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News Article | April 18, 2017
Site: www.eurekalert.org

EUGENE, Ore. -- April 18, 2017 -- The signage varies but the message is working. Drinking by pregnant women is down 11 percent in states requiring point-of-sale warning signs, says a health economist at the University of Oregon. The benefits to heeding the warnings show up in fewer extremely premature births (less than 32 weeks gestation) and very-low-birth-weight babies (less than 3.5 pounds), reports Gulcan Cil in a paper published in the May issue of the Journal of Health Economics. The biggest effects are seen among those with the most drinking behavior -- women 30 and older. Her complex breakdown of extensive data, she said, indicates reduced drinking by pregnant women associated with signage and suggests a likely causal relationship between drinking while pregnant and birth outcomes. "The signage is working," said Cil, a visiting instructor in the Department of Economics and postdoctoral fellow in the department's Mikesell Environmental and Resource Economics Research Lab. "Drinking alcohol while pregnant has been an issue that many policies have tried to address over the last few decades. An 11 percent change in the prevalence of drinking is not trivial. It is big enough to show up in the birth outcomes." The study involved regression analyses of data available in two national sources and information from the 23 states and Washington, D.C., which have adopted such signage, and a group of states that have not. The study's control group included women who had lived in non-adopting states and women who lived in adopting states before signage requirements were implemented. The primary data source was the National Vital Statistics Natality Detail Files, a collection system based on information obtained on birth certificates. The focus was on data from 1989, when information on alcohol consumption during pregnancy was required, to 2010. Data also came from the Behavioral Risk Factor Surveillance System, 1985-2010. The system, Cil said, gathers information that women were likely to freely share about their drinking patterns during the previous 30 days before taking the telephone-based survey. Her analytic approach to compare data from sign-adopting states and states not using signage allowed Cil to identify the direct relationship between drinking while pregnant and birth outcomes, reducing the likelihood that other factors such as cigarette smoking, drug abuse, nutritional deficiencies and other risky life choices were at play in behavioral changes. "It's very hard to isolate one thing from another," she said. "One thing that we do in empirical economics, in general, or applied econometrics is to try to find something that changes one variable at a time." The study examined data on drinking in general terms. It was not able to sufficiently probe effects related to heavy drinking, which is known to contribute fetal alcohol spectrum disorders. The failure to find statistical significance for behavioral change related fetal alcohol disorders, Cil noted, may reflect the fact that the disorders are rarely diagnosed at birth and reported on birth certificates. Point-of-sale signage, she said, appears to be an effective, low-cost approach to protect the health of pregnant women and the babies they carry. "Some people never get exposed to these kinds of educational campaigns," Cil said, adding that the signage that she saw at a Eugene grocery store, which sparked her study, reinforced what she already knew about drinking while pregnant. "I found that the issue has never been studied and evaluated as a public education program or public awareness program." Cil noted that the signage used in Oregon contain an eye-catching graphic depicting a pregnant woman, while signs used in other states do not. All contain similar language. A future study might explore whether variations in signage -- graphics, fonts, colors and language -- may best influence behavioral change. Note: The UO is equipped with an on-campus television studio with a point-of-origin Vyvx connection, which provides broadcast-quality video to networks worldwide via fiber optic network. There also is video access to satellite uplink and audio access to an ISDN codec for broadcast-quality radio interviews.


