Partnership for Prevention published a state case study telling the story of Colorado’s journey toward comprehensive tobacco cessation coverage. Entitled “A Collaborative Approach to Meeting the U.S. Preventive Services Task Force Recommendations on Tobacco Cessation Screening and Intervention”, it describes how the Colorado Tobacco Cessation and Sustainability Partnership worked closely with public and private health plans to provide coverage for tobacco treatment. As a result, the majority of Colorado smokers have access to free or low-cost evidence-based cessation services and support for the state’s QuitLine has been enhanced. Advances were made in spite of decreased state tobacco control program funding.
Leaders in many states have begun to work with health plans to discuss the provision of preventive services. As the implementation of federal health reform moves forward it is Partnership’s hope that states can benefit from Colorado’s pioneering work in advancing tobacco cessation treatment. As states and territories progress toward a more integrated approach to preventive health, the Colorado Tobacco Cessation and Sustainability Partnership model for engaging health plans to implement USPSTF recommendations for cessation coverage can be applied to other preventive health services.
Showing posts with label USPSTF. Show all posts
Showing posts with label USPSTF. Show all posts
Monday, 9 May 2011
Thursday, 24 March 2011
Women’s Health Care and the Affordable Care Act
Only one year after the landmark legislation was signed, the Affordable Care Act (ACA) is already improving women’s access to high quality, affordable health care. When the law is fully implemented in 2014, it will signify the greatest leap forward for American women’s health in decades.
New protections for women under the ACA include:
New protections for women under the ACA include:
- Improved Access to Affordable Coverage: Under the ACA, adolescents and young adults up to age 26 may now remain on their families’ plans. Due to substantial new tax credits, more small businesses are now offering health care coverage to their employees. And beginning in 2014, expanded Medicaid eligibility means improved access to healthcare coverage for lower income women and families.
- Free Preventive Care: Under the ACA, women receive recommended preventive services without copayments or deductibles. This includes U.S. Preventive Services Task Force A- and B-rated services such as mammograms, screenings for cervical cancer and chlamydia, prenatal care and more.
- The End of Gender-Based Discrimination: Before the ACA, women could be charged higher premiums than men for the same insurance policy. Beginning in 2014, it will be illegal for insurance companies to charge women higher premiums on the basis of gender.
- Being a Woman is No Longer a Pre-Existing Condition: Before the ACA became law, insurers could deny women coverage for “pre-existing conditions” such as pregnancy, Cesarean sections, and breast cancer. Beginning in 2014, insurers cannot deny coverage to anyone based on pre-existing conditions. Already under the ACA, children cannot be denied coverage because of pre-existing conditions.
- The End of Lifetime Limits: Under the ACA, insurance companies cannot place a lifetime limit on the amount of coverage an individual receives. Beginning in 2014, annual limits are banned as well.
Wednesday, 16 March 2011
Older Adults Lack Preventive Care
Adults over the age of 65 are not getting the preventive services that they need, according to a report released by the Department of Health and Human Services on Monday. The report found that preventive services, including vaccinations, tobacco cessation, and screening for cancer, diabetes, lipid disorders, and osteoporosis are underutilized. The report emphasizes that adults over 65 should be taking advantage of preventive services on a regular basis, and notes that many beneficiaries don’t know what services are covered by Medicare.
As a provision of the Affordable Care Act, certain USPSTF A and B recommended preventive services are covered without cost sharing by Medicare patients. In order to promote uptake of preventive services, including those services that are currently underutilized, Medicare has instituted an annual wellness visit. The wellness visit will allow Medicare beneficiaries access to preventive services on a regular and continued basis. It will be based on a detailed Health Risk Assessment (HRA), which allows patients and providers to create a personalized prevention plan. Partnership for Prevention, along with the CDC, has assisted the Centers for Medicare and Medicaid Services (CMS) in the effort to design and implement the HRA by interviewing and convening a group of HRA experts.
Medicare coverage, along with outreach and education for the annual wellness visit, will help to bring awareness to the need for and use of preventive services for those over the age of 65.
Rebecca Doigan, MPH
Research Fellow and Program Associate
As a provision of the Affordable Care Act, certain USPSTF A and B recommended preventive services are covered without cost sharing by Medicare patients. In order to promote uptake of preventive services, including those services that are currently underutilized, Medicare has instituted an annual wellness visit. The wellness visit will allow Medicare beneficiaries access to preventive services on a regular and continued basis. It will be based on a detailed Health Risk Assessment (HRA), which allows patients and providers to create a personalized prevention plan. Partnership for Prevention, along with the CDC, has assisted the Centers for Medicare and Medicaid Services (CMS) in the effort to design and implement the HRA by interviewing and convening a group of HRA experts.
