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Out-of-Pocket Health Care Expenses by Age and Insurance Coverage, 2011

July 29, 2014 Comments off

Out-of-Pocket Health Care Expenses by Age and Insurance Coverage, 2011
Source: Agency for Healthcare Research and Quality

Highlights

  • In 2011, an average of $703 was paid out of pocket for health care among people with some health care expenses. However, the median out-of-pocket amount was notably lower ($237).
  • Nearly one-fifth of people with some health care expenses had out-of-pocket expenses greater than $1,000 while 8.2 percent had out-of-pocket expenses greater than $2,000.
  • Average out-of-pocket expenses increased with age, ranging from $283 for children under 18 to $1,215 for people age 65 and older.
  • On average, the uninsured paid nearly two-thirds of their health care expenses out of pocket while people under age 65 covered by public insurance and people age 65 and older covered by Medicare and other public insurance paid a substantially lower percentage (only 9–11 percent).
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HHS — Unaccompanied Children Released to Sponsors By State

July 29, 2014 Comments off

Unaccompanied Children Released to Sponsors By State
Source: U.S. Department of Health and Human Services, Office of Refugee Resettlement

When a child who is not accompanied by a parent or guardian is apprehended by immigration authorities, the child is transferred to the care and custody of the Office of Refugee Resettlement (ORR). ORR cares for the children in shelters around the country until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed.

Ensuring that a potential sponsor can safely and appropriately care for the child is a top priority. A background check is conducted on all potential sponsors, and steps are taken to verify a potential sponsor’s identity and relationship to the child. In some cases where concerns are raised, a home study is done.

Before children are released to a sponsor, they receive vaccinations and medical screenings. We do not release any children who have a contagious condition.

The sponsor must agree to cooperate with all immigration proceedings.

If ORR cannot identify a viable sponsor, the child will typically remain in ORR care unless the following happens:

  • The child goes before the immigration judge and requests a voluntary departure
  • A judge orders the child to be deported and DHS repatriates
  • The child turns 18, transferring custody back to DHS
  • Legal relief, in some form is granted by an immigration judge
  • Ensuring the privacy and safety of children is of paramount importance. We cannot release information about individual children that could compromise the child’s location or identity.

The data in the table below shows state-by-state placement of unaccompanied children with sponsors. ACF will update this data during the first week of each month.

FDA approves new extended-release oxycodone with abuse-deterrent properties

July 29, 2014 Comments off

FDA approves new extended-release oxycodone with abuse-deterrent properties
Source: U.S. Food and Drug Administration

Today, the U.S. Food and Drug Administration approved Targiniq ER (oxycodone hydrochloride and naloxone hydrochloride extended-release tablets), an extended-release/long-acting (ER/LA) opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Targiniq ER is the second ER/LA opioid analgesic with FDA-approved labeling describing the product’s abuse-deterrent properties consistentwith the FDA’s 2013 draft guidance for industry, Abuse-Deterrent Opioids – Evaluation and Labeling.

Targiniq ER has properties that are expected to deter, but not totally prevent, abuse of the drug by snorting and injection. When crushed and snorted, or crushed, dissolved and injected, the naloxone in Targiniq ER blocks the euphoric effects of oxycodone, making it less liked by abusers than oxycodone alone. Naloxone is a medication that is commonly used to reverse the effects of opioid overdose. Targiniq ER can still be abused, including when taken orally (by mouth), which is currently the most common way oxycodone is abused. It is important to note that taking too much Targiniq ER for purposes of abuse or by accident, can cause an overdose that can result in death.

NIH-commissioned Census Bureau report highlights effect of aging boomers

July 28, 2014 Comments off

NIH-commissioned Census Bureau report highlights effect of aging boomers
Source: National Institutes of Health/U.S. Census Bureau

While rates of smoking and excessive drinking have declined among older Americans, prevalence of chronic disease has risen, and many older Americans are unprepared to afford the costs of long-term care in a nursing home, according to a report from the U.S. Census Bureau commissioned by the National Institutes of Health.

