Tuesday, December 17, 2002

Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001
A "Tracking Report" from the Center for Studying Health System Change that examines the small decrease in physicians serving Medicaid patients and the large decrease in those providing charity care, and warns that "new budget pressures could lead states to freeze or cut Medicaid provider payment rates, which could then trigger access problems."  
  

SSA Disability: Enhanced Procedures and Guidance Could Improve Service and Reduce Overpayments to Concurrent Beneficiaries
A report from the General Accounting Office that examines differences in the work incentives in the Social Security Disability Insurance, Supplemental Security Income, Medicare and Medicaid programs. This report is available through the Open Minds web site, which routinely makes a selection of white papers and reports available at no charge.  
  

Brain Scans May Detect Early Signs of Psychosis
Reuters story at Yahoo based on research published in The Lancet - "Brain imaging may help doctors determine if people who are at high risk of developing psychotic disorders such as schizophrenia will go on to experience a break with reality, researchers said Tuesday. Sophisticated scanning techniques may be able to detect changes in areas of the brain that occur before or while a severe mental disorder is developing..."  
  

'Fear gene' could unlock mental illness
BBC story, based on research at the Howard Hughes Medical Institute regarding the discovery of a gene in mice that plays a role in learning to be afraid - and could "provide clues to the origins of severe mental illness."  
  

Is There A Common Genetic Link For Depression And Cardiovascular Disease?
Molecular Psychiatry article at InteliHealth on the large body of evidence that has emerged over several years for an association between depressive disorder and cardiovascular disease - and "recent support for the assumption that the relation between both disorders may be bi-directional."  
  

Team Treatment Helps Elderly Depression
AP story at InteliHealth - "Elderly patients suffering from depression fared better when there was a team approach to their care, a study suggests. Researchers found patients had fewer symptoms and greater quality of life when specially trained case managers worked with primary care doctors to help develop treatment plans."  
  

Psychiatric Disorders Common Among Detained Youth
A December 10 National Institute of Mental Health press release on research reported in the December 2002 Archives of General Psychiatry which found that "among teens in juvenile detention, nearly two thirds of boys and nearly three quarters of girls have at least one psychiatric disorder."  
  

Higher Out-of-Pocket Costs Cause Massive Non-Compliance in the Use of Prescription Drugs, and This Is Likely to Grow
A Health Care News story in Adobe Acrobat format - "A new Harris Interactive survey shows that as a direct result of the high out-of-pocket cost of drugs, many millions of people do not ask doctors for the prescriptions they need, do not fill the prescriptions they are given, use lower doses of drugs than those prescribed and take their drugs less often than they should. The higher people’s out-of-pocket cost for drugs, the more likely they are to be non-compliant. Furthermore, non-compliance is much worse among people in only fair or poor health – the people who need the drugs the most – than among those in good health."  
  

Shift in treatment funds? (Virginia)
Richmond Times Dispatch story - "Gov. Mark R. Warner wants to transfer about $22 million in services and staff from state mental hospitals to treat mentally disabled people in communities. Sources said hundreds of mentally ill people would be treated in programs run by localities and financed by the state out of savings from closing wards in Virginia's mental institutions. The governor will announce the plan today."  
  

State mental health centers sued (Nebraska)
Omaha World Herald story - "More than a dozen women have sued the leaders of Nebraska's three mental-health regional centers, alleging that they weren't protected from sexual assaults and weren't helped in dealing with the resulting trauma. The civil-rights action, filed Friday afternoon in U.S. District Court, is an outgrowth of several claims by former patients of the Lincoln Regional Center stating that an employee sexually assaulted them last year."  
  

Mental health fixes won't be sweeping, expert says Cleveland Plain Dealer story on the recommendations likely to be made by President's New Freedom Commission on Mental Health, which is chaired by Michael Hogan, director of the Ohio Department of Mental Health.  
  

Aid for in-home care may end (Michigan)
Detroit Free Press story on proposed guideline changes which would eliminate in-home care as a Medicaid-funded service, and leave the state no longer required to pay for supervision, help with medication and meal preparation have been funded for people with disabilities who live in their own homes.  
  

Lawsuit Over Adult Home (New York)
New York Times story - "The New York attorney general ... sued the former operators of one of the state's largest and most troubled adult homes for the mentally ill yesterday, seeking $12 million in damages to compensate hundreds of residents who had been subjected to what state lawyers described as years of scandalous care and deplorable conditions." [Viewing New York Times resources requires registration, which is free].  
  

Michigan Plan to Cut Drug Costs Is Upheld
New York Times story - "Michigan acted legally when it attempted to cut costs by limiting the drugs doctors can prescribe to low-income patients, the state appeals court said in a decision released Monday. The unanimous decision was a victory for the Michigan Department of Community Health. It also sent a clear signal to other states, who have been waiting to see if courts would approve Michigan's unique approach." [Viewing New York Times resources requires registration, which is free]. See also the story at ABC News. Mental health advocates and pharmaceutical companies had together brought a lawsuit that led to a preliminary injunction halting the program earlier this year. Yesterday's action by the state appeals court lifted that injunction, as "drug companies and mental health advocates failed to show their case was likely to succeed."  
  

Psychiatrists 'driven by fear' (UK)
BBC story on research appearing in the Postgraduate Medical Journal on "so-called defensive medicine" - "Fear of being sued or pilloried in the media is forcing many psychiatrists to take the safe treatment option - even if it is not necessarily the best for the patient."