"Obesity is linked to more than 230 other medical conditions, often more prevalent in the older generation," she said. "We know that even a 5% to 10% weight loss may significantly reduce health risks associated with obesity, so there is a pressing need for the health care community to focus on ensuring early and comprehensive access to obesity care. Collaboration between people with obesity and HCPs is a key part of the solution for addressing and treating this chronic, progressive disease and improving health outcomes." According to Golden, this will require PwO, especially older ones, and HCPs to shift the dialogue in the medical setting. Study findings show that currently, of those PwO who discussed their weight with HCPs, a lesser proportion (56%) of older PwO report that they "seek support" from their HCP for weight loss as compared with younger PwO (65%). Additionally, fewer older PwO (50%) reported having received a "formal diagnosis" of obesity as compared with younger PwO (56%).1 These findings held true despite older PwO reporting greater prevalence of obesity-related conditions such as high blood pressure, high cholesterol, diabetes and sleep apnea (variable by condition, as much as twice the prevalence as the younger group).1 The ACTION Study was a cross-sectional U.S.-based study, conducted through online surveys, included over 3,000 adults with obesity (BMI ≥ 30 kg/m2 based on self-reported height and weight), of which 946 or 31% were 65 or older. About ACTION The "Awareness, Care and Treatment In Obesity Management" (ACTION) study is the first U.S. nationwide study to investigate barriers to obesity management from the perspective of people with obesity, health care professionals and employers. In addition, the study aims to generate insights to guide collaborative action to improve obesity care, education and support. Sponsored by Novo Nordisk, the ACTION study was led by a multi-disciplinary steering committee comprised of representatives from The Obesity Society, the Obesity Action Coalition, and the Integrated Benefits Institute, as well as obesity experts in the fields of primary care, endocrinology, physiology and nursing. The study involved more than 3,000 people with obesity, 600 health care professionals, and 150 employers in the United States. To learn more about the study, please visit www.ACTIONStudy.com. About obesity Obesity is a chronic disease requiring long-term management.2 Complex and multifactorial in nature, obesity is influenced by genetic, physiological, environmental and psychological factors and is associated with many serious health consequences.3,4 The global increase in the prevalence of obesity is a public health issue that has severe cost implications to health care systems.5,6 In the United States, approximately 35% of adults, or nearly 79 million adults, live with obesity.7 Despite the high prevalence of obesity, many people with obesity lack support in their efforts to lose weight and the disease remains substantially underdiagnosed and underreported.8 About Novo Nordisk Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people with other serious chronic conditions: hemophilia, growth disorders and obesity. With U.S. headquarters in Plainsboro, N.J., Novo Nordisk Inc. has nearly 5,000 employees in the United States. For more information, visit novonordisk.us or follow us on Twitter: @novonordiskus. 1 Look M, Golden A, Kyle T, et al. Insights and Perceptions of Obesity Management in Older People with Obesity: Results of National Study. Poster presentation presented at: AACE 2017; May 3-7, 2017; Austin, TX. 2 American Medical Association. Business of the American Medical Association House of Delegates 2013 Annual Meeting annotated reference committee reports: reference committee D. http://www.ama-assn.org/assets/meeting/2013a/a13-addendum-refcomm-d.pdf. Approved June 8, 2014. Accessed October 11, 2016. 3 Wright SM, Aronne LJ. Causes of obesity. Abdom Imaging. 2012;37(5):730-732. 4 Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9(88):1-20. 5 World Health Organization. Fact sheet no. 311: obesity and overweight. http://www.who.int/mediacentre/factsheets/fs311/en/. Updated June 2016. Accessed October 1, 2016. 6 Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Economics. 2012;31(1):219-230. 7 Centers for Disease Control and Prevention. Adult obesity facts. http://www.cdc.gov/obesity/data/adult.html. Updated September 1, 2016. Accessed October 11, 2016. 8 Crawford AG, Cote C, Couto J, et al. Prevalence of Obesity, Type II Diabetes Mellitus, Hyperlipidemia, and Hypertension in the United States: Findings from the GE Centricity Electronic Medical Record Database. Popul Health Manag. 2010;13:151–161. Novo Nordisk is registered trademark of Novo Nordisk A/S. © 2017 Novo Nordisk   All rights reserved.   USA17SAM01030   May 2017 To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/heart-attacks-strokes-and-other-major-health-events-play-key-role-in-driving-older-americans-with-obesity-to-address-their-weight-300451138.html