The report highlights those trends and others among America’s older population, now over 40 million and expected to more than double by mid-century, growing to 83.7 million people and one-fifth of the U.S. population by 2050. Population trends and other national data about people 65 and older are presented in the report, 65+ in the United States: 2010 (PDF, 12.0M). It documents aging as quite varied in terms of how long people live, how well they age, their financial and educational status, their medical and long-term care and housing costs, where they live and with whom, and other factors important for aging and health.

Perception of Weight Status in U.S. Children and Adolescents Aged 8–15 Years, 2005–2012

July 24, 2014 Comments off

Perception of Weight Status in U.S. Children and Adolescents Aged 8–15 Years, 2005–2012
Source: National Center for Health Statistics

Key findings
Data from the National Health and Nutrition Examination Survey, 2005–2012

  • About 30% of children and adolescents aged 8–15 years in the United States misperceive their weight status. Weight status misperception is more common among boys (32.3%) than girls (28.0%).
  • About one-third of Mexican-American (34.0%) and non-Hispanic black (34.4%) children and adolescents misperceive their weight status compared with non-Hispanic white children and adolescents (27.7%).
  • Approximately 81% of overweight boys and 71% of overweight girls believe they are about the right weight.
  • Nearly 48% of obese boys and 36% of obese girls consider themselves to be about the right weight.

NSCAW Child Well-Being Spotlight: Teenage Girls in the Child Welfare System Report High Rates of Risky Sexual Activity and Pregnancy

July 21, 2014 Comments off

NSCAW Child Well-Being Spotlight: Teenage Girls in the Child Welfare System Report High Rates of Risky Sexual Activity and Pregnancy
Source: U.S. Department of Health and Human Services (Administration for Children & Families)

This National Survey of Child and Adolescent Well-Being (NSCAW) spotlight describes the high rates of risky sexual activity and pregnancy among teenage girls in the second cohort of NSCAW (NSCAW II). According to data from the National Survey of Child and Adolescent Well-Being (NSCAW), 16.8% of girls ages 14-17, and 45.1% of girls ages 18-20, had experienced at least one pregnancy.

Selection and Costs for Employer-Sponsored Health Insurance in the Private Sector, 2013 versus 2012

July 18, 2014 Comments off

Selection and Costs for Employer-Sponsored Health Insurance in the Private Sector, 2013 versus 2012
Source: Agency for Healthcare Research and Quality (Medical Expenditure Panel Survey)

Highlights

  • In 2013, 51.3 percent of private-sector employees enrolled in employer-sponsored health insurance chose single coverage, rather than employee-plus-one or family coverage. This percentage did not differ from that for 2012.
  • Average annual total premiums across all three coverage types were up in 2013 compared to 2012. Single premiums rose 3.5 percent, employee-plus-one premiums rose 3.5 percent, and family premiums rose 3.6 percent.
  • The average annual dollar amount that employees contributed toward the premium also rose for all three types of coverage in 2013 versus 2012.

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?

July 18, 2014 Comments off

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?
Source: Substance Abuse and Mental Health Services Administration

Reports on a technical expert panel convened to assess the research about services for foster care children in therapeutic or treatment care. Reviews the scientific evidence and expert panel input to identify actions to be taken and further research needs.

Using Dietary Supplements Wisely

July 18, 2014 Comments off

Using Dietary Supplements Wisely
Source: National Center for Complementary and Alternative Medicine

Like many Americans, you may take dietary supplements in an effort to stay healthy. With so many dietary supplements available and so many claims made about their health benefits, how can you decide whether a supplement is safe or useful? This fact sheet provides a general overview of dietary supplements, discusses safety considerations, and suggests sources for additional information.

Update on findings in the FDA cold storage area on the NIH campus

July 17, 2014 Comments off

Update on findings in the FDA cold storage area on the NIH campus
Source: U.S. Food and Drug Administration

As previously reported, on July 1, 2014, biological samples were found in the cold storage area of U.S. Food and Drug Administration laboratories on the National Institutes of Health campus. The FDA has since acquired additional information from the federal investigative agencies regarding inventories of the materials.

