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FDA: Avoid Cipro, Similar Drugs for Common Infections

Agency says risks outweigh benefits

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Now Available: National Quality Strategy 5th Anniversary Update

At the 5-year anniversary of the National Quality Strategy, progress is being made towards the three aims of the National Quality Strategy, to provide better, more affordable care for individuals and the community, according to the new 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy. For the first time, this year's Agency for Healthcare Research and Quality (AHRQ) National Healthcare Quality and Disparities Report and the National Quality Strategy Annual Progress Report are integrated, providing a comprehensive update on the Nation’s progress in improving health care access, quality, and disparities.

Key findings from the new report include:

  • More people have health care coverage, have a usual place to go for medical care, and can more easily afford medical bills after the Affordable Care Act’s provisions have taken effect.
  • More people had a usual place to go for medical care. The percentage of people with a usual place to go for medical care increased overall for Blacks and Hispanics. Hispanics showed the biggest gains in this measure, climbing from 77 percent in 2010 to 83 percent in the first half of 2015.
  • The cost of health care coverage also became more affordable as fewer people overall reported having trouble paying medical bills within the past year. Low-income people saw the greatest benefit, and all racial and ethnic groups showed a decline in payment problems during this period.
  • Quality of care is improving, particularly in hospitals and for measures that are being publicly reported by the Centers for Medicare & Medicaid Services. However, quality is still far from optimal overall, and disparities based on race/ethnicity and income continues to impact the care people receive.

To view the report and other related materials, go to: http://www.ahrq.gov/workingforquality/reports.htm.

Talking with patients about cognitive problems

Are you a health professional working with older adults? Your patients may be concerned about changes in their memory and thinking skills, and may worry about dementia disorders like Alzheimer’s disease. You can help.

Talking With Your Older Patient: A Clinician’s Handbook has information on cognitive problems to help you:

  • Determine when to screen for cognitive impairment
  • Convey findings about memory problems
  • Communicate with a confused patient

AHRQ White Paper Offers Strategies to Integrate Team-based and Patient-centered Care in Primary Care Settings

A new AHRQ white paper, “Creating Patient-Centered, Team-Based Primary Care,” offers a conceptual framework, as well as strategies, that health care providers have used to ensure team-based care offered in primary care settings is patient-centered.  The paper discusses the potential well-implemented team-based care has to improve the overall quality and comprehensiveness of primary care. It also stresses that team-based approaches have the ability to disrupt or change specific aspects of care, such as ongoing relationships, important to patients and providers. Strategies and resources provided in the white paper are intended to help create the culture, structure, and processes that support the development and maintenance of these relationships.

The paper is designed for physicians in primary care practices, practice facilitators, decision makers, and others committed to helping practices successfully transition to patient-centered team-based care. This paper and additional AHRQ resources related to the patient-centered medical home and primary care improvement are available on AHRQ’s PCMH Resource Center web site at pcmh.ahrq.gov.

USPSTF Publishes Final Recommendation Statement: Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer

Dear Colleague,

Thank you for submitting comments on the U.S. Preventive Services Task Force (USPSTF, Task Force) draft recommendation statement and draft evidence reviews for aspirin use for the primary prevention of cardiovascular disease and colorectal cancer during the public comment period. We appreciate your input and carefully considered all comments as we finalized the recommendation and evidence summary.

I am writing to let you and your members know that the Task Force has published the final recommendation statement. In addition, the evidence summaries for this topic have been published. The evidence summaries outline the studies the Task Force reviewed to reach its recommendation. The final recommendation statement and evidence summaries were published in the online edition of Annals of Internal Medicine and are available on the Task Force Web site. A fact sheet that explains the final recommendation in plain language is also available on the Task Force Web site.

Please consider sharing this recommendation statement and evidence summary with your members.

If you are interested in learning about Task Force recommendations like aspirin use for the primary prevention of cardiovascular disease and colorectal cancer, public comment opportunities, and other Task Force activities, then we encourage you to sign up for the USPSTF email list. Please note that this will bring you to a sign-up page on the Agency for Healthcare Research and Quality (AHRQ) Web site. AHRQ manages the administration of the Task Force email list as part of the support it provides to the Task Force.

