Moving Care

As post-treatment care shifts from oncologists to primary care providers (PCPs), survivors need to explicitly determine the roles their physicians assume in their monitoring and preventive care strategies, a recent study suggests.

Using a Medicare database, researchers from Johns Hopkins University and the Dana-Farber Cancer Institute followed 1,541 patients for five years starting 365 days after diagnosis. They found the rate of preventive care dropped, particularly for cancer screenings, as the shared care between oncologists and primary care providers shifted to care by the primary care provider only. 

The study found the rates of cholesterol screening, mammography and cervical cancer screening were highest during the first year of survivorship. Researchers also found that patients who had visits to both primary  care providers and oncologists were more likely to get flu shots, cholesterol screenings, mammograms, cervical cancer screening and bone density tests. 

Lead investigator Claire Snyder, PhD, from Johns Hopkins School of Medicine, said these results support the need for survivors to have a strategy after treatment.

“These survivorship care plans should define the roles and responsibilities of PCPs and oncology specialists and take into account that, over time, survivors may visit oncology specialists less often and rely solely on PCPs more often,” she said (see “Paradigm Shift” on page 44). “Developing survivorship care plans with clearly delineated roles for PCPs and oncology specialists can help ensure that quality care is provided in a coordinated and efficient manner.”

Snyder said she is currently examining how care has changed over time across different groups of survivors and how care for breast cancer survivors compares with care for women who do not have breast cancer. 
American Society of Clinical Oncology Annual Meeting, June 2007, and interview, 12/18/07

Drug labeling

For the first time in 25 years, the Food and Drug Administration has revised the format of prescription drug information labels. Consumers, healthcare providers and others can visit DailyMed at http://dailymed.nlm.nih.gov to find up-to-date medication labeling and other information. 
U.S. Food and Drug Administration, November 2007 

Quotable

No Money for Mistakes

As of October 2008, Medicare will no longer pay for care related to hospital incidents that it deems preventable.

The rule identifies conditions that Medicare will not cover, including objects left in a patient during surgery, injuries caused by falls, and bedsores or pressure ulcers. “If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm,” Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services, told The New York Times. The federal Medicare/Medicaid agency plans to add three more preventable conditions to the list this year. 
The New York Times, 8/19/07

Retirees Experience Healthcare Hikes

Among large companies that still offer retiree health plans, retired workers are paying more of their total health costs, a new survey finds. Retirees who left their jobs on or after Jan. 1, 2006, experienced premium hikes averaging 15.1 percent for early retirees and 9.6 percent for retirees ages 65 and older. 

The survey, conducted by the Kaiser Family Foundation, also found that only 25 percent of companies are setting aside money for future retiree health obligations. Another 2007 Kaiser survey revealed that between 1998 and 2006, large employers offering retiree benefits dropped from 66 percent to 35 percent, raising concern about the future of retiree health benefits.  
Retiree Health Benefits Examined: Findings from the Kaiser/Hewitt 2006 Survey on Retiree Health Benefits, December 2007

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