Medicare coverage, along with outreach and education for the annual wellness visit, will help to bring awareness to the need for and use of preventive services for those over the age of 65.
Rebecca Doigan, MPH
Research Fellow and Program Associate
Monday, 9 August 2010
Health Reform Benefits Women
The good news is that 30 million women who are currently uninsured or underinsured will benefit from the recently passed Affordable Care Act (ACA). These women and their children will enjoy a full range of comprehensive benefits through private insurance, or the Medicare and Medicaid programs. A recently released study by the Commonwealth Fund, “Realizing Health Reform’s Potential: Women and the Affordable Care Act of 2010,” examined the ACA’s provisions to identify their impact on access to health services, as well as future cost implications. Provisions eliminating the pre-existing condition exclusion, requiring coverage for maternity and newborn care, providing insurance purchase subsidies, limiting out-of-pocket expenses and prohibiting higher premiums based on gender, all contribute to a significantly more positive future for women seeking health care.
The report also highlights the new preventive care benefits that will provide increased access to high value recommended services from the U.S. Preventative Services Task Force (USPSTF) without cost-sharing. However, the report missed the mark by failing to mention tobacco cessation. Tobacco-related disease is the leading cause of death in the U.S. causing over 170,000 deaths per year among women. In 2006, 18 percent of adults with private health insurance were current smokers, compared to 35 percent of Medicaid recipients and 34 percent of the uninsured population. All USPSTF recommendations are linked to a letter grade that reflects the level of certainty of the evidence supporting the preventive service. The ACA will make access to the “A” ranked smoking cessation treatments a reality for more women. And, their children will benefit from reduced exposure to secondhand smoke, thereby decreasing incidence of asthma and other related conditions. Under the federal Medicaid program, tobacco cessation services are a mandated benefit for pregnant women. A good start, but all Medicaid enrollees should have access to smoking cessation counseling and medications.
Preventive services not only help keep people healthy, they also save lives. 42,000 lives can be saved each year by helping more smokers quit.
Read the full report - Realizing Health Reform's Potential: Women and the Affordable Care Act of 2010.
Diane Canova
Vice President, Policy & Programs
Partnership for Prevention
The report also highlights the new preventive care benefits that will provide increased access to high value recommended services from the U.S. Preventative Services Task Force (USPSTF) without cost-sharing. However, the report missed the mark by failing to mention tobacco cessation. Tobacco-related disease is the leading cause of death in the U.S. causing over 170,000 deaths per year among women. In 2006, 18 percent of adults with private health insurance were current smokers, compared to 35 percent of Medicaid recipients and 34 percent of the uninsured population. All USPSTF recommendations are linked to a letter grade that reflects the level of certainty of the evidence supporting the preventive service. The ACA will make access to the “A” ranked smoking cessation treatments a reality for more women. And, their children will benefit from reduced exposure to secondhand smoke, thereby decreasing incidence of asthma and other related conditions. Under the federal Medicaid program, tobacco cessation services are a mandated benefit for pregnant women. A good start, but all Medicaid enrollees should have access to smoking cessation counseling and medications.
Preventive services not only help keep people healthy, they also save lives. 42,000 lives can be saved each year by helping more smokers quit.
Read the full report - Realizing Health Reform's Potential: Women and the Affordable Care Act of 2010.
Diane Canova
Vice President, Policy & Programs
Partnership for Prevention
Thursday, 15 July 2010
Partnership for Prevention Featured on Sirius Radio
Robert J. Gould, PhD, President and CEO and Jason M.M. Spangler, MD, MPH, Senior Program Officer were interviewed this morning by Dr. Nieca Goldberg, a cardiologist and women's health expert at NYU Medical Center, on her radio show, "Doctor Radio", carried by Sirius XM Radio. The broadcast garnered interest from the public, as several people called/emailed in with specific screening questions.
In addition to fielding questions, Dr. Gould and Dr. Spangler discussed Partnership’s mission and stressed the importance of prevention. Dr. Gould and Dr. Spangler highlighted the critical work Partnership is accomplishing in the areas of tobacco cessation and control, vaccines, and aspirin use. Dr. Goldberg is a member of Partnership’s Aspirin Task Force, an advisory group tasked with increasing aspirin counseling and aspirin use for primary prevention of cardiovascular disease.
Dr. Gould and Dr. Spangler also touched on the new regulations that require insurance plans to provide United States Preventive Services Task Force (USPSTF) A and B recommended preventive services without cost sharing. These regulations will begin to remove barriers to access to preventive care.
The interview will be re-broadcast today at 5 pm Eastern, Friday July 16 at 5 am Eastern and Sunday July 18 at 5 am Eastern on Sirius channel 114 and XM channel 119.
If you don't have a Sirius or XM subscription, you can sign up for a 7-day free trial period by visiting this website: www.sirius.com/freetrial/register. We hope you will tune in.