The investigation found 12 boxes containing a total of 327 carefully packaged vials labeled with names of various biological agents such as dengue, influenza, Q fever, and rickettsia. Upon the discovery of these vials on July 1, 2014, FDA employees followed standard protocol and turned them all over to the appropriate NIH safety program officials, who in turn transferred them to the appropriate investigative agencies, as per standard protocols.

CDC — New state physical activity indicator report now available online

July 17, 2014 Comments off

New state physical activity indicator report now available online
Source: CDC

More than half of youth in the United States have access to parks or playground areas, recreation centers, boys’ and girls’ clubs, and walking paths or sidewalks in their neighborhoods, according to a new report, State Indicator Report on Physical Activity, 2014.
The report also finds that 27 states have adopted policies that formalize their intent to plan, design and maintain streets so they are safe for all users including pedestrians, bicyclists, motorists, transit riders, and those in wheelchairs.
The report includes physical activity behavior, environment and policy information for each state and is available at www.cdc.gov/physicalactivity/downloads/pa_state_indicator_report_2014.pdf

Sexual Orientation and Health Among U.S. Adults: National Health Interview Survey, 2013

July 15, 2014 Comments off

Sexual Orientation and Health Among U.S. Adults: National Health Interview Survey, 2013 (PDF)
Source: National Center for Health Statistics

Objective—
To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS).

Methods—
NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18–64, and separately for men and women.

Results—
Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ‘‘something else,’’ stated ‘‘I don’t know the answer,’’ or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18–64 who identified as straight, gay or lesbian, or bisexual.

Conclusion—
NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual.

Restaurant Menu Labeling Use Among Adults — 17 States, 2012

July 15, 2014 Comments off

Restaurant Menu Labeling Use Among Adults — 17 States, 2012
Source: Morbidity and Mortality Week Report (CDC)

Many persons underestimate the calories in restaurant foods (1). Increased attention has been given to menu labeling (ML) as a way to provide consumers with point-of-purchase information that can help them reduce calorie intake and make healthier dietary choices (1–3). In 2010, a federal law was passed requiring restaurants with 20 or more establishments to display calorie information on menus and menu boards.* The regulations to implement this federal law have not been finalized, but some states and local jurisdictions have implemented their own ML policies, and many restaurants have already begun providing ML. To assess fast food and chain restaurant ML use by state and by demographic subgroup, CDC examined self-reported ML use by adults in 17 states that used the Sugar-Sweetened Beverages and Menu Labeling optional module in the 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey. Based on approximately 97% of adult BRFSS respondents who noticed ML information at restaurants, the estimated overall proportion of ML users in the 17 states was 57.3% (range = 48.7% in Montana to 61.3% in New York). The prevalence of ML use was higher among women than men for all states; the patterns varied by age group and race/ethnicity across states. States and public health professionals can use these findings to track the use of ML and to develop targeted interventions to increase awareness and use of ML among nonusers.

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012

July 15, 2014 Comments off

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012
Source: Morbidity and Mortality Weekly Report (CDC)

During 2003–2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam (1). In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010–2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities.

TV Watching and Computer Use in U.S. Youth Aged 12–15, 2012

July 15, 2014 Comments off

TV Watching and Computer Use in U.S. Youth Aged 12–15, 2012
Source: National Center for Health Statistics

Key findings

Data from the National Health and Nutrition Examination Survey (NHANES) and the NHANES National Youth Fitness Survey, 2012

  • Nearly all (98.5%) youth aged 12–15 reported watching TV daily.
  • More than 9 in 10 (91.1%) youth aged 12–15 reported using the computer daily outside of school.
  • In 2012, 27.0% of youth aged 12–15 had 2 hours or less of TV plus computer use daily.
  • Among youth aged 12–15, girls (80.4%) were more likely to use the computer 2 hours or less daily when compared with boys (69.4%).
  • Fewer non-Hispanic black youth aged 12–15 (53.4%) reported watching 2 hours or less of TV daily than non-Hispanic white (65.8%) and Hispanic (68.7%) youth.

