Wipak Medical & Healthmark Industries announce the acquisition
of Kimberly-Clark’s peel pouch business

Healthmark Industries Co. Inc (St. Clair Shores, MI) and Wipak Medical (Nastola, Finland) are pleased to announce acquisition and assumption of Kimberly-Clark Health Care’s (Roswell, GA) peel pouch business. Wipak produces and markets flexible packaging, including peel pouches. Healthmark, founded in 1969, is a supplier of innovative products and solutions for Central Sterilization, including sterilization packaging and accessories. Information about Healthmark and Wipak can be found at THIS LINK and THIS LINK, respectively.

The acquisition will allow Healthmark and Wipak to establish a broader line of sterilization packaging in the market while allowing Kimberly-Clark to focus on innovation in the rest of its line of medical devices and supplies. As of November 30, 2007, the Kimberly-Clark worldwide peel pouch and tubing business will officially transition to Healthmark. Through November 30, 2007, customers will continue to purchase peel pouch and tubing products from Kimberly-Clark. As of December 1, 2007 and from that date forward, Healthmark will take ownership of all existing product inventories and assume full accountability for order processing, customer service, and other sales activities. Wipak and Healthmark will make the utmost effort to ensure a seamless and pain-free transition for all Kimberly-Clark packaging customers.

After December 1, 2007 direct inquiries to:
Healthmark Industries Company Inc.
Phone: 1-586-774-7600
Toll Free: 1-800-521-6224
Fax: 1-586-774-6473
Email: Healthmark@hmark.com

CMS publishes national list of poor-performing nursing homes,
key tool for families seeking quality care

The Centers for Medicare & Medicaid Services (CMS) released the first ranking of the nation’s poor-performing nursing homes. Release of the national list of facilities, identified as special focus facilities (SFFs), is expected to offer individuals, seeking long-term healthcare services, and their families powerful new information when choosing nursing homes. Release of the list was prompted by the number of facilities that were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next (for many of the same problems as before). Such facilities with a “yo-yo” compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies. Once a facility is selected as an SFF, the state survey agency conducts twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and is no longer identified as an SFF, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid. CMS and the state can more quickly terminate a facility that is placing residents in immediate jeopardy.

The CMS policy of progressive enforcement means that any nursing home, not just those identified as an SFF, that reveals a pattern of persistent poor quality is subject to increasingly stringent enforcement action. If problems continue, the severity of penalties will increase over time, ranging from civil monetary penalties, denial of payment for new admissions and, ultimately, removal from Medicare and/or Medicaid. As of October 2007, there were 128 SFFs, out of about 16,000 active nursing homes. The number of SFFs in each state varies according to the number of nursing homes in the state. These nursing homes, at the time of their selection as an SFF, had survey results that were among the poorest five or 10 percent in each state. Today’s list includes 54 facilities that are at the top of the poorest performers in those states and among those facilities that have failed to improve significantly.   Typically, these facilities achieve improved survey results after being selected for the initiative. The CMS data indicate that about 50 percent of the nursing homes identified as SFFs significantly improve their quality of care within 24-30 months, while about 16 percent are terminated from Medicare and Medicaid.

In addition to publishing the list of SFFs, CMS is taking many other steps to improve the quality of care in the nation’s nursing homes including a new program that will make the payment system more sensitive to quality improvements; developing new, more stringent systems for criminal background checks on facility workers and applicants; unprecedented focus on preventing catastrophic pressure ulcers in nursing home residents; and improving the state survey process. The CMS list of SFFs can be found at THIS LINK
 

