The Institute
of Medicine (IOM) painted a grim picture of the future of health
care for 78 million Baby Boomers in a report released last week.
The document, "Retooling for an Aging America: Building the Health
Care Workforce," warned that the low number of physicians in geriatrics
will not meet the impending demand. The report identified the shortage
of doctors interested in the specialty and the lack of financial
support from Medicare to provide the collaborative care seniors
need as sources of the problem. Another issue noted in the report
is the limited training med school students receive in the field,
although that was said to have improved in recent years due to funding
from public and private organizations (including the AAMC-Hartford
Foundation grants program).
Some recommendations for improvement included: financial incentives
and loan forgiveness for those entering geriatrics;
a mandatory, demonstrated competence in geriatrics by health care
professionals in order to receive certification or licensure; and
a revision of Medicare reimbursable services to include proper care
for chronic illnesses. The report was produced by an independent
committee comprised of educators and health care professionals.
Association urges Senate support
for genetic nondiscrimination bill
AAMC President and CEO Darrell G. Kirch, M.D., sent a letter
last week to all members of the U.S. Senate urging support for the
"Genetic Information Nondiscrimination Act (GINA)." The bill seeks
to prohibit discrimination on the basis of genetic information with
respect to health insurance and employment. Approved unanimously
by the Senate in the 108th and 109th Congresses, the measure has
not progressed past the committee level in the 110th Congress. The
House passed its version of the bill in April 2007. The AAMC letter
notes that "if patients, researchers, clinicians, and industry are
to realize the promise of personalized medicine and the use of genetic
information in health care, Congress must pass GINA."
LCME increases transparency of its processes
The Liaison Committee on Medical Education (LCME) is taking on
a more consultative role as it assists prospective medical schools
through the accreditation pipeline. The sole accrediting body for
educational programs leading to the M.D. degree, the LCME is making
a renewed effort on a variety of fronts to ensure that relevant
officials and members of the public have an understanding of the
accreditation process. A full account of the LCME's efforts, as
well as the medical school accreditation process, appears in the
April issue of the AAMC
Reporter, the association's monthly news publication.
AAMC concerned with House proposal
to increase small business research funding
Last week, AAMC President and CEO Darrell G. Kirch, M.D., sent
a letter
to members of the U.S. House of Representatives, opposing legislation
that would increase the amount of money set-aside from federal science
agency budgets used to fund the Small Business Innovation Research
(SBIR) program and the Small Business Technology Transfer Research
program. In the letter, Dr. Kirch noted, "Increasing the SBIR set-aside
at a time when congressional appropriations for agencies such as
the National Institutes of Health and the National Science Foundation
have stagnated for the past several years will result in funding
cuts for these agencies, further hampering the nation's efforts
to sustain innovation in the biomedical and physical sciences."
The U.S. Small Business Administration also opposes the legislation.
Today marks the start of "National Small Business Week."
The Centers
for Medicare and Medicaid Services (CMS) has released the fiscal
year 2009 Medicare hospital inpatient prospective payment system
(IPPS) proposed rule, to be put into effect on Oct. 1. The proposed
rule would implement the current legal requirement that base payments
be increased per the level of inflation, estimated at 3 percent.
While there are no proposed changes to the graduate medical education
and indirect medical education adjustments, the IPPS proposed rule
affects: the physician self-referral ("Stark") rule; the Emergency
Medical Treatment and Active Labor Act (EMTALA), the "anti-dumping"
law; the post-acute care policy; and the wage index.
The rule also proposes changes to quality provisions related to
hospital acquired conditions; present on admission coding; reporting
of hospital quality data; and the Medicare hospital value-based
purchasing plan. Comments on the proposed rule are due June 13.
Department of Education completes rulemaking
on student loan regulations
The Department of Education has completed negotiations
on new regulations that implement the "College Cost Reduction and
Access Act." Effective July 1, 2009, the new regulations eliminate
the debt-to-income ratio that qualifies medical residents for economic
hardship deferment; define public service qualifications for a new
loan forgiveness program; and implement the income-based repayment
program.
AHRQ resource highlights health
care innovations and tools
The Agency for Healthcare
Research and Quality (AHRQ) has published an online resource
that allows users to learn, share, and adopt innovations in the
delivery of health services. The Health Care Innovations Exchange
is the federal government's repository for successful health care
innovations. It also includes useful descriptions of attempts at
innovations that failed. The Web site is a tool for health care
leaders, physicians, nurses, and other health professionals who
seek to reduce health care disparities and improve health care overall.