Excessive screen-time behaviors, such as using a computer and watching TV, for more than 2 hours daily have been linked with elevated blood pressure, elevated serum cholesterol, and being overweight or obese among youth (1–3). Additionally, screen-time behavior established in adolescence has been shown to track into adulthood (4). The National Heart, Lung, and Blood Institute-supported Expert Panel and the American Academy of Pediatrics (AAP) recommend that children limit leisure screen time to 2 hours or less daily (5,6). This report presents national estimates of TV watching and computer use outside of the school day.

OIG HHS — Questionable Billing for Medicare Part B Clinical Laboratory Services

July 11, 2014 Comments off

Questionable Billing for Medicare Part B Clinical Laboratory Services
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Medicare is the largest payer of clinical laboratory (lab) services in the nation. From 2005 to 2010, Part B Medicare enrollment increased by 10 percent, while spending for lab services increased by 29 percent. In 2010, Medicare payments for all Part B lab services totaled $8.2 billion. We conducted this study to identify questionable billing patterns among Medicare lab services.

HOW WE DID THIS STUDY
We based this study on an analysis of Part B claims for lab services with dates of service in 2010. Labs submit claims for each lab service provided for Medicare beneficiaries. Each claim contains information about the lab provider, the ordering physician, the beneficiary, and the lab service. We developed 13 measures to describe labs’ billing patterns and to identify labs with questionable billing patterns. We calculated and analyzed the distribution of the measures for each lab. We then calculated a statistical threshold for the 13 measures and determined whether a lab’s billing was unusually high for each measure. Additionally, we calculated the total number of claims and total allowed amount associated with certain measures of questionable billing.

WHAT WE FOUND
In 2010, over 1,000 labs exceeded the thresholds (i.e., had unusually high billing) for 5 or more measures of questionable billing for Medicare lab services. For example, a lab might have an unusually high percentage of claims with ineligible and/or invalid ordering-physician numbers, or an unusually high allowed amount per ordering physician. Almost half of the labs that exceeded the thresholds for five or more measures of questionable billing-compared to 13 percent of all labs-were located in California and Florida, areas known to be vulnerable to Medicare fraud. Some labs that exceeded the thresholds for fewer than five measures also exhibited billing that may warrant further review. Medicare allowed $1.7 billion across all labs for claims associated with questionable billing.

WHAT WE RECOMMEND
There may be some labs that have legitimate reasons for exceeding certain thresholds. However, collectively, these findings call for stronger oversight of labs and identify specific issues with Medicare payments for lab services that need to be addressed to more effectively safeguard Medicare. Therefore, we recommend that CMS (1) review the labs identified as having questionable billing and take appropriate action, (2) review existing program integrity strategies to determine whether these strategies are effectively identifying program vulnerabilities associated with lab services, and (3) ensure that existing edits prevent claims with invalid and ineligible ordering-physician numbers from being paid. CMS concurred with all recommendations.

HHS — Elder Justice Roadmap Project Report

July 10, 2014 Comments off

Elder Justice Roadmap Project Report (PDF)
Source: U.S. Department of Health and Human Services (National Center on Elder Abuse)

The Top Five Priorities critical to understanding and reducing elder abuse and to promoting health, independence, and justice for older adults, are:
1. Awareness: Increase public awareness of elder abuse, a multi-faceted problem that requires a holistic, well-coordinated response in services, education, policy, and research.
2. Brain health: Conduct research and enhance focus on cognitive (in)capacity and mental health – critical factors both for victims and perpetrators.
3. Caregiving: Provide better support and training for the tens of millions of paid and unpaid caregivers who play a critical role in preventing elder abuse.
4. Economics: Quantify the costs of elder abuse, which is often entwined with financial incentives and comes with huge fiscal costs to victims, families and society.
5. Resources: Strategically invest more resources in services, education, research, and expanding knowledge to reduce elder abuse.

Hat tip: PW

Prevalence of Incontinence Among Older Americans

July 9, 2014 Comments off

Prevalence of Incontinence Among Older Americans (PDF)
Source: National Center for Health Statistics

Objective
This report presents national estimates of incontinence prevalence in the United States using data source-specific definitions of incontinence among persons aged 65 and over by sociodemographic characteristics during 2007–2010.