In addition to fielding questions, Dr. Gould and Dr. Spangler discussed Partnership’s mission and stressed the importance of prevention. Dr. Gould and Dr. Spangler highlighted the critical work Partnership is accomplishing in the areas of tobacco cessation and control, vaccines, and aspirin use. Dr. Goldberg is a member of Partnership’s Aspirin Task Force, an advisory group tasked with increasing aspirin counseling and aspirin use for primary prevention of cardiovascular disease.
Dr. Gould and Dr. Spangler also touched on the new regulations that require insurance plans to provide United States Preventive Services Task Force (USPSTF) A and B recommended preventive services without cost sharing. These regulations will begin to remove barriers to access to preventive care.
The interview will be re-broadcast today at 5 pm Eastern, Friday July 16 at 5 am Eastern and Sunday July 18 at 5 am Eastern on Sirius channel 114 and XM channel 119.
If you don't have a Sirius or XM subscription, you can sign up for a 7-day free trial period by visiting this website: www.sirius.com/freetrial/register. We hope you will tune in.
Friday, 5 March 2010
Aspirin Use in Asymptomatic Patients
Earlier this week, the research article, “Aspirin for Prevention of Cardiovascular Events in a General Population Screened for a Low Ankle Brachial Index (ABI)”, was published in JAMA. The goal of the study was to determine if daily aspirin reduced the risk of heart attack and stroke in patients with a low ABI, a quick and inexpensive way to establish risk for these events, and no other risk factors. Researchers hoped to show that the ABI could identify asymptomatic higher risk individuals that could benefit from preventive treatments, such as aspirin use.
The researchers found that aspirin was not effective in preventing first heart attack, stroke, or other cardiovascular events for individuals with low ABI and an absence of other risk factors. However, due to the fact that ABI was the only indicator used when determining risk, the study population was ultimately found to be at very low risk for heart attack and stroke. According to current guidelines, this low risk group would not be encouraged to use aspirin. So the study may actually say more about ABI or the range of ABI as a screening tool for cardiovascular risk than aspirin for primary prevention of cardiovascular events.
Other issues with the study include adherence to the therapy and disproportionate number of females in the study. Interestingly, the study showed no statistically significant difference between the aspirin and control groups for bleeding. Recently, aspirin use for primary prevention has been questioned due to a potential increased risk for gastrointestinal and intracranial bleeding; this study shows that bleeding events were similar between aspirin and non-aspirin users.
Ultimately, this study shows that ABI or the ABI threshold measurement used (0.95) is not enough to predict higher risk of heart attack and stroke on a population level. Future studies with more participants, improved compliance rates, a more equitable distribution of males and females, and a lower level of ABI for study inclusion are necessary to shed more light on this issue. An editorial, also published in JAMA, further explains the potential limitations of the study. Although at first glance this article appears to be another critique on aspirin for primary prevention-as many media outlets suggested- the current American Heart Association and United States Preventive Services Task Force guidelines for aspirin use to prevent first heart attacks and strokes should still be followed. And, as they recommend, those considering aspirin should talk to their health care provider to determine if aspirin is right for them.
Posted by:
Rebecca Doigan
Program Associate, Partnership for Prevention
The researchers found that aspirin was not effective in preventing first heart attack, stroke, or other cardiovascular events for individuals with low ABI and an absence of other risk factors. However, due to the fact that ABI was the only indicator used when determining risk, the study population was ultimately found to be at very low risk for heart attack and stroke. According to current guidelines, this low risk group would not be encouraged to use aspirin. So the study may actually say more about ABI or the range of ABI as a screening tool for cardiovascular risk than aspirin for primary prevention of cardiovascular events.
Other issues with the study include adherence to the therapy and disproportionate number of females in the study. Interestingly, the study showed no statistically significant difference between the aspirin and control groups for bleeding. Recently, aspirin use for primary prevention has been questioned due to a potential increased risk for gastrointestinal and intracranial bleeding; this study shows that bleeding events were similar between aspirin and non-aspirin users.
Ultimately, this study shows that ABI or the ABI threshold measurement used (0.95) is not enough to predict higher risk of heart attack and stroke on a population level. Future studies with more participants, improved compliance rates, a more equitable distribution of males and females, and a lower level of ABI for study inclusion are necessary to shed more light on this issue. An editorial, also published in JAMA, further explains the potential limitations of the study. Although at first glance this article appears to be another critique on aspirin for primary prevention-as many media outlets suggested- the current American Heart Association and United States Preventive Services Task Force guidelines for aspirin use to prevent first heart attacks and strokes should still be followed. And, as they recommend, those considering aspirin should talk to their health care provider to determine if aspirin is right for them.