Oxygen suppliers fight to keep a Medicare boon

Millions of people with respiratory diseases have relied on oxygen equipment, delivered to their homes, to help them breathe. A basic setup, including three years of deliveries of small oxygen tanks, can be bought from pharmacies and other retailers for as little as $3,500, or about $100 a month. Unless, that is, the buyer is Medicare. Despite enormous buying power, Medicare pays far more. Rather than buy oxygen equipment outright, Medicare rents it for 36 months before patients take ownership, and pays for a variety of services that critics say are often unnecessary. The total cost to taxpayers and patients is as much as $8,280, or more than double what somebody might spend at a drugstore. The high expense of oxygen equipment, which cost Medicare over $1.8 billion last year, is hardly an anomaly. Medicare spends billions of dollars each year on products and services that are available at far lower prices from retail pharmacies and online stores, according to an analysis of federal data by The New York Times. The government agency has paid above-market costs for dozens of items, a comparison of Medicare figures with retail catalogs finds.

For example, last year Medicare spent more than $21 million on pumps to help older and disabled men attain erections, paying about $450 for the same device that is available online for as little as $108. Even for a simple walking cane, which can be purchased online for about $11, the government pays $20, according to government data. These widespread price discrepancies, including those for oxygen services, have been noted in dozens of regulatory reports. But when officials and politicians have tried to cut these costs, they have often encountered a powerful foe: the companies that sell these devices, who ask their elderly customers to serve, in effect, as unpaid lobbyists, calling and writing to their representatives in Congress, protesting at rallies, and even participating in political attacks against individual lawmakers who take on the issue. As the nation’s elderly population grows, dozens of industries have tried to harness the political might of older Americans for corporate goals. Physician groups, medical device manufacturers, insurance companies and other businesses have rallied aging voters to protest even minor legislative changes.

Many of those battles focus on the $427 billion Medicare program. Because of fierce patient and corporate lobbying, for instance, Medicare still pays prices for many items that are based on rates established in the early 1980s, when devices were often much more expensive than they are now. Even as the actual cost of many machines and services has fallen, Medicare has only occasionally lowered what it pays. “There’s no question that parts of Medicare are mispriced,” said Herb B. Kuhn, deputy administrator of the Centers for Medicare and Medicaid Services, the agency overseeing Medicare. Kuhn said the program had made price refinements and was in the process of carrying out a competitive bidding system to help bring down the cost of products like oxygen equipment. But, Kuhn acknowledged, officials have confronted political and logistical obstacles in adjusting a program that last year provided services to 43 million older and disabled Americans.

The battles over oxygen equipment highlight many of those challenges. Medicare pays the same rental amount to provide each oxygen patient with equipment and services, regardless of how often they are used. For patients who require constant monitoring and frequent deliveries of tanks, high prices may be justified. And for people who use equipment for only a few months, renting may be cheaper than buying. Earlier this decade, legislators ordered the government agency to pay less and use the competitive bidding program. Then the oxygen industry started fighting back. Companies organized themselves into a deep-pocketed lobbying force that has defeated attempts to cut Medicare’s rates, and has attacked the competitive bidding program. The government’s overall bill for Medicare soared last year to an average of $8,568 per beneficiary, up from $5,522 in 1999, an increase that outpaces inflation by 34 percent. In 1997 and 2003, Congress lowered oxygen reimbursements by a total of about 39 percent. (The New York Times) To read the entire article see THIS LINK
 

FDA is urged to toughen rules on salt; intake causing deaths, consumer group says

A consumer group prodded the Food and Drug Administration to regulate salt as a food additive, arguing that excessive salt consumption by Americans may be responsible for more than 100,000 deaths a year. The government has long placed salt in a "generally recognized as safe" or GRAS category, which grandfathers in a huge list of familiar food ingredients. But in an FDA hearing this week, the Center for Science in the Public Interest (CSPI) urged the agency to enforce tougher regulations for sodium. Doing so "lays the foundation for saving tens of thousands of lives per year," said CSPI Director Michael Jacobson in an interview after the hearing. It "just has tremendous potential to health and to cut healthcare costs." CSPI first petitioned the FDA in 1978 to regulate salt in food more closely and has since sued the agency unsuccessfully in federal court twice over the ingredient. A 2005 petition to the FDA by CSPI prompted the agency to hold hearings yesterday to review sodium chloride's status in food.

