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NCQA Report on State of Health Care Quality: Some Good News, Some Bad
There has been no progress in reducing overuse of antibiotics, but some progress in fighting childhood obesity, according to the latest report from the National Committee for Quality Assurance (NCQA). The report also found that more kids are receiving recommended influenza and rotavirus vaccinations, but there has not yet been a full recovery from the declining vaccination rates of other crucial immunizations that began in 2010. Medicaid enrollees are increasingly happy with their primary care and specialist physicians—an important finding since enrollment in the program has been growing and will continue to grow with forthcoming expansions to eligibility. The 2013 State of Health Care Quality Report summarizes Healthcare Effectiveness Data and Information Set (HEDIS) results from health plans covering 136 million people, or 43 percent of the U.S. population, for 2012. HEDIS is health care's most widely used performance improvement tool.

Tracking Regional Variation in Prescription Drug Use
Heart attack patients in Ogden, Utah, are twice as likely to be prescribed cholesterol-lowering medications to reduce their risk of future attacks than are such patients in Abilene, Texas, according to a new report from the Dartmouth Atlas Project. Dartmouth Atlas researchers also found that use of drugs known to be effective, as well as those that are potentially risky, varies widely across U.S. regions. The report notes that the health status of a region's Medicare population accounts for less than a third of the variation in total prescription drug use, and that higher spending is not related to higher use of proven drug therapies.

Choosing Wisely List Has Nearly 200 Entries
The "Choosing Wisely" list of medical tests and procedures that physicians and patients should question now has nearly 200 recommendations, up from 45 when the campaign was launched in April 2012 by the American Board of Internal Medicine (ABIM) Foundation. Newly added to the list are recommendations against using CT scans for low-risk patients with minor head injuries and an admonition not to delay engagement of hospice or palliative services for emergency department patients likely to benefit, as suggested by the American College of Emergency Physicians. Twenty-one organizations that received funding from the ABIM Foundation are working to educate physicians about the list and teach them communication skills to engage their patients in discussions about high-value care.

Crunching the Numbers on the Nation's "Superutilizers"
One percent of American patients accounted for 21 percent of total health care spending in 2010, according to a report from the Agency for Healthcare Research and Quality that was published in August. The report used the latest data (from 2010) on total health care expenditures to put a price tag on the nation's "superutilizers"—including those who rack up bills averaging $88,000 annually as they cycle in and out of hospitals and emergency departments seeking care for multiple chronic conditions. Five percent of patients accounted for 50 percent of all health care costs, while the bottom 50 percent of patients accounted for just 2.8 percent of spending that year.

How Physicians Can Save Health Care Dollars
A group of practicing physicians provides recommendations on how to control health care costs in a new issue brief from the Robert Wood Johnson Foundation, while the Costs of Care organization, a nonprofit funded by the ABIM Foundation and several other groups, is crowdsourcing ideas about how to educate medical students in ways to reduce costs.

Use of Health Information Exchange Saves $2,000 per ED Patient
Enabling emergency department (ED) physicians to look up a patient's medical information through a health information exchange saved nearly $2,000 per patient by avoiding unnecessary medical tests and procedures, according to a new study from the American College of Emergency Physicians. The researchers tracked the care of ED patients over one year at 11 South Carolina hospitals and found having access to patient records enabled physicians to avoid laboratory and imaging procedures, as well as consultations and admissions.

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