Federal Flu Fighters

Experts say that a pandemic flu outbreak will hit the United States—a pandemic large enough to stretch our healthcare resources to the breaking point and overwhelm hospitals.

“They say it’s not if, but when,” says James C. Pile, MD, FACP, Division of Hospital Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, an infectious diseases specialist with a longstanding interest in bioterrorism/pandemic preparedness, and former editor of The Hospitalist.

Your Government at Work

The federal government is taking a lead role in preparing for this outbreak or outbreaks. President George W. Bush issued a National Strategy for Pandemic Influenza in November 2005, which focuses on measures to slow or stop the spread of a pandemic flu and on “sustaining infrastructure and mitigating impact to the economy and the functioning of society.”

That strategy charges the Department of Health and Human Services (HHS) with leading federal pandemic preparedness. The HHS is working with state and local agencies on planning and has made $600 million available for state and local preparedness efforts, including the exercising of pandemic plans across communities and at all levels of government.

Total congressional funding for pandemic flu preparedness, says Dr. Pile, is “somewhere in the neighborhood of $5 billion dollars.”

Policy Points

It Pays to Be on Medicare

According to a new study released by the healthcare ratings firm HealthGrades, hospital patients on Medicare who were treated at hospitals ranked in the top 5% nationwide have almost a one-third better chance of surviving than patients admitted to other hospitals. The study focused on patients admitted to top-rated hospitals for various procedures and diagnoses, including cardiac surgery, angioplasty and stent, and heart attack and heart failure. The study also found that patients who underwent surgery at these hospitals had a 5% lower risk of complications.

Source: www.healthgrades.com/media/dms/pdf/HospitalQualityClinicalExcellenceStudy2007.pdf

CMS Declares Pay-for-Performance Trial a Success

The first national pay-for-performance trial launched by Medicare has been declared a success. Hospitals participating in the Premier Hospital Quality Improvement Demonstration reported significant improvement in quality of care across five clinical focus areas, measured by more than 30 standardized quality indicators. More than 250 hospitals participated in the demonstration project, and the average improvement in performance in the project’s second year was 6.7 percentage points, for total gains of 11.8 percentage points over the project’s first two years.

Source: Medicare News press release, 1/26/07

House Law Would Require Price Negotiations for Medicare Drugs

On January 12, 2007, just days after the new Congress convened, the House of Representatives voted 255-170 to require HHS to negotiate with pharmaceutical companies over prices for prescription drugs covered by Medicare Part D. H.R. 4, the Medicare Prescription Drug Price Negotiation Act of 2007, would repeal a provision in the current law that prohibits negotiating with drug makers. President Bush has threatened to veto the bill.

Sources: Modern Healthcare Alert from 1/12/07 and www.louise.house.gov/index.php?option =com_content&task=view&id=742&Itemid=

A Working Plan

In May 2006, President Bush released the Implementation Plan for the National Strategy, which stipulates more than 300 actions for federal departments and agencies and sets clear expectations for state and local governments. It also provides guidance for all federal departments and agencies on the development of their own plans.

The latest update on the Implementation Plan (released in December 2006) lists dozens of action items, including:

The Department of Homeland Security will provide emergency response element training (e.g., incident management, triage, security, and communications) and provide assistance, when requested, to state, local, and public health entities within six months.
HHS will work with state and local governments to develop protocols for the distribution of critical medical materials such as ventilators in times of medical emergency, also within six months.
HHS will prepare guidance for local Medical Reserve Corps coordinators describing the role of the Corps during a pandemic. The Medical Reserve Corps comprises teams of local volunteer medical and public health professionals who can contribute their skills and expertise during times of need.