"After 25 years of inactivity, the FDA is taking the salt issue seriously," Jacobson said. "They're really gathering information . . . and getting an earful from all sides." The average American consumes 3,353 milligrams of sodium every day, more than twice what the Institute of Medicine says is adequate for healthy people and 1,000 milligrams more than the 2,300 milligrams set as a daily limit by the 2005 U.S. Dietary Guidelines. The intake considered adequate is far lower: 1,500 milligrams for those 9 to 50 years old; 1,300 milligrams for those 51 to 70, and 1,200 milligrams for people 70 and older, or less than what is found in a ham and Swiss cheese sandwich on whole wheat with mustard. Salt intake is closely linked to stroke, kidney disease and high blood pressure.

As a prelude to yesterday's hearing, CSPI and the Grocery Manufacturers Association held a joint conference in October to encourage food companies, restaurants, health professionals and government agencies to help Americans limit sodium. Seventy-five percent of the salt consumed in the United States is found in processed foods bought at grocery stores, vending machines, restaurants and fast-food franchises. How best to cut sodium in the American diet is greatly debated. CSPI advocates more federal regulation. Industry groups want reductions to be voluntary. "There is no reason for the FDA to revoke the GRAS status of salt," said Robert Earl, the Grocery Manufacturers' senior director of nutrition policy. "It should look for alternative approaches to support industry's efforts to reduce sodium in food. There are lots and lots of companies trying to reduce salt." Five years ago, ConAgra Foods, which produces Healthy Choice, Banquet, Chef Boyardee, Orville Redenbacher and Smart Pop foods, began looking for ways to cut sodium, said its director of nutrition, Patty Packard. "We found that we could fairly easily remove 15 to 20 percent of sodium in most products," Packard said. "That totals 2.8 million pounds of salt that we have removed on an annual basis." (The Washington Post) See THIS LINK
 

Cancer patients may benefit from reporting symptoms online in real time

Traditionally, clinicians have relied on information provided by cancer patients during their office visits as the primary means of assessing patients’ symptoms and side effects. However, potentially serious consequences could arise if important symptoms go unreported during those visits because they occur between appointments. A new study by researchers at Memorial Sloan-Kettering Cancer Center (MSKCC) finds that even the sickest cancer patients are willing and able to “self-report” symptoms using the Internet, thus supplying key data in real time to their healthcare providers. Published in the December 1, 2007, issue of the Journal of Clinical Oncology, the study suggests a new direction in cancer care. According to the authors, supplementing traditional office visit discussions with online patient self-reporting can fill important gaps in clinicians’ knowledge and in doing so may significantly improve patient safety and quality of care. “Cancer care has become increasingly complex, causing office visits to become more compressed. This makes it challenging for the clinician to comprehensively assess each patient’s symptoms in that brief window of time,” said the study’s lead author, Ethan Basch, MD, a medical oncologist at MSKCC. “Because cancer therapies can be highly toxic, early detection of symptoms and timely treatment is vital. What is exciting to us about online self-reporting is that patients can alert clinicians to crucial symptoms in real time.”

The research team developed a Web-based system that patients in the study could access using computers in waiting-room kiosks and at home to communicate their symptoms directly to clinicians. Investigators adapted the National Cancer Institute’s standard terminology for tracking patient toxicities in clinical trials and translated it into patient-friendly language. The new terms were uploaded to a secure Web site called Symptom Tracking and Reporting (STAR). Participants used the system to report their cancer- and chemotherapy-related side effects, including pain, fatigue, constipation, diarrhea, nausea, vomiting, shortness of breath, and decreased mobility, as well as their overall quality of life. From June 2005 through March 2006, 107 lung cancer patients receiving outpatient chemotherapy at MSKCC enrolled in the study. Patients were followed for up to 16 months and 40 visits. Patients were more likely to use the system if they had prior computer experience; however, age, gender, and cancer stage had no effect on log-in rates. Researchers found that 100 percent of patients used the waiting room kiosks at some or all of their office visits. An average of 78 percent of participants logged in to the system at any given office visit. According to the findings, patients were satisfied with the system. Most respondents (98 percent) found STAR easy to use, 90 percent said it was useful, and 77 percent expressed that it improved the quality of their discussions with clinicians.  