Posted by:
Rebecca Doigan
Program Associate, Partnership for Prevention
Friday, 26 February 2010
More Confusion Over Aspirin Use?
Recently, the Wall Street Journal (WSJ) posted an article, “The Danger of Daily Aspirin,” that questioned the use of aspirin for prevention of cardiovascular disease and stroke, citing the increased risk for gastrointestinal (GI) bleeding. Although the WSJ article is generally balanced in its discussion about aspirin use, the headline and some comments from the piece add to the confusion about the appropriate use of aspirin for primary prevention.
The WSJ article references a meta-analysis published in The Lancet in May 2009 as evidence for its arguments regarding caution when taking aspirin for primary prevention of heart disease and stroke. But the story really begins in April 2009 when the U.S. Preventive Services Task Force (USPSTF) – the quasi-governmental body that rigorously evaluates the effectiveness of clinical preventive services – reported that regular aspirin use can reduce first heart attacks in men and first strokes in women. The findings from the USPSTF apply to men 45 and 79 years of age and to women 55 to 79. The USPSTF found that aspirin should be used when the benefits outweigh the harms for potential GI bleeding. This straightforward recommendation helped resolve the often confusing messages consumers receive about aspirin use.
Or so it appeared. Little more than a month later, The Lancet study offered a seemingly conflicting conclusion, namely, that the long-term use of aspirin in preventing first heart attacks and strokes is of uncertain net benefit since the potential benefits and harms may cancel each other out.
The study from the USPSTF and the study appearing in The Lancet relied on the same meta-analyses in their research but still came to different conclusions. How could this happen? In layman’s terms, the reason for the seemingly conflicting conclusions appears to be that the authors of the second study gave equal weight to incidents of GI bleeding as to heart attacks and strokes. In contrast, the USPSTF appears to conclude that it is more important to prevent heart attacks and strokes than to prevent gastrointestinal bleeding events.
Upon closer examination, though, the findings of the two studies are far more similar than they appear. Both the USPSTF and the authors of The Lancet study underscore the importance of patients and healthcare providers discussing the benefits and harms of regular aspirin use.
Partnership for Prevention’s Aspirin Task Force – an independent panel made up of some of the nation’s leading experts on aspirin use – carefully reviewed the methodology, findings, and conclusions of this study. The Aspirin Task Force recommended no immediate change in the use of aspirin and aspirin counseling. Its assessment of The Lancet study can be found here.
The decision to take aspirin can sometimes be difficult. It does have a proven track record in preventing first heart attacks and strokes in men and women, respectively, but, like all medications it does have risks. Therefore, as reiterated by the Aspirin Task Force, the key step in the decision-making process is an informed discussion between patients and their healthcare providers to ensure the appropriate use of aspirin. That is not confusing at all.
Rebecca Doigan
Research Fellow and Program Associate
Partnership for Prevention
The WSJ article references a meta-analysis published in The Lancet in May 2009 as evidence for its arguments regarding caution when taking aspirin for primary prevention of heart disease and stroke. But the story really begins in April 2009 when the U.S. Preventive Services Task Force (USPSTF) – the quasi-governmental body that rigorously evaluates the effectiveness of clinical preventive services – reported that regular aspirin use can reduce first heart attacks in men and first strokes in women. The findings from the USPSTF apply to men 45 and 79 years of age and to women 55 to 79. The USPSTF found that aspirin should be used when the benefits outweigh the harms for potential GI bleeding. This straightforward recommendation helped resolve the often confusing messages consumers receive about aspirin use.
Or so it appeared. Little more than a month later, The Lancet study offered a seemingly conflicting conclusion, namely, that the long-term use of aspirin in preventing first heart attacks and strokes is of uncertain net benefit since the potential benefits and harms may cancel each other out.
The study from the USPSTF and the study appearing in The Lancet relied on the same meta-analyses in their research but still came to different conclusions. How could this happen? In layman’s terms, the reason for the seemingly conflicting conclusions appears to be that the authors of the second study gave equal weight to incidents of GI bleeding as to heart attacks and strokes. In contrast, the USPSTF appears to conclude that it is more important to prevent heart attacks and strokes than to prevent gastrointestinal bleeding events.
Upon closer examination, though, the findings of the two studies are far more similar than they appear. Both the USPSTF and the authors of The Lancet study underscore the importance of patients and healthcare providers discussing the benefits and harms of regular aspirin use.
Partnership for Prevention’s Aspirin Task Force – an independent panel made up of some of the nation’s leading experts on aspirin use – carefully reviewed the methodology, findings, and conclusions of this study. The Aspirin Task Force recommended no immediate change in the use of aspirin and aspirin counseling. Its assessment of The Lancet study can be found here.
