The Obama administration is moving forward with an ambitious, fast-moving agenda to improve the treatment of Alzheimer’s disease and unlock a method to prevent it by 2025.

The final draft of the plan, released today, also sets up a wide-ranging effort to improve the care that Alzheimer’s patients receive and support families.

I am not alone – alzheimers.gov

As many as 5.1 million Americans are diagnosed with Alzheimer’s disease, and that number could more than double in the next few decades, said Health and Human Services Secretary Kathleen Sebelius when she unveiled the plan at a National Institutes of Health summit on Alzheimer’s-related research.

The majority of the plan’s expected funding – $130 million over the next two years – will go toward NIH research, but another $26 million will go toward Alzheimer’s care and public awareness.

Chief among those is a government website, alzheimers.gov, also launched Tuesday. The site serves as a “one-stop shop,” Sebelius said, for patients and their families.

It features information on Alzheimer’s diagnosis, caregiver support, insurance coverage and clinical trials for new treatments.

A radio, TV and print campaign will promote the site beginning this summer and encourage families to plan ahead for the care of their loved ones.

The site will also serve as a resource for health care providers, featuring up-to-date information on how to diagnose and treat Alzheimer’s.

Secretary Kathleen Sebelius

Sebelius noted that the health law requires Medicare providers to check patients for cognitive impairment during annual wellness visits, but it will be increasingly important for all providers to have guidelines for Alzheimer’s diagnosis and to look for signs of illness prior to age 65.

The online resources will complement several on-the-ground initiatives. Grants are being awarded this summer to educational centers that work with geriatricians, nurses and others to develop new curricula and training programs.

Sebelius said that the administration’s goal is to “improve the care, immediately, that people with the disease receive.”

In addition, the administration plans to evaluate how Alzheimer’s patients fare within new health care models, like the medical homes and accountable care organizations being promoted by the health law.

Reviews will focus on changes in patients’ cognitive function and on the efficiency of services provided. Work on that front is projected for completion by the end of this year.

It will take much longer, though, to find new treatments, or even a preventive treatment, for Alzheimer’s. NIH Director Francis Collins said Tuesday that study of the disease is “at an exceptional moment.”

He went on to announce two major research grants: one will evaluate a nasal spray that could improve patients’ brain function; the other will test a preventive medication among a large family in Colombia whose members have a genetic predisposition to Alzheimer’s.

Know where to turn: alzheimers.gov

The national plan for Alzheimer’s has been through several months of development since President Barack Obama signed the National Alzheimer’s Project Act in January 2011.

Funding, however, remains an issue. The administration announced in February it would devote $156 million over two years to the national plan.

Immediately, $50 million of already available NIH funds were transferred to Alzheimer’s-related projects. Another $80 million was requested as part of the president’s Fiscal Year 2013 budget, which has yet to be passed by Congress.

Much of the $26 million going toward Alzheimer’s care and awareness is also awaiting approval.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

The event — sponsored by the Polyclinic Community Health Foundation, Seattle Young Artists Music Festival, and Sherman Clay Pianos — combines musical performances and a silent auction.

Funds raised at last year’s event made it possible to provide more than $150,000 worth of medications for low-income or uninsured Polyclinic patients.

All told, working with Kelley-Ross Pharmacy and The Polyclinic physicians, the Pharmacy Assistance program assisted more than 160 patients in 2010 and helped fill more than 3,800 prescriptions.

For more information on the Foundation, please click here.

WHEN:

Wednesday, May 23rd.

The silent auction and hors d’oevres begin at 6 p.m., and the concert begins at 7:30 p.m.

WHERE:

The cost for tickets is $25 for adults, $10 for students, and children 12 and under are free.

To Buy Tickets Online:

https://auctions.readysetauction.com/musicformedicine/tickets/buy

The Polyclinic Community Health Foundation

The Polyclinic Community Health Foundation (PCHF) is a 501 (c) 3 organization that provides medications and supplies to the people who do not have the benefit of medical coverage, are low income and suffer from a chronic illness.

The Seattle Young Arts Music Festival Association

The Seattle Young Arts Music Festival Association (SYAMF) is a volunteer, not-for-profit, 501 (c) (3) organization dedicated to extending educational and performance opportunities to young musicians. For more information about SYAMF, please click here.

The Polyclinic has completed its move to its new flagship clinic in Seattle’s First Hill neighborhood.

More than 120 physicians and other providers have made the move to the new Polyclinic Madison Center, a nine-story building at the corner of 7th and Madison, just east of I-5.

The move consolidates many of The Polyclinic’s services, allowing patients to obtain both primary and specialty care under one roof, said Polyclinic Executive Director Lloyd David.

“This is not only convenient for patients; it also facilitates collaboration between our physicians and other providers,” David said.

The new center will also house the Polyclinic’s advanced diagnostic imaging services, including MRI, CT scanning, and a new tomosynthesis 3D breast screening mammography.

