Americans selected plans in the Health Insurance Marketplace in October and
Health and Human Services (HHS) Secretary Kathleen Sebelius announced that
nearly 365,000 individuals have selected plans from the state and federal
Marketplaces by the end of November. November alone added more than a
quarter million enrollees in state and federal Marketplaces. Enrollment in
the federal Marketplace in November was more than four times greater than
October’s reported federal enrollment number.
Since October 1, 1.9 million have made it through another critical step, the
eligibility process, by applying and receiving an eligibility determination,
but have not yet selected a plan. An additional 803,077 were determined or
assessed eligible for Medicaid or the Children’s Health Insurance Program
(CHIP) in October and November by the Health Insurance Marketplace.
The HHS issue brief highlights the following key findings, which are among
many newly available data reported today on national and state-level
November’s federal enrollment number outpaced the October number by more
than four times.
Nearly 1.2 million Americans, based only on the first two months of open
enrollment, have selected a plan or had a Medicaid or CHIP eligibility
Of those, 364,682 Americans selected plans from the state and federal
803,077 Americans were determined or assessed eligible for Medicaid or CHIP
by the Health Insurance Marketplace.
39.1 million visitors have visited the state and federal sites to date.
There were an estimated 5.2 million calls to the state and federal call
The report groups findings by state and federal marketplaces. In some cases
only partial datasets were available for state marketplaces. The report
features cumulative data for the two month period because some people apply,
shop, and select a plan across monthly reporting periods.
These counts avoid potential duplication associated with monthly reporting.
For example, if a person submitted an application in October, and then
selected a Marketplace plan in November, this person would only be counted
once in the cumulative data. To read the report
"R3 Report" explains new clinical alarm National Patient Safety Goal
The Joint Commission released an “R3 Report” for the new National Patient
Safety Goal (NPSG) that requires accredited hospitals and critical access
hospitals to improve the safety of their clinical alarm systems. “R3 Report”
provides accredited healthcare organizations and interested healthcare
professionals in-depth information about the rationale and references that
were employed in the development of the new alarm NPSG.
The alarm NPSG is being implemented in two phases. The first phase will go
into effect on January 1, 2014, and heightens awareness of the potential
risks associated with clinical alarms. The second phase, will be effective
January 1, 2016, and introduces requirements to mitigate those risks. The
goal addresses clinical alarms that can compromise patient safety if they
are not properly managed. This includes alarms from equipment such as
cardiac monitors, IV machines, ventilators, etc. that have visual and/or
auditory components. In general, this does not include items such as nurse
call systems, alerts from computerized provider order entry, or other
information technology systems.
Highlights of the report include:
The history of the first alarm NPSG, and why a new NPSG is needed.
Activities that led up to the development of the current NPSG, including a
summit co-convened by The Joint Commission, the Association for the
Advancement of Medical Instrumentation, ECRI Institute, the American College
of Clinical Engineering, and the Food and Drug Administration.
Information about responses from the field on the proposed NPSG and how it
affected the current version of the goal and how future input will be used.
A select bibliography of sources that informed development of the NPSG.
To view “R3 Report,” visit
new white paper - Cost, Quality, and Outcomes: The Supply Chain Value
AHRMM has released a white paper, “Cost, Quality, and Outcomes: The Supply
Chain Value Equation” that presents healthcare supply chain tools and
strategies for navigating the Cost, Quality, and Outcomes (CQO) Movement,
and explores new initiatives designed to advance the supply chain from a
transactional program to a strategic contributor to organizational success.
The paper, which is split into five parts, opens with a strategic
discussion, led by AHRMM13 keynote presenters, Annette Pummel and
Christopher O’Connor, which focuses on AHRMM’s CQO Movement and examines
where the supply chain is in relation to CQO and what additional resources
may be needed to advance the supply chain profession.
“The executive thought leaders agreed that the supply chain must operate
from the intersection of cost, quality, and outcomes in order to succeed.
CQO is boosting strategic thinking, which will help to facilitate
advancement of the supply chain to the C-suite," noted Annette Pummel, RN,
CMRP, Chair of AHRMM.
The paper also summarizes the core organizational competencies and key
transitional steps required for hospitals to successfully transition from
the first curve to the second curve as presented by Heather Jorna, Vice
President of AHA affiliate, Health Research and Education Trust (HRET).
The next part presents the results of the 2013 Healthcare Provider Executive
Supply Chain Survey, which were presented by Jamie Kowalski, Jamie C.
Kowalski, FACHE, FAHRMM, Jamie C. Kowalski Consulting, LLC. Key findings
from C-level and supply chain professionals include agreement that:
the need for the supply chain to optimize will intensify,
optimization is one of the top three expense reduction strategies used to
meet the challenge of reform,
supply chain management must become a core competency,
and the supply chain has a direct, critical relationship and impact on
patient safety, quality outcomes, and margin management.
Finally, John Gaida and Mary Starr, both AHRMM past presidents, discussed
the new AHRMM Mentor Program. Refer to
www.ahrmm.org/mentor for additional information.
The white paper was written as a result of the AHRMM Executive Thought
Leader Forum, sponsored by VHA, held during the AHRMM13 Conference &
Exhibition in San Diego, California. This full-day forum on the effects and
implications of the transforming healthcare environment hosted approximately
30 healthcare supply chain executives.
Download the complete white paper (pdf).
For more information about CQO Movement, please visit
www.ahrmm.org/CQO or email your questions to
Prolystica HP in response to healthcare industry demand for better
performing cleaning chemistries
STERIS Corporation, with more than 100 years of experience in surgical and
infection control environments, has introduced Prolystica Ultra Concentrate
HP Cleaning Chemistries; a new innovation to its premium instrument cleaning
chemistries, specifically designed for high-performance in today’s
challenging healthcare environments.
The latest Prolystica formulations are a 10x concentrate with added
de-foaming properties to further reduce the time and effort it takes to
rinse surgical tools and equipment. Additionally, the chemistries have
proven stronger in removing difficult healthcare soils such as lipids and
blood, including those associated with orthopedic surgeries, and cleans
devices in less time than previous formulations.
The Prolystica Ultra Concentrate HP cleaning chemistries are designed for
use in hospital washer/disinfectors. They are formulated for processing
surgical instruments and are compatible with an extensive range of
substrates, even soft metals.
With Prolystica HP Cleaning Chemistries, performance qualities, that already
set the brand apart from competitors, have been enhanced to provide improved
levels of productivity and flexibility as well as cost savings. In addition
to removing difficult soils, rinsing easily and employing faster cycle
times, they are effective across a broad range of water quality.
Further, Prolystica HP Cleaning Chemistries are designed to protect and
maintain the life of the instruments and washers in which they are used;
resulting in reductions in inventory and utility consumption.
Visit STERIS for the release.
More than 100
hospitals in Northeast Purchasing Coalition select aptitude for online
direct contracting benefits
aptitude LLC, the healthcare industry's first online direct contracting
market, today announced an agreement with the Northeast Purchasing Coalition
(NPC) that will enable more than 100 hospitals in the New England area to
execute and manage contracts for medical supplies, devices, and products via
the online market.
While consolidation is a trend in the industry, consensus on how to source
supplies for hospitals can be complex. As a contracting market, aptitude
facilitates agreements between hospitals and suppliers, empowering both
parties with this direct approach. Cost savings through online contracting
as well as the ability to source, bid, execute and monitor contracts more
efficiently is compelling to the NPC and are the primary reasons to begin
contracting through aptitude.
"When you look at the pressures on the healthcare industry and the
challenges of the future, we felt compelled to be an early adopter of the
aptitude platform," said Leanne Todisco, Vice President of Supply Chain
Operations for the NPC. "Through its unique approach, our group stands to
benefit from the fact that aptitude can help us contract more efficiently,
while also giving us the flexibility to align resources by integrating
evidence-based practice with strategic sourcing to deliver the best overall
value to the NPC members."
Since aptitude launched in April, the company emphasized its ability to
drive innovation in the healthcare supply chain environment by bridging the
relationship between hospitals and suppliers. Based on current market
conditions, hospitals and suppliers are agreeing to contracts in an average
of 38 days with an average savings of 10 to 15 percent.
Self-contracting represents about 40 percent of healthcare purchasing, a $55
billion spend nationwide. Before online contracting, these agreements often
took between six and nine months from proposal to contract.
Visit here for more information.
You are what your
Mothers get all the attention. But a study led by McGill researcher Sarah
Kimmins suggests that the father’s diet before conception may play an
equally important role in the health of their offspring. It also raises
concerns about the long-term effects of current Western diets and of food
The research focused on vitamin B9, also called folate, which is found in a
range of green leafy vegetables, cereals, fruit and meats. It is well known
that in order to prevent miscarriages and birth defects mothers need to get
adequate amounts of folate in their diet. But the way that a father’s diet
can influence the health and development of their offspring has received
almost no attention.
Now research from the Kimmins group shows for the first time that the
father’s folate levels may be just as important to the development and
health of their offspring as are those of the mother. Indeed, the study
suggests that fathers should pay as much attention to their lifestyle and
diet before they set out to conceive a child as mothers do.
“Despite the fact that folic acid is now added to a variety of foods,
fathers who are eating high-fat, fast food diets or who are obese may not be
able to use or metabolize folate in the same way as those with adequate
levels of the vitamin,” says Kimmins. “People who live in the Canadian North
or in other parts of the world where there is food insecurity may also be
particularly at risk for folate deficiency. And we now know that this
information will be passed on from the father to the embryo with
consequences that may be quite serious.”
The researchers arrived at this conclusion by working with mice, and
comparing the offspring of fathers with insufficient folate in their diets
with the offspring of fathers whose diets contained sufficient levels of the
vitamin. They found that paternal folate deficiency was associated with an
increase in birth defects of various kinds in the offspring, compared to the
offspring of mice whose fathers were fed a diet with sufficient folate.
The research from the Kimmins’ group shows that there are regions of the
sperm epigenome that are sensitive to life experience and particularly to
diet. And that this information is in turn transferred to a so-called
epigenomic map that influences development and may also influence metabolism
and disease in the offspring in the long-term. (The epigenome is like a
switch, which is affected by environmental cues, and is involved in many
diseases including cancer and diabetes. The epigenome influences the way
that genes are turned on or off, and hence how heritable information gets
passed along). To read the full article
face U.S. scrutiny on investigator bump
U.S. regulators are more than tripling to 27 the number of workers they’ll
have in China to inspect pharmaceutical plants and products, a move that may
spur a wave of enforcement similar to what’s happening in India.
An increased number of Food and Drug Administration investigators in India
this year led to import bans against some generic drugs from Ranbaxy
Laboratories Ltd. and Wockhardt Ltd. for failure to meet U.S. standards. The
China expansion is the culmination of almost two years of negotiations with
government officials, Christopher Hickey, director of the FDA’s China
office, said in a telephone interview from Beijing.
China, like India, has become a significant supplier around the world of the
active ingredients found in prescription drugs, Hickey said. U.S. Vice
President Joe Biden visited the capital, Beijing, last week and was able to
secure a final commitment from the government to allow more inspectors into
China to routinely review drug manufacturing practices and conditions.
Among the 19 new employees stationed in China, 10 will be pharmaceutical
inspectors, Hickey said. The number of food inspectors will increase to
eight over the next year, allowing the FDA to complete about 160 inspections
a year, compared with 20 to 25 now, he said. Drugmakers will see a similar
China became a particular point of focus after contaminated doses of Baxter
International Inc.’s blood thinner heparin was linked to 246 death reports
from Jan. 1, 2007, to May 31, 2008. The active pharmaceutical ingredient was
made in China. Around that same time, tainted jerky treats imported from
China began to be linked to thousands of dog illnesses in the U.S.