News Article | May 4, 2017
Site: www.eurekalert.org

Although radiation therapy is an essential part of modern cancer treatment, and is indicated for about half of all new cancer patients, facilities for its provision are sadly lacking in many countries worldwide. Indeed, 29 out of 52 African nations have no radiotherapy facilities whatsoever. At the ESTRO 36 conference today (Friday) leaders of the European Society for Radiotherapy and Oncology (ESTRO) will announce plans for a partnership to tackle the global problem of access to radiotherapy, with the ultimate aim of saving one million lives by 2035. The Global Impact of Radiation in Oncology (GIRO) partnership aims to unite leaders in radiation oncology in order to create awareness of current problems and help provide solutions. "First of all, we need to understand what are the barriers to an adequate provision of radiotherapy and define how we can best tackle them, as well as outlining actions that the healthcare community can take to improve the current situation, both in their own countries and across the world," says ESTRO President Professor Yolande Lievens of Ghent University, Ghent, Belgium, who is also a member of the project steering committee. ESTRO already has considerable experience in this field at European level through the Health Economics in Radiation Oncology (HERO) project, which addresses the availability, the need for, the cost, and the cost-effectiveness of radiation therapy across Europe. GIRO takes the idea to a higher level, not just in its global reach, but also by concentrating on creating awareness of the problem of lack of access in countries where there may be not only little understanding of the scale of the problem, but also a lack of knowledge of the benefits of radiotherapy. "It will be very important to increase understanding of the advantages of radiation therapy among patients as well as healthcare professionals in certain countries," says Edward Naessens, patient representative on the ESTRO Radiation Oncology Safety and Quality Committee, and soon to be chair of the society's Patient Advisory Group. "Imagine that you come from a country with no radiotherapy facilities; how much are you likely to know about its potential contribution to your cancer treatment? We need to ensure that everyone concerned is properly informed on what is possibly the best-kept secret in cancer cure and management, as well as providing them with the tools that can help bring about change for the better." The GIRO project will now apply data in pilot cases, and then be able to provide tools to enable decision-makers to address the problems of gaps in access to radiotherapy in a practical way. These data have been gathered at European level by HERO, and at global level by the Global Task Force on Radiotherapy for Cancer Control, convened by the board of the Union for International Cancer Control (UICC), and chaired by Professor Mary Gospodarowicz, University of Toronto, Toronto, Canada. "Radiotherapy is an essential part of any successful cancer control programme," says Prof Lievens. "ESTRO and our partners in GIRO consider it our duty to use the knowledge we have gained over many years to help others who have been less fortunate. We are determined to make this project work for the benefit of all." ESTRO 36 is attended by about 5000 participants from 80 countries. It features new research results in clinical radiation oncology, radiobiology, physics, technology, and brachytherapy, presented by top doctors and scientists from all over the world.


News Article | May 5, 2017
Site: www.biosciencetechnology.com

Although radiation therapy is an essential part of modern cancer treatment, and is indicated for about half of all new cancer patients, facilities for its provision are sadly lacking in many countries worldwide. Indeed, 29 out of 52 African nations have no radiotherapy facilities whatsoever. At the ESTRO 36 conference on Friday leaders of the European Society for Radiotherapy and Oncology (ESTRO) will announce plans for a partnership to tackle the global problem of access to radiotherapy, with the ultimate aim of saving one million lives by 2035. The Global Impact of Radiation in Oncology (GIRO) partnership aims to unite leaders in radiation oncology in order to create awareness of current problems and help provide solutions. "First of all, we need to understand what are the barriers to an adequate provision of radiotherapy and define how we can best tackle them, as well as outlining actions that the healthcare community can take to improve the current situation, both in their own countries and across the world," says ESTRO President Professor Yolande Lievens of Ghent University, Ghent, Belgium, who is also a member of the project steering committee. ESTRO already has considerable experience in this field at European level through the Health Economics in Radiation Oncology (HERO) project, which addresses the availability, the need for, the cost, and the cost-effectiveness of radiation therapy across Europe. GIRO takes the idea to a higher level, not just in its global reach, but also by concentrating on creating awareness of the problem of lack of access in countries where there may be not only little understanding of the scale of the problem, but also a lack of knowledge of the benefits of radiotherapy. "It will be very important to increase understanding of the advantages of radiation therapy among patients as well as healthcare professionals in certain countries," says Edward Naessens, patient representative on the ESTRO Radiation Oncology Safety and Quality Committee, and soon to be chair of the society's Patient Advisory Group. "Imagine that you come from a country with no radiotherapy facilities; how much are you likely to know about its potential contribution to your cancer treatment? We need to ensure that everyone concerned is properly informed on what is possibly the best-kept secret in cancer cure and management, as well as providing them with the tools that can help bring about change for the better." The GIRO project will now apply data in pilot cases, and then be able to provide tools to enable decision-makers to address the problems of gaps in access to radiotherapy in a practical way. These data