The Polyclinic Broadway will continue to house several medical practices and services, including the Endoscopy Center, the Breast Imaging Center, and the Ambulatory Surgery Center, among others.

The Sleep Medicine Center will remain across the street from the Broadway clinic, and Vascular Surgery will remain on the Swedish Cherry Hill campus.

The Polyclinic’s neighborhood clinics in Northgate, Ballard, Downtown, Sand Point, Jefferson Park, Sequim and Edmonds will not be affected by the change.

• A map and driving directions to The Polyclinic Madison Center can be found here.

Can you cut health care spending without undermining the quality of care? It’s a major concern as Medicare prepares to prod hospitals to provide medical care more efficiently by giving bonuses to those whose patients cost less and taking money away from places that send the government higher bills.

Last week, Kaiser Health News’ blog Capsules culled through the Medicare data to identify the hospitals whose patients cost Medicare the most, from the three days before admission to a month afterward.

Here is an admittedly unscientific first pass at how the nation’s best-regarded hospitals rate in terms of their patients’ Medicare spending.

Kaiser Health News looked at the 16 hospitals that U.S. News includes in its widely followed “Best Hospitals’ Honor Roll,” which is calculated based on a mix of quality indicators and reputation surveys.

(One hospital, Johns Hopkins in Baltimore, was omitted because Medicare didn’t provide figures for Maryland hospitals.)

As a group, the average cost to Medicare for a patient at a U.S. News top hospital was $17,808, or 1 percent below the national median spending of $17,988.

The least expensive of these hospitals had patients who, on average, cost Medicare 5 percent below the median (represented as a ratio of 0.95).

The most expensive hospital had patients who, on average, cost Medicare 3 percent above the median (1.03).

• New York-Presbyterian Hospital (New York, N.Y.): $17,089 (0.95)

• University Of Washington Medical Center (Seattle, Wash.): $17,089 (0.95)

• Mayo Clinic St. Mary’s Hospital (Rochester, Minn.): $17,269 (0.96)

• Mount Sinai Hospital (New York, N.Y.): $17,269 (0.96)

• Ronald Reagan UCLA Medical Center (Los Angeles, Calif.): $17,628 (0.98)

• UCSF Medical Center (San Francisco, Calif.): $17,628 (0.98)

• Duke University Hospital (Durham, N.C.): $17,628 (0.98)

• Cleveland Clinic (Cleveland, Ohio): $17,808 (0.99)

• Barnes Jewish Hospital (Saint Louis, Mo.): $17,808 (0.99)

• Vanderbilt University Hospital (Nashville, Tenn): $17,808 (0.99)

• Stanford Hospital (Stanford, Calif.): $17,808 (0.99)

• UPMC Presbyterian Shadyside (Pittsburgh, Penn.): $18,168 (1.01)

• University Of Michigan Health System (Ann Arbor, Mich.): $18,168 (1.01)

• Brigham And Women’s Hospital (Boston, Mass.): $18,348 (1.02)

• Hospital Of University Of Pennsylvania (Philadelphia, Penn.): $18,348 (1.02)

• Massachusetts General Hospital (Boston, Mass.): $18,528 (1.03)

None were outliers among the 3,346 hospitals that Medicare evaluated.

In fact, more than a quarter of the nation’s hospitals were more costly than all of the “honor roll” hospitals and another quarter of the hospitals were less expensive than all of the “honor roll” hospitals.

Let us know what you think about Medicare’s Spending Per Hospital Patient ratings in a comment below.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

By Judith Graham

This story was produced in collaboration with 

Doctors assess patients’ breathing, heart rate and blood pressure routinely at office visits. Soon, they may be adding body mass index to that list too.

Tracking this measure – an indicator of whether someone is obese or overweight – as if it were a vital sign at medical checkups is among a new set of strategies recommended for battling obesity, a concern that some experts predict will affect 42 percent of adults by 2030.

Although professional medical societies have said for years that physicians should monitor patients’ body mass index, most doctors fail to do so.

For example, a 2006 survey of family physicians found that fewer than half checked BMIs for children over the age of 2, even though 71 percent knew this has been recommended.

Just over 40 percent of adult patients in commercial HMOs had documented BMI measurements in 2009 and 2010, according to a survey by the National Committee for Quality Assurance, an organization that evaluates health plans. That figure falls to 12 percent for patients in commercial PPOs, a more common type of plan.

The Institute of Medicine last week called for the medical profession and health insurers to become more rigorous in their approach in a report proposing an anti-obesity campaign that would involve every part of society, from individuals and families to schools, communities, workplaces, the food industry and the media.

Pointing to the more than 90 million children, teens and adults counted as obese, well-established links to medical conditions such as diabetes, hypertension, heart disease, and arthritis, and annual healthcare expenses exceeding $190 billion, the report urged comprehensive and sustained action.