The decision to take aspirin can sometimes be difficult. It does have a proven track record in preventing first heart attacks and strokes in men and women, respectively, but, like all medications it does have risks. Therefore, as reiterated by the Aspirin Task Force, the key step in the decision-making process is an informed discussion between patients and their healthcare providers to ensure the appropriate use of aspirin. That is not confusing at all.
Rebecca Doigan
Research Fellow and Program Associate
Partnership for Prevention
Thursday, 14 January 2010
Preserve Expertise, Independence of Prevention Task Forces, PfP Urges Congress
Partnership for Prevention sent a letter to congressional negotiator
"It is vital that each body continue to offer unbiased, objective recommendations that can inform physicians, public health officials, and other health professionals about the quality of evidence of clinical and community services," Partnership President/CEO Robert J. Gould wrote Sen. Tom Harkin, D-Iowa, and Sen. Henry Waxman, D-Calif.
"...To maintain this scientific independence, it is absolutely essential that task force members have the necessary training and expertise to fulfill their primary responsibility: the review of scientific evidence related to the effectiveness of clinical and community preventive services and applying this evidence to decision-making.
"Any other qualifications for appointment, such as expertise in employer health or school health or clinical experience, should be a supplemental qualification and not an alternative..." he concluded.
"It is vital that each body continue to offer unbiased, objective recommendations that can inform physicians, public health officials, and other health professionals about the quality of evidence of clinical and community services," Partnership President/CEO Robert J. Gould wrote Sen. Tom Harkin, D-Iowa, and Sen. Henry Waxman, D-Calif.
"...To maintain this scientific independence, it is absolutely essential that task force members have the necessary training and expertise to fulfill their primary responsibility: the review of scientific evidence related to the effectiveness of clinical and community preventive services and applying this evidence to decision-making.
"Any other qualifications for appointment, such as expertise in employer health or school health or clinical experience, should be a supplemental qualification and not an alternative..." he concluded.
Tuesday, 8 December 2009
Washington Post/Consumer Reports Lists "Unnecessary" Screening Tests
In the wake of the recent controversy over the US Preventive Services Task Force's recommendations on mammograms, the Washington Post has reprinted a piece issued earlier this year by the folks at Consumer Reports where they list several other common screening services it says the task force has deemed unnecessary "for healthy or average-risk people."
The exams listed have been given a D rating by the task force, meaning that they failed to meet the group's standards. "Many of those tests should be limited to people who have symptoms or risk factors for specific conditions," Consumer Reports said.
The exams listed have been given a D rating by the task force, meaning that they failed to meet the group's standards. "Many of those tests should be limited to people who have symptoms or risk factors for specific conditions," Consumer Reports said.
Thursday, 3 December 2009
Senate Votes to Guarantee Coverage for Mammograms, Other Preventive Screenings
The Senate voted 61-39 Thursday "to safeguard coverage of mammograms and preventive screening tests for women under any health care overhaul legislation." The revision, which was advanced by Sen. Barbara Mikulski, D-Md., Sen. Olympia Snowe, R-Maine, "would allow the Health and Human Services secretary to require insurers to cover preventive health screenings free of charge."
The vote came in the wake of recent controversy over federal task force recommendations that women in their 40s consult with their doctors about the advisability of getting mammograms, rather than considering them a routine procedure. On a 59-41 vote, the Senate rejected an amendment by Sen. Lisa Murkowski, R-Alaska, to ensure the task force recommendations could be ignored.
The vote came in the wake of recent controversy over federal task force recommendations that women in their 40s consult with their doctors about the advisability of getting mammograms, rather than considering them a routine procedure. On a 59-41 vote, the Senate rejected an amendment by Sen. Lisa Murkowski, R-Alaska, to ensure the task force recommendations could be ignored.
Wednesday, 2 December 2009
11 Health & Prevention Organizations Defend Task Force, Mammogram Recommendations in Letter to Congress
Partnership for Prevention and 10 of the nation's leading health and prevention organizations have sent a letter to Congress defending the recent recommendations of the US Preventive Services Task Force regarding breast cancer screening and set the record straight about recent public misstatements regarding the recommendations.
“The U.S. Preventive Services Task Force was established as an independent body to apply rigor and objectivity to the analysis of clinical preventive care – even on issues that arouse passions and political posturing,” the organization leaders said in a letter to Rep. Henry Waxman, D-Calif.., and Rep. Joe Barton, R-Texas. “The misstatements we have noted are evidence of both of these dangers, and the Task Force is our best defense against both.
“Our common goal is for preventive services to improve the health of all Americans,” they continued. “We believe the Task Force is the best way to ensure we’re guided toward that goal by recommendations of experts who are guided by science, and only by science.”