Also, if you know of any other organizations, subject matter experts, or individuals who may be interested in being informed of Task Force recommendations, please encourage them to sign up.

If you have any questions, please contact the USPSTF Coordinator at coordinator@uspstf.net.

Together, we can improve the health of all Americans.

Sincerely,

Albert L. Siu, M.D., M.S.P.H.
Chair, U.S. Preventive Services Task Force

The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. The Task Force welcomes public comments throughout the recommendation development process to ensure that final recommendations are valid, reliable, and useful for health professionals, patients, and family members.

Announcing Comprehensive Primary Care Plus (CPC+)

Today, CMS announced Comprehensive Primary Care Plus (CPC+), an advanced primary care model and our largest investment in primary care transformation to date. At CMS, we know that strengthening primary care is critical to promoting healthy communities and reducing overall health care costs in the U.S. In CPC+, we have built on the foundation of the Comprehensive Primary Care (CPC) initiative by enhancing the payment and care delivery design. Our goal is to support primary care practices to deliver better care, smarter spending, and healthier people.

CPC+ is a regionally-based, multi-payer care delivery and alternative payment model (APM) that rewards value and quality through an innovative payment structure to support comprehensive primary care. The model will offer two tracks with incrementally advanced care delivery requirements and payment options to meet the diverse needs of primary care practices.

CPC+ is a five-year model that will begin in January 2017. We anticipate partnering with commercial and State payers in up to 20 regions around the country to support primary care practices. CMS will also engage directly with health information technology (health IT) vendors that provide products to advanced CPC+ practices.

Beginning on April 15, 2016, we will solicit payer proposals to partner in CPC+. Based on payer interest and coverage, we will announce the CPC+ regions in July 2016, and solicit applications from eligible practices within these geographic locales.

For questions about the model and solicitation process, please visit the Comprehensive Primary Care Plus web page or email CPCplus@cms.hhs.gov. Information about the model will be posted to the website on an ongoing basis as it becomes available.

To read the Viewpoint article on CPC+ published today in the Journal of the American Medical Association (JAMA), please visit the JAMA article.

All interested stakeholders are invited to attend the Comprehensive Primary Care Plus (CPC+) Announcement Events:

Thursday, April 14, 2016 at 3pm EDT. Please register for this session.

Tuesday, April 19, 2016 at 3pm ET. Please register for this session.


We are excited to share Medicare’s vision for primary care and look forward to partnering in the years ahead to enhance and support high value, comprehensive care for all Americans.

-The CPC Team

Screening for Chronic Obstructive Pulmonary Disease

The U.S. Preventive Services Task Force released today a final recommendation statement on screening for chronic obstructive pulmonary disease (COPD). The Task Force found no benefit for screening in persons without respiratory symptoms and recommends against screening for COPD in asymptomatic adults. To view the recommendation and the evidence on which it is based, please go to http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/chronic-obstructive-pulmonary-disease-screening. A fact sheet that explains the final recommendation in plain language is available. The final recommendation statement can also be found in the April 5 online issue of JAMA.

Join the Million Hearts® Model to help prevent 1 million heart attacks and strokes by 2017!

In response to the continued interest in the Million Hearts® Cardiovascular Disease Risk Reduction Model (MH Model) CMS has re-opened the LOI and application deadline as of April 4, 2016. LOIs and RFAs are due by April 15, 2016.

Do not miss out on this exciting opportunity for your patients and practice!

  • It is important to your patients: Cardiovascular disease is the leading cause of death for men and women in the United States, accounting for one in three deaths, at an annual cost of over $300 billion annually.
  • It is important to your practice: The Secretary of Health and Human Services recently announced the national goal of shifting 85% of all traditional Medicare payments to quality or value by 2016 and 90% by 2018.
  • It provides payment incentives without any risk of penalties: The MH Model's value-based payment incentives will reward clinicians on a sliding scale tiered by aggregate absolute risk reduction across their high-risk patient panel.
  • It is a new way of promoting prevention: The MH Model will attempt to determine whether financially rewarding reductions in 10-year predicted risk of initial heart attack or stroke across a physician's high risk patient population is an effective approach for value-based prevention.