For physicians, monitoring body mass index – a ratio of height to weight – is at the top of the list of priorities because it’s the best way to identify people who have a weight problem. (Adults are counted as obese if they have a BMI of 30 or higher; children if their BMI is at the 95 percentile or higher for kids of the same age and sex.)

“We need to normalize the process of obesity screening and lifestyle counseling so they’re usual and people expect this,” said Dr. Sandra Hassink, a member of the panel that prepared the IOM report and director of the Obesity Initiative at Nemours, a pediatric health system in four states.

Medical Groups Call For Change

Groups such as the American Medical Association and the American Academy of Pediatrics have recommended regular BMI checks for years. Several health care systems also have embraced the practice.

Kaiser includes BMI as a “vital sign” in electronic medical records for nearly 9 million members, and it is planning to do the same for physical activity, another contributor to the obesity epidemic, said Ray Baxter, the plan’s senior vice president for community benefit and health policy. (Kaiser Health News is not affiliated with Kaiser Permanente.)

So why the problem? Many harried physicians are unprepared to advise people about how to change their behaviors, unconvinced they have time to do so, and therefore look skeptically at screening, said Dr. Robert Kushner, clinical director of the Comprehensive Center on Obesity at Northwestern University.

If doctors are overweight themselves, they’re less likely to recognize the issue in their patients, research shows. What’s more, doctors aren’t trained in medical school to handle weight issues.

They also often aren’t convinced obesity treatments work, and many believe there aren’t good community programs to which they can refer patients.

“The question is, how many programs are out there for primary care doctors to refer to in the community, and answer is – not many,” said Dr. Ned Calonge, a Colorado physician who is the immediate past chairman of the U.S. Preventive Services Task Force.

Northwestern is tackling a part of that by weaving instruction in “lifestyle medicine” throughout all four years of a new medical school curriculum being introduced this August.

Another significant problem has been a historic lack of reimbursement from insurers for obesity screening and counseling. That changed last year for seniors, when Medicare said it would cover up to six months of weight loss counseling for obese beneficiaries as part of a package of new preventive services. Nearly 13 million Medicare members are thought to be obese.

Meanwhile, new preventive services guidelines from the government call for all insurance plans to cover obesity screening and counseling without charge to patients.

And insurers are expanding childhood obesity programs following a 2010 recommendation from the U.S. Preventive Services Task Force that endorsed comprehensive weight management programs for youngsters at least 6 years old. Previously, the task force supported BMI screening but not weight loss programs.

Seeking Evidence-Based Programs

For the insurance industry, the challenge now is providing evidence-based programs that can be introduced on a broad scale.

UnitedHealth Group is promoting “Join for Me,” a year-long behavioral modification program piloted with the YMCA of Greater Providence, R.I., in which youngsters 6 to 17 years old, accompanied by a parent, learn about healthy eating and exercise in a group led by a coordinator.

“Doctors are in short supply” and it makes sense to conduct intensive behavioral change programs in the community, not in their offices, said Dr. Deneen Vojta, senior vice president of UnitedHealth’s Center for Health Reform & Modernization.

For overweight and obese adults, the company is looking at offering a version of the Diabetes Prevention Program, a well-studied intensive intervention that has been shown to help people lose weight.

WellPoint has taken a different approach, choosing to work through doctors and with the Alliance for a Healthier Generation, an organization that’s trying to convince health plans to offer more comprehensive coverage for obesity counseling and treatment.

The alliance asks participating plans to offer four visits with a child’s primary care doctor and four visits with a dietitian if the youngster is found to be overweight or obese.

So far several plans, including WellPoint, Aetna, Humana and Highmark, Inc., have signed up, and 2.4 million children are covered.

WellPoint recently launched a limited pilot study of this type of benefit in California and is learning what physicians need and members want before deciding whether to roll it out more broadly, said Harvinder Sareen, clinical program director for the insurance company.

Insurance companies and some self-insured employers are also exploring the use of financial incentives — cash payments or reduced premiums or deductibles – to motivate members to keep their weight in check and to adopt other lifestyle changes.

One program at UnitedHealthcare offers members up to $250 for reaching a BMI of 25 or less, and similar incentives for not smoking and lowering cholesterol and blood pressure.

“Is there coverage [for obesity] is yesterday’s conversation. Today’s conversation is how to design coverage to encourage people to use it and continue using it,” said Karen Ignagni, president of America’s Health Insurance Plans, an industry trade group.

Others disagree that coverage for obesity counseling is adequate.

“The problem is there’s no real incentive for the insurance industry to pay for better prevention and treatment, because the costs are immediate while the benefits are long-term,” said Dr. David Ludwig, director of the new Balance Foundation Obesity Prevention Center at Children’s Hospital, Boston. “Although reducing the prevalence of obesity is one of the most profitable investments the healthcare system could make, it doesn’t make a lot of sense for individual plans when families change policies every three to five years.”

Updated at 2:00 p.m. on May 13 to clarify the description of the NCQA study findings.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.