The letter was signed by leaders of the following organizations: American Academy of Family Physicians, American Academy of Nurse Practitioners, American Academy of Physician Assistants, American College of Physicians, American College of Preventive Medicine, American Journal of Preventive Medicine, American Public Health Association, National Association of County and City Health Officials, Partnership for Prevention, Public Health Institute, and Trust for America’s Health.
Waxman and Barton are the chairman and ranking Republican of a House committee that held a Dec. 2 hearing on the USPSTF recommendations.
The letter, a copy of which is available online at http://www.prevent.org/images/mammographyletter.pdf
specifically addressed three misstatements:
• The Task Force recommends that women aged 40 – 49 not receive mammograms. “The Task Force does not recommend that all women in this age group automatically start receiving mammograms at age 40.” the letter states. “Rather, it simply recommends that those women and their health care professionals have a full discussion about the potential pros and cons of screening. This allows the patient to incorporate information about her family history, overall health, and personal values and preferences along with the best scientific information into the decision-making process.
“The result is an empowered patient who is able to make an informed decision about whether or not to be tested. In fact, many women may choose to continue mammography because they value the small chance that they might benefit, but other women may choose to defer beginning mammograms until the balance of benefits and risks is more favorable.”
• The Task Force recommendations were intended to reduce costs. “The Task Force never uses cost as a reason to recommend against a service that has been proven to be effective,” the letter states. “In its review of the evidence about breast cancer screening, the Task Force had a single objective – to determine how to maximize the health of women.”
• Members of the Task Force are not qualified to make scientific recommendations. “Since its inception (in 1984), it has been recognized as the authoritative source for determining the effectiveness of clinical preventive services, and its methods have been adapted by guidelines groups worldwide,” the letter says. “While this small group of distinguished health care professionals and researchers is largely unknown to the general public, its work is well known to clinicians in preventive and primary care practice...The preventive services recommended by the Task Force have prevented hundreds of thousands, if not millions, of premature deaths and averted needless harms.
“The U.S. Preventive Services Task Force was established as an independent body to apply rigor and objectivity to the analysis of clinical preventive care – even on issues that arouse passions and political posturing,” the organization leaders said in a letter to Rep. Henry Waxman, D-Calif.., and Rep. Joe Barton, R-Texas. “The misstatements we have noted are evidence of both of these dangers, and the Task Force is our best defense against both.
“Our common goal is for preventive services to improve the health of all Americans,” they continued. “We believe the Task Force is the best way to ensure we’re guided toward that goal by recommendations of experts who are guided by science, and only by science.”
The letter was signed by leaders of the following organizations: American Academy of Family Physicians, American Academy of Nurse Practitioners, American Academy of Physician Assistants, American College of Physicians, American College of Preventive Medicine, American Journal of Preventive Medicine, American Public Health Association, National Association of County and City Health Officials, Partnership for Prevention, Public Health Institute, and Trust for America’s Health.
Waxman and Barton are the chairman and ranking Republican of a House committee that held a Dec. 2 hearing on the USPSTF recommendations.
The letter, a copy of which is available online at http://www.prevent.org/images/mammographyletter.pdf
specifically addressed three misstatements:
• The Task Force recommends that women aged 40 – 49 not receive mammograms. “The Task Force does not recommend that all women in this age group automatically start receiving mammograms at age 40.” the letter states. “Rather, it simply recommends that those women and their health care professionals have a full discussion about the potential pros and cons of screening. This allows the patient to incorporate information about her family history, overall health, and personal values and preferences along with the best scientific information into the decision-making process.
“The result is an empowered patient who is able to make an informed decision about whether or not to be tested. In fact, many women may choose to continue mammography because they value the small chance that they might benefit, but other women may choose to defer beginning mammograms until the balance of benefits and risks is more favorable.”
• The Task Force recommendations were intended to reduce costs. “The Task Force never uses cost as a reason to recommend against a service that has been proven to be effective,” the letter states. “In its review of the evidence about breast cancer screening, the Task Force had a single objective – to determine how to maximize the health of women.”
• Members of the Task Force are not qualified to make scientific recommendations. “Since its inception (in 1984), it has been recognized as the authoritative source for determining the effectiveness of clinical preventive services, and its methods have been adapted by guidelines groups worldwide,” the letter says. “While this small group of distinguished health care professionals and researchers is largely unknown to the general public, its work is well known to clinicians in preventive and primary care practice...The preventive services recommended by the Task Force have prevented hundreds of thousands, if not millions, of premature deaths and averted needless harms.
Tuesday, 1 December 2009
Mammography Recommendations and Conflicts of Interest
A couple of women's health experts have turned the tables on some of the critics who accuse the US Preventive Services Task Force of potential conflicts of interest regarding its mammogram recommendations.