Methods
Data are from the 2007–2010 National Health and Nutrition Examination Survey (NHANES), the 2010 National Survey of Residential Care Facilities (NSRCF), the 2007 National Home and Hospice Care Survey (NHHCS), and the 2009 Long Term Care Minimum Data Set (MDS). Findings are based on in-home interviews with 2,625 noninstitutionalized respondents (NHANES) and reports provided by designated facility or agency staff members for 6,856 residential care facility (RCF) residents (NSRCF), 3,226 current home health care patients (NHHCS), 3,918 hospice discharges (NHHCS), and 2,416,705 nursing home residents (MDS). Response rates for incontinence questions were 84% among noninstitutionalized persons (NHANES), 98% among RCF residents and home health and hospice care patients (NSRCF and NHHCS), and 99% for nursing home residents (MDS).

Results
This is the first report presenting national estimates on incontinence for subpopulations of older persons sampled in the Centers for Disease Control and Prevention’s National Center for Health Statistics surveys and the Centers for Medicare & Medicaid Services’ Long Term Care Minimum Data Set. Because a different definition of incontinence is used by each data collection system, it is not possible to make data comparisons between them or to summarize results across all surveys. Accordingly, only survey-specific results are presented. Including recent data from all of these data collection systems facilitates a multidimensional picture of incontinence, while underscoring the need for a standardized definition.

Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance

July 9, 2014 Comments off

Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
This evaluation responded to a congressional request for OIG to review grantees’ use of Department of Health and Human Services (HHS) funds and awarding agencies’ implementation and oversight regarding the prohibitions on the use of grant funds for lobbying activities.

HOW WE DID THIS STUDY
This evaluation included 13 grantmaking agencies (awarding agencies) within HHS. We collected and reviewed departmental and awarding agency directives in place for fiscal years (FYs) 2011 and 2012. We conducted structured telephone interviews with each agency’s Chief Grants Management Officer and/or his or her designated staff. We asked about awarding agencies’ notifications to grantees of the prohibitions on the use of grant funds for lobbying. We also asked about awarding agencies’ mechanisms for identifying grantees that may have violated lobbying prohibitions and the mechanisms in place for reviewing allegations of lobbying. We conducted surveys with a sample of grantees from five awarding agencies regarding their awareness of the lobbying prohibitions.

WHAT WE FOUND
All awarding agencies reported using Federal and departmental sources of guidance regarding the prohibitions on the use of grant funds for lobbying. Through grant applications, notices of award, and/or training, all awarding agencies informed grantees of the prohibitions. For all sampled grant awards, grantees reported being aware of the lobbying prohibitions. However, limited methods exist to identify noncompliance. HHS awarding agencies found two instances of noncompliance in FYs 2011 and 2012.

WHAT WE RECOMMEND
We recommend that ASFR facilitate Departmentwide information sharing among awarding agencies about methods to identify the use of grant funds for prohibited lobbying activities. We also recommend that ASFR centralize on its Web site the guidance pertaining to the prohibitions on the use of grant funds for lobbying. ASFR concurred with our recommendations.

Mind and Body Practices for Fibromyalgia

July 8, 2014 Comments off

Mind and Body Practices for Fibromyalgia
Source: National Center for Complementary and Alternative Medicine

Fibromyalgia syndrome is a common and chronic disorder characterized by widespread pain, diffuse tenderness, fatigue, and a number of other symptoms that can interfere with a person’s ability to carry out daily activities. It is estimated that fibromyalgia affects 5 million American adults. Most people with fibromyalgia—between 80 and 90 percent—are women. However, men and children also can have the disorder, which is often associated with other syndromes. The causes of fibromyalgia are unknown, but there are probably a number of factors involved. Recently, researchers have focused on abnormalities in processing of pain by the central nervous system.

Fibromyalgia can be difficult to diagnose and treat. Current diagnostic criteria are available from the American College of Rheumatology. Treatment often involves an individualized approach that may include both pharmacologic therapies (prescription drugs, analgesics, and NSAIDs) and nonpharmacologic interventions such as exercise, muscle strength training, cognitive behavioral therapy, movement/body awareness practices, massage, acupuncture, and balneotherapy.

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