Factor is a key measure reflecting the average number of citations to recent articles published in the journal. It is frequently used as a proxy for the relative importance of a journal within its field. AJPM ranks 14th of 162 journals in the Public, Environmental & Occupational Health subject category and 19th of 153 journals in the Medicine, General and Internal subject category. AJPM’s 2014 Five-Year Impact Factor—a measure of the relative importance and staying power of journal content—also continues to grow, reaching 5.395 in 2014, compared to 5.042 in 2013.
The journal also continues to experience rapid growth—more than 30 percent in five years—in article submissions. The editorial team, led by chief editor Matthew Boulton, MD, MPH, FACPM, has worked to expand the portfolio of prevention topics covered in the journal. Congratulations to the entire AJPM team for this tremendous accomplishment!
8. ACPM JOINS LETTER OPPOSING ELIMINATION OF AHRQ IN FY16 BUDGET
ACPM joined its partners in medicine and public health on a sign-on letter opposing the termination of the Agency for Healthcare Research and Quality (AHRQ) as proposed in the House FY 2016 Labor, Health and Human Services, and Education Appropriations bill. House appropriators targeted AHRQ for elimination in order to re-direct dollars authorized under the Affordable Care Act.
The letter argues, “To terminate AHRQ in the current fiscal environment is pennywise and pound foolish. Our nation spends $3 trillion annually on health care – the largest share of which are federal purchases through Medicare, Medicaid, the Federal Employees Health Benefits Plan, insurance exchanges, TRICARE, and veterans’ health care. Americans deserve reliable information on how to deliver the best possible care, at the greatest value, with the best outcomes. AHRQ-funded health services research provides those answers.”
9. ACPM JOINS LETTER IN SUPPORT OF PNEUMOCOCCAL IMMUNIZATION MEASURES FOR HOSPITALS
ACPM joined its partners in the Adult Vaccine Access Coalition (AVAC) on a sign-on letter to the Centers for Medicare and Medicaid Services (CMS) expressing concern that the Medicare Inpatient Prospective Payment System proposed rule seeks to remove the IMM-1 (Pneumococcal Immunization -NQF #1653) from the Hospital Inpatient Quality Reporting Program beginning in FY2016 for the FY 2018 payment determination and in subsequent years. The letter notes that “removing IMM-1 is a step in the wrong direction for health care quality improvement, particularly when CMS is seeking to expand care improvement and readmissions measurement for patients with a pneumonia diagnosis. It is also in contrast to CMS’ Quality Improvement Network Quality Improvement Organization (QIN-QIO) 11th Scope of Work (SOW) that includes strategies aimed at improving reporting of all adult immunizations and increasing immunization rates among the Medicare population.”
Despite a successful vote in the House Appropriations Committee to continue level funding for the Centers for Disease Control and Prevention’s (CDC) National Violent Death Reporting System (NVDRS) at roughly $11.3 million, Republican appropriators succeeded in inserting a policy rider into the appropriations bill that prevents the CDC from using any federal funds “on gun research, to include collecting data for potential future research, such as was proposed in the budget request for the National Violent Death Reporting System.” While Rep. Nita Lowey (D-NY) proposed an amendment to strike the language from the bill, the amendment failed to garner majority support.
An opportunity to strike the language is expected given that the Senate’s companion bill does not include such language. ACPM, through its role as chair of the National Violence Prevention Network, will work over the coming months to build awareness among policymakers regarding the chilling effect such a policy rider would have on the continued success of the NVDRS program.
11. USPTSF: FINAL RECOMMENDATION ON SCREENING FOR SPEECH/LANGUAGE DISORDERS IN CHILDREN
The United States Preventive Services Task Force (USPTSF) has published a final recommendation statement that concludes the current evidence is insufficient to assess the balance and harms of screening for speech and language delay and disorders in children aged 5 years or younger. The evidence summary outlines the studies the Task Force reviewed to reach its recommendation. The USPTSF makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms.
Research and Reports
In the past four years, the number of injury-related deaths has increased significantly in 17 states, remained stabled in 24 states, and decreased in 9 states, according to a state-by-state policy report on injury prevention recently released by Trust for America’s Health and Robert Wood Johnson Foundation.
The report also includes a report card of 10 key indicators of leading evidence-based strategies that help reduce injuries and violence. Some of the indicators include presence of a seat belt law, car and booster seats, graduated driver’s license program, bicycle helmet law, and adhering to certain established national goals to reduce homicide, child abuse and neglect, unintentional falls and prescription abuse. Four states including Florida, Iowa, Missouri, and Montana had the lowest score of 2 out of possible 10 injury prevention indicators. New York had the highest score of 9.
Women covered by Medicaid received fewer preventive services than women who had private insurance and made visits to physicians with office-based practices, according to a study published in the June issue of Health Affair. The study used data from the 2006-2010 National Ambulatory Medical Care Surveys and compared 12,444 visits made to primary care practitioners by privately insured women to 1,519 visits made by women covered by Medicaid. The five preventive services that were studied include breast exams, Pap tests, pelvic exams, mammogram and depression screening.
Among women with Medicaid 26% requested at least one of the five services as opposed to 31% of the women who were privately insured. The author suggests there is strong evidence that women under Medicaid are requesting fewer breast exams and Pap tests, as well. However, women covered by Medicaid aren’t necessarily receiving lower quality of care since they could be getting additional services at community health centers.
14. PREVENTIVE MEDICINE RESIDENCY DIRECTOR JOB OPENING AT UNIVERISTY OF TEXAS
The University of Texas Rio Grande Valley is recruiting a Program Director for a new Preventive Medicine Residency Program at Doctors Hospital at Renaissance in Edinburg, Texas. The Preventive Medicine Residency Program is a multisite, academic, community-based program located in the Lower Rio Grande Valley of South Texas.
Applicants must be board-certified in Preventive Medicine and eligible to obtain a Texas medical license.
For more information about the position, please visit the online position profile: http://bit.ly/1JU77RJ
15. MEMBERS IN THE NEWS: RONALD PRIMAS; MICHAEL CRUPAIN; ASIM JANI
Healthy People 2020 provides a comprehensive set of 10-year national objectives for improving the health of all Americans. HealthyPeople.gov provides tools to monitor progress and track the Nation’s health and highlight evidence-based strategies to achieve Healthy People 2020 objectives. A few key features of HealthyPeople.gov include:
HealthyPeople.gov has resources for all types of health professionals working to improve population health.