N.C. considers penalties for doctors who don't join Medicaid networks | MedPAC report suggests MIPS may not help patients, clinicians | Direct primary care model may not mean better health, analysts say
A proposed bill in the North Carolina Senate would cut doctors' and dentists' Medicaid pay by 10% if they do not accept managed care contracts or if they fail to meet network quality standards. The state is seeking federal permission to pay managed care organizations per Medicaid patient instead of paying for each health care service.
A Medicare Payment Advisory Commission report said commissioners are looking at revising the Quality Payment Program because its Merit-based Incentive Payment System may not help people choose a clinician or help practitioners change their practices to improve value. The Commission also made recommendations on ways to improve the Medicare Part B drug program.
Health care analysts' concerns about the viability of direct primary care models, which allow patients unlimited services for a flat fee, have been renewed following news that Seattle-based practice Qliance, one of the pioneers in this type of care, has closed its public clinics. Some analysts say the model encourages the "worried well" to get unnecessary care without guarantees patients will get evidence-based services that will improve their health, while others argue cost-effective primary care must be developed inside the health insurance context.
Adults living in rural areas who had uncontrolled type 2 diabetes improved their HbA1C levels, low-density lipoprotein levels and weight within the first year of participating in a telemedicine-based, interdisciplinary diabetes management program. Moreover, 67% of participants who had symptoms of depression at the beginning of the study reported improvements in their symptoms at the end of the study, researchers reported in the North Carolina Medical Journal.
Elderly patients often are discharged from the hospital with recommendations for home care services, but up to 28% decline to take advantage of them, according to a report from the United Hospital Fund. Study data show refusing home care can increase the risk of a slower recovery and hospital readmission, and experts say elderly patients are worried about maintaining their independence, do not want strangers invading their privacy or underestimate their need for assistance.
Counseling families on healthy eating habits was effective at getting them to reduce food portion sizes and sugar-sweetened beverages served at the table, researchers reported in the Journal of the Academy of Nutrition and Dietetics. The study found other messages, such as eating more fruits and vegetables, did not resonate as much with families, but children in the counseling group still were less likely to gain unhealthy weight.
CDC data showed 48.8% of pregnant women in the US received the CDC-recommended Tdap booster vaccine against tetanus, diphtheria and pertussis in 2016, an increase from 42.1% in 2015. The study found 69.9% of women got the vaccination when it was recommended by a nurse or physician who also offered the shot, compared with 30.8% of women whose provider just recommended the vaccination, and 1.4% of women who did not get a recommendation.