Dr. Adriane Fugh-Berman MD of Georgetown University Medical Center, and director of PharmedOut.org and Alicia M. Bell, project manager of PharmedOut and member of the board of directors of the National Women's Health Network, identified specific potential conflicts of interest in some of the critics. Their article in the Hastings Center's Bioethics Forum, entitled "Mammography and the Corporate Breast," is an interesting read.
Dr. Adriane Fugh-Berman MD of Georgetown University Medical Center, and director of PharmedOut.org and Alicia M. Bell, project manager of PharmedOut and member of the board of directors of the National Women's Health Network, identified specific potential conflicts of interest in some of the critics. Their article in the Hastings Center's Bioethics Forum, entitled "Mammography and the Corporate Breast," is an interesting read.
Quote of the Day
"The fact is that guidelines for screenings do change (quite frequently) over time based on continuing research. To have some means to continue such deliberation is to recognize the value of evidence-based medicine."
- The New Republic's Suzy Khimm, in an article entitled "Who Will Decide If Women Have to Pay for Mammograms?"
- The New Republic's Suzy Khimm, in an article entitled "Who Will Decide If Women Have to Pay for Mammograms?"
Monday, 30 November 2009
Chairman Intends to "Get to the Bottom" of Task Force Mammogram Recommendations
A congressional subcommittee chairman said he called a hearing this week "to get to the bottom" of a recent task force recommendation on mammogram screening for women in their 40s.
"My goal is to get to the bottom of why the task force made these recommendations," Rep. Frank Pallone, D-Va., told the New Jersey Star-Ledger. "Has anything changed in the way we’re looking at testing? And find out about better ways of breast cancer screening to develop in the future, including more efficient blood tests and exams with no radiation impact."
Pallone, who chairs the health subcommittee of the House Energy and Commerce Committee, says the recommendation made it "very confusing for women deciding what to do." He said he wants insurance companies to continue to allow coverage for those women who want the mammogram at a younger age, and said the flap should not affect the outcome of health reform legislation.
"There’ll always be disagreements about tests and procedures," he said. "Health care reform needs to move forward, as fast as possible. More people lack coverage, insurance premiums and drug prices are going up. We can’t delay it any longer."
"My goal is to get to the bottom of why the task force made these recommendations," Rep. Frank Pallone, D-Va., told the New Jersey Star-Ledger. "Has anything changed in the way we’re looking at testing? And find out about better ways of breast cancer screening to develop in the future, including more efficient blood tests and exams with no radiation impact."
Pallone, who chairs the health subcommittee of the House Energy and Commerce Committee, says the recommendation made it "very confusing for women deciding what to do." He said he wants insurance companies to continue to allow coverage for those women who want the mammogram at a younger age, and said the flap should not affect the outcome of health reform legislation.
"There’ll always be disagreements about tests and procedures," he said. "Health care reform needs to move forward, as fast as possible. More people lack coverage, insurance premiums and drug prices are going up. We can’t delay it any longer."
Tuesday, 24 November 2009
U.S. Women Plan to Disregard Task Force Mammogram Recommendations
A USA TODAY/Gallup Poll of American women indicates that most of them plan to disregard the new recommendations from the U.S. Preventive Services Task Force about mammograms. The poll also shows that most women sharply overestimate their risk of developing the disease.
The task force last week suggested that most women don't need mammograms on a routine basis until age 50. Women under 50 should consult their doctors to see if mammograms are approrpriate for them.
In the survey of 1,136 women, 76% said they disagree or strongly disagree with the recommendations, while 84% of women ages 35 to 49 said they plan to get mammograms before age 50 despite the task force recommendations.
But the poll found that most women have misconceptions about the disease and the panels' motives. Seventy-six percent the panel based its conclusions on cost, even though the task force's report included only scientific studies. Forty percent estimated that a 40-year-old's chance of developing breast cancer over the next decade is 20% to 50%. But the real risk is 1.4%, according to the National Cancer Institute.
The task force last week suggested that most women don't need mammograms on a routine basis until age 50. Women under 50 should consult their doctors to see if mammograms are approrpriate for them.
In the survey of 1,136 women, 76% said they disagree or strongly disagree with the recommendations, while 84% of women ages 35 to 49 said they plan to get mammograms before age 50 despite the task force recommendations.
But the poll found that most women have misconceptions about the disease and the panels' motives. Seventy-six percent the panel based its conclusions on cost, even though the task force's report included only scientific studies. Forty percent estimated that a 40-year-old's chance of developing breast cancer over the next decade is 20% to 50%. But the real risk is 1.4%, according to the National Cancer Institute.
Tuesday, 17 November 2009
Partnership President Comments on USPTF Mammogram Recommendations
Partnership for Prevention President/CEO Robert J. Gould, Ph.D. today issued the following statement about the revised recommendations of the US Preventive Services Task Force regarding breast cancer screening:
The US Preventive Services Task Force is the nation’s best-equipped institution to make science-based recommendations on the use of clinical preventive services. Accordingly, we accept their recommendations on breast cancer screening.