Start an LOI! If your organization has already submitted an LOI, proceed to completing your RFA.

For questions about the application, including username and password:
Email: CMMIForceSupport@cms.hhs.gov
Phone: 888-734-6433 and select "option 5"

For questions about the Model:
Email: mhmodel@cms.hhs.gov
Phone: 703-894-4399

AHRQ Announces Interest in Research that Uses Shared Decision Making as a Tool to Improve the Quality of Care for Low Income and Racial and Ethnic Minority Patients

Notice Number: NOT-HS-16-010

Key Dates

Release Date: March 23, 2016
Related Announcements
None

Issued by

Agency for Healthcare Research and Quality (AHRQ)

Purpose

AHRQ supports research, evaluations, and demonstration projects concerning the delivery of health care in inner-city and rural areas (including frontier areas), and health care for priority populations. Priority populations include low income groups; minority groups; women; children; the elderly; and individuals with special health care needs, including individuals with disabilities and individuals who need chronic care or end-of-life health care. 42 USC 299(c). Investigators should review the document entitled, "AHRQ Policy on the Inclusion of Priority Populations," which is available http://grants.nih.gov/grants/guide/notice-files/NOT-HS-03-010.html.

This Special Emphasis Notice (SEN) informs the research community that AHRQ intends to support research on models of shared decision making (SDM) that are tailored to the needs of low income and racial and ethnic minority patients. While models of SDM in the general population are available, models of SDM for racial and ethnic minority populations are lacking.

SDM occurs when a clinician and patient work together to make a health care decision that is best for the patient. The optimal decision takes into account evidence-based information about available health care options, the clinician's knowledge and experience, and the patient's values and preferences (Source: http://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/index.html. Decision support tools, namely decision aids, are often used to facilitate the decision making process.

SDM is not only intended to impart knowledge—a necessary but insufficient initiator of behavior change—but also to engage the patient in the decision making process. SDM also presents opportunities to address health literacy, cultural, language, access and trust issues that many racial and ethnic and low income groups experience, and can support the delivery of patient-centered care that is evidence-based. For example, SDM can be used to facilitate the dissemination and uptake of PCOR findings.

AHRQ is interested in understanding how SDM can be used to promote informed decision making, to increase patient engagement, and to improve the quality of care among low income and racial and ethnic minority patients. Examples of potential research include:

Development and evaluation of new models of SDM or adaptations of existing models of SDM to meet the needs of low income and racial and ethnic minority populations.
Development and evaluation of tools that support SDM, facilitate participatory decision making; and/or combine information about effectiveness, safety and opportunity costs with the burden of treatment.
Studies that provide an understanding of the patient's perspective in SDM, and in the implementation and evaluation of SDM models in healthcare settings where low income and racial and ethnic minority populations seek care.
Development and evaluation of interventions that increase patient and clinician awareness of biases that influence decision-making and that address barriers to effective patient-clinician communication.

Further Guidance
For the purposes of this notice, AHRQ encourages that a sufficient number of research study participants be comprised of low income, racial and ethnic minorities receiving healthcare in under resourced settings (i.e., safety net hospitals and ambulatory care facilities) to ensure meaningful findings for this population.

AHRQ will use standing research program announcements for the R01 (see http://grants.nih.gov/grants/guide/pa-files/PA-14-291.html), R03 (see http://grants.nih.gov/grants/guide/pa-files/PA-15-147.html), and R18 (see http://grants.nih.gov/grants/guide/pa-files/PA-14-290.html) funding mechanisms to support this research.

Inquiries

Please direct all inquiries to:

Marian James
Agency for Healthcare Research and Quality (AHRQ)
Center for Evidence and Practice Improvement
Telephone: 301-427-1609
Email: sdm@ahrq.hhs.gov