Most Americans Not Familiar with Parts of ACA Designed to Improve Coverage Access

The August 2011 tracking poll conducted by the Henry J. Kaiser Family Foundation focused on the opinions of Americans currently without health insurance and the ways they think the Patient Protection and Affordable Care Act (ACA) will affect them. Experts estimate that 32 million Americans <65 years of age who are uninsured will gain coverage under the ACA. However, just over half of those responding to the poll are aware of provisions in the new law that will help them afford coverage. In addition, only 51% of those currently uninsured are aware of the individual mandate provision of the law. This month’s poll also found that 47% of the uninsured do not think they will be affected, either positively or negatively, by the ACA; 31% say the law will be beneficial in helping them get health insurance overage, while 14% think the law will impact them negatively. When asked poll questions about the ACA in general, the August poll results showed no change in public opinion nationwide. The latest results found that 39% of Americans view the ACA favorably, 44% say they have an unfavorable view, and 17% report they do not know enough about the law to say. While division along partisan lines continues, the line seems to have softened a bit recently. The August poll had the lowest percentage of Democrats supporting the law (60%) and the highest percentage of Republicans holding a favorable opinion of the law since its passage (24%). Another area covered by the ACA was included in the August poll: the requirement for health insurance plans to cover the full cost of birth control and other preventive services for women. In general, 66% of those polled say they support the new requirements. Support is roughly equal among women (68%) and men (62%), but does differ by age and party affiliation. Among adults aged 18 to 29 years, 75% are in favor of the measure; among seniors (≥65 years of age), 51% are in favor. Overall, 82% of Democrats, 64% of independents, and 47% of Republicans indicate they are in favor of the requirement. Azithromycin Provides Benefits in COPD In at-risk patients with chronic obstructive pulmonary disease (COPD), acute exacerbations of the disease declined with treatment with azithromycin, according to an article in Medpage Today. The study, reported in the New England Journal of Medicine, found that the hazard ratio for acute exacerbations of COPD declined by 27% during 1 year of follow-up. In addition, the time to first exacerbation of COPD increased by >50% with azithromycin treatment compared with placebo. Patients in the group treated with azithromycin reported a >4-fold improvement in lung function compared with those given placebo; 20% more azithromycin patients met criteria for clinically important improvement. The researchers cautioned that patients should be screened and monitored for QT prolongation and hearing loss. They added that the long-term safety of the therapy is not known; the implications of long-term therapy on bacterial resistance are also unclear. CMS Launches Bundled Payment Initiative The Centers for Medicare & Medicaid Services (CMS) has launched its Bundled Payments for Care Improvement initiative, offering 4 reimbursement programs intended to encourage hospitals, physicians, and other provider organizations to work collaboratively to improve patient care and potentially lower costs. The bundled payment models are as follows: (1) acute hospital stay only, (2) acute care stay + associated post-acute care, (3) just the post-acute care following discharge, and (4) a single prospective bundled payment encompassing all services provided by the hospital, physicians, and other providers during an inpatient stay. According to an article in Health Data Management, the initiative follows a bundled payment demonstration project for heart bypass surgery. The demonstration program saved Medicare $42.3 million, saved patients $7.9 million in coinsurance costs, and lowered mortality rates. DHHS Releases Guidelines for Women’s Preventive Care In an August press release, the US Department of Health and Human Services (DHHS) announced new guidelines ensuring that women receive preventive healthcare at no additional cost. New health insurance plans are now required to cover preventive services for women, including well-woman visits, breastfeeding support, domestic violence screening, and contraception with no copayment, coinsurance, or deductible. The guidelines, developed by the independent Institute of Medicine, are part of initiatives created as part of the Patient Protection and Affordable Care Act. New health plans will be required to include the services outlined in the guidelines beginning August 1, 2012. Plans will still have the flexibility to control costs and encourage efficient delivery of care by continuing to charge cost-sharing for branded drugs when a generic version is available and equally as safe and effective. Drugs for Acute Radiation Syndrome The US Department of Health and Human Services’ Biomedical Advanced Research and Development Authority has awarded the first 2 contracts for the advanced development of drugs to treat injuries to the gastrointestinal tract associated with acute radiation syndrome. In an August press release, the agency said the contracts are part of “an ongoing effort to develop diagnostic tools and drugs to protect health and save lives in a radiological or nuclear emergency such as a nuclear bomb or improvised nuclear device.” The contracts were awarded to Apogee Biotechnology Corporation of Hummelstown, Pennsylvania, and Avaxia Biologics of Wayland, Massachusetts. Both contracts provide funding for studies to determine whether the drugs under development are effective when administered ≥24 hours following radiation exposure. HPV Vaccine Rates for Teens Of the 3 vaccines recommended for teens and preteens, vaccination rates for human papillomavirus (HPV) lag behind those for Tdap, which protects against tetanus, diphtheria, and pertussis, and MenACWY, which protects against meningococcal meningitis. According to a press release from the Centers for Disease Control and Prevention, approximately 6 million people become infected with HPV and 12,000 women are diagnosed with cervical cancer every year. The vaccine for HPV is administered in 3 doses over a 6-month period; it is important that girls receive all 3 shots. The press release noted that coverage for the 3 routine vaccines was 49% for 1 dose of HPV vaccine, 63% for MenACWY, and 69% for Tdap. The increase in coverage for HPV was 5.3 points, compared with 13.3 points for Tdap and 9.1 points for MenACWY. Lobbying Campaign to Avoid Funding Cuts The Alliance for Quality Nursing Home Care and the American Health Care Association (AHCA), nursing-home industry groups, have launched an ad campaign aimed at preventing cuts to Medicare and Medicaid when Congress is back in session. According to Healthwatch, the healthcare blog of The Hill, the multimillion-dollar advertising buy and advocacy campaign has been launched in 8 states: Florida, Massachusetts, Michigan, Missouri, New Mexico, Nevada, Virginia, and Washington. The campaign is expected to expand to a broader lobbying effort beyond those 8 states in the coming weeks. Data cited in Healthwatch outline federal payment cuts made in the past 2 years that will amount to $128 billion over the coming decade. According to Mark Parkinson, president of the AHCA, the ads are intended to send a message to lawmakers that additional cuts to nursing homes and assisted living facilities “threaten access to quality care needed by America’s seniors and individuals with disabilities.”