To help avoid any possible confusion about these new recommendations, we would strongly note three areas where theyhave not changed:
• Mammograms are still recommended for women 40-49 with high risk of breast cancer;
• Mammography has clearly been shown to save lives and is a vital component of our nation’s arsenal to fight breast cancer; and
• All women should talk with their physicians about their individual risks and the value of screening.
The US Preventive Services Task Force is the nation’s best-equipped institution to make science-based recommendations on the use of clinical preventive services. Accordingly, we accept their recommendations on breast cancer screening.
To help avoid any possible confusion about these new recommendations, we would strongly note three areas where theyhave not changed:
• Mammograms are still recommended for women 40-49 with high risk of breast cancer;
• Mammography has clearly been shown to save lives and is a vital component of our nation’s arsenal to fight breast cancer; and
• All women should talk with their physicians about their individual risks and the value of screening.
Wednesday, 21 October 2009
Breast Cancer Screening: Consult Your Doctor
Partnership for Prevention President Robert J. Gould today issued the following statement regarding a New York Times article about a report that breast cancer screening may be leading to overtreatment similar to that resulting from prostate cancer screening:
“The US Preventive Services Task Force has never recommended screening for prostate cancer, but it has recommended mammograms and has modified those recommendations as necessary. The proper use of screening remains an invaluable tool in breast cancer detection and treatment and in saving lives. A woman’s personal physician is the expert best equipped to help her decide what procedures should be employed in her individual circumstances. This important public discussion about screening should not discourage anyone from consulting their doctor.”
“The US Preventive Services Task Force has never recommended screening for prostate cancer, but it has recommended mammograms and has modified those recommendations as necessary. The proper use of screening remains an invaluable tool in breast cancer detection and treatment and in saving lives. A woman’s personal physician is the expert best equipped to help her decide what procedures should be employed in her individual circumstances. This important public discussion about screening should not discourage anyone from consulting their doctor.”
Thursday, 30 July 2009
Eliminate Cost-Sharing for Medicaid Preventive Services, Partnership Urges House Committee
Partnership for Prevention today urged the House Energy and Commerce Committee to prohibit cost-sharing to Medicaid patients for recommended clinical preventive services.
Partnership President Robert J. Gould praised an amendment offered by Rep. Lois C. Capps, D-Calif., to a historic health reform bill being crafted by the Committee. Her amendment would eliminate cost-sharing requirements for Medicaid clinical preventive services that have been recommended by the U.S. Preventive Services Task Force (USPSTF).
“This amendment delivers one of the eight consumer protections that President Obama recently outlined for health reform legislation,” said Gould.
“Chronic diseases are causing health care costs to spiral upward, and Medicaid patients are already among the most underserved and at-risk populations for these conditions,” Gould said. “At the same time, they are among those who can least afford high out-of-pocket costs. We should be encouraging - not discouraging - the use of preventive services as a way to help keep this vulnerable population healthy. Waiting for people to get sick and need expensive treatment isn’t real health reform. Real health reform starts with prevention.”
The USPSTF reviews scientific evidence on clinical preventive services and rates them according to their effectiveness. A Partnership for Prevention study of USPSTF recommendations found 17 clinical preventive services that either save money or are cost-effective (cost less than $50,000 per quality-adjusted life year, or QALY). Of those 17, it found 10 that cost less than $15,000 per QALY.
Partnership President Robert J. Gould praised an amendment offered by Rep. Lois C. Capps, D-Calif., to a historic health reform bill being crafted by the Committee. Her amendment would eliminate cost-sharing requirements for Medicaid clinical preventive services that have been recommended by the U.S. Preventive Services Task Force (USPSTF).
“This amendment delivers one of the eight consumer protections that President Obama recently outlined for health reform legislation,” said Gould.
“Chronic diseases are causing health care costs to spiral upward, and Medicaid patients are already among the most underserved and at-risk populations for these conditions,” Gould said. “At the same time, they are among those who can least afford high out-of-pocket costs. We should be encouraging - not discouraging - the use of preventive services as a way to help keep this vulnerable population healthy. Waiting for people to get sick and need expensive treatment isn’t real health reform. Real health reform starts with prevention.”
The USPSTF reviews scientific evidence on clinical preventive services and rates them according to their effectiveness. A Partnership for Prevention study of USPSTF recommendations found 17 clinical preventive services that either save money or are cost-effective (cost less than $50,000 per quality-adjusted life year, or QALY). Of those 17, it found 10 that cost less than $15,000 per QALY.
Subscribe to:
Posts (Atom)