China has been a growing player in the healthcare industry, with sales there
for eight foreign drugmakers, including GlaxoSmithKline Plc, Pfizer Inc. and
Merck & Co., climbing 40 percent in 2011. Growth has slowed to 20 percent
this year, data compiled by Bloomberg show, mainly because of more modest
expansion of the Chinese economy.
Glaxo, based in London, also faces a corruption probe in China for allegedly
bribing hospitals and doctors that may further shrink growth.
As part of the agreement secured by Biden, the Chinese government also will
take steps to register bulk chemical manufacturers that make active
ingredients. The industry is currently unregulated in China and more
oversight could help combat counterfeit medicines worldwide, the White House
The FDA first started discussions with Chinese officials after U.S.
President Barack Obama’s fiscal 2013 budget request included funds for
additional inspectors. The State Department became concerned in October 2012
that an FDA hire hadn’t gotten a visa applied for in August, Hickey said.
Visit Bloomberg for the story.
Task force: Ban
drug reps from 'Ivory Towers'
Drug sales reps should be banned from academic medical centers, but mingling
between faculty and pharma researchers is not a problem, according to a
conflict-of-interest task force.
"Pharmaceutical sales representatives should not be allowed access to any
faculty, students, or trainees in academic medical centers or affiliated
entities," the task force, convened by the Pew Charitable Trusts, wrote in a
30-page report released Tuesday. "However, faculty may invite pharmaceutical
scientists for specific educational or scientific discussions that do not
involve marketing of a specific product."
The task force -- with representatives from seven academic medical centers,
various consumer organizations, the Association of American Medical Colleges
(AAMC), and the American Medical Student Association -- referenced a review
of 29 studies that found physicians who interacted with sales reps
prescribed lower-quality, higher-cost drugs compared with non-exposed
Current AAMC policy recommends that sales reps only be allowed on academic
medical centers by appointment and that they be prohibited from entering
patient-care areas. Banning sales reps is one of seven recommendations the
task force made, all of which would tighten current AAMC recommendations.
Pew convened the task force as the last comprehensive standards were
released by the AAMC in 2008, and the group believed it was time to update
recommendations now that more data on industry influence have been
"The guiding principle was to balance appropriate boundaries in
physician-industry relationships with the need to encourage collaborations
crucial for improving medical care and practice," David Korn, MD, a former
vice provost for research at Harvard Medical School, and Daniel Carlat, MD,
director of Pew's Prescription Project, wrote in a Viewpoint article
published simultaneously in the Journal of the American Medical
The conflict-of-interest policies should also apply to training sites such
as affiliated hospitals and clinics, the task force recommended.
Of the 15 recommendations made, several vary at least somewhat slightly from
what the AAMC already recommends to its member schools, including:
No gifts or meals of any value should be accepted, including gifts deemed
"educational" for medical staff. However, patient educational materials are
Drug samples are only allowed if they aren't used for marketing purposes.
Faculty shouldn't accept funding for speaking engagements directed toward
physicians, students, health professionals, or the public. The restriction
doesn't apply to scientific presentations made to industry employees.
Residents and medical students may not accept industry-sponsored fellowships
for clinical training.
Members of pharmacy and therapeutics committees should be recused from
discussion and voting if conflicts arise.
Continuing medical education (CME) should be limited to specialized training
"such as new medical devices for which expertise may be very limited and
cost of training high," Carlat and Korn wrote. Existing industry-funded CME
may continue provided that safeguards are in place.
A statement from the Pharmaceutical Research and Manufacturers of America,
the trade group of drugmakers, wasn't immediately available as its offices
were closed Tuesday due to inclement weather in Washington.
The seven academic medical centers participating in the task force included
the University of Michigan Medical School, Stanford University School of
Medicine, Harvard Medical School, Cleveland Clinic, University of Pittsburgh
School of Medicine, UMass Memorial Healthcare, and Kaiser Permanente.
Work published earlier this year in BMJ found physicians who attended a
medical school with a policy that banned gifts from drug companies were less
likely to prescribe two of three newly marketed psychotropic drugs once in
Visit MedPageToday for the article.