Although the study focused on the patient experience, its results suggest that self-reported data is a potentially valuable resource for clinicians as well. At each follow-up office visit, symptom reports were printed for clinical nurses. “All of the nurses who participated in the study understood the reports and felt this information was highly useful for clinical decisions, documentation, and discussions,” said Ann Culkin, RN, a nurse on the Thoracic Oncology Service at MSKCC and a co-author of the study. The nurses all noted that they had altered management based on patient-reported information and alerts from STAR, including recommending medication and lifestyle changes and arranging for additional physician consultations. The authors concluded that online self-reporting is a feasible long-term strategy for monitoring toxicities during chemotherapy, even among very ill patients. However, explicit reminders to log in and clinician feedback on self-reported information are important to maintain patients’ continued interest and participation between visits.
 

Message from Dr. Margaret Chan, WHO Director-General, for World AIDS Day

“The first World AIDS Day was staged by WHO in 1988, at a time when the world was waking up to this disease and its multiple catastrophic impact. Since then, the face of the epidemic has changed in significant ways, and we are gaining better insight every day. Some trends have been positive. Leaders in most countries are fully awake to the threat. Awareness has brought commitment, and resources continue to increase, including for the development of new tools. This year’s report on the epidemic, jointly prepared by UNAIDS and WHO, indicates that HIV incidence peaked in the late 1990s and prevalence has been level since 2001. Data set out in this report further suggest that prevention efforts are leading to fewer new infections, especially in young people, and that greater access to treatment is contributing to fewer HIV-associated deaths.

These positive trends mask some alarming changes in the epidemic. My main message today is straightforward: do not forget Africa, and do not forget women. Today, HIV/AIDS is overwhelmingly concentrated in sub-Saharan Africa, where it thrives on and traps people in poverty. This region accounts for over two thirds of people living with HIV and over three quarters of HIV-associated deaths. In all regions, the proportion of women living with HIV is growing. In sub-Saharan Africa, it now approaches 61%, the highest in the world.” To read the full statement see THIS LINK

Neopost introduces online shipping; web-based multi-carrier solution
allows users to ship packages at optimal cost

Neopost, a provider of mailing and shipping solutions, announces Neopost Online Shipping. Through an agreement with United Parcel Service (UPS) and the United States Postal Service (USPS), Neopost is able to provide its customers with a new multi-carrier web-based shipping application that allows users to easily compare shipping options. By taking advantage of this advanced shipping tool, customers can access the best delivery options available, reduce shipping costs and increase efficiency. Users will benefit from the easy-to-use “Find Best Service” panel, while the built-in CASS-certified address verification software minimizes the added cost of returned packages. Enabling users to prepare a shipment in a simple three step process, set default shipping service preferences and track multiple orders from a central location, Neopost Online Shipping further increases shipping productivity. The shipping solution sends automatic email confirmation and tracking details to specified recipients, and lets users view shipment histories and receive one combined activity report for all shipments made during a specified date range. Neopost is a participating member of the UPS Ready program which enables companies to integrate UPS technologies and solutions within their offerings. To learn more, visit THIS LINK or THIS LINK
 

New corporate headquarters for HPN

Healthcare Purchasing News has moved its headquarters. Please note our new address: 2477 Stickney Point Road, Suite 315B, Sarasota, FL 34231.  

All other contact information remains the same: Phone: (941)927-9345, FAX: (941)927-9588, Website: www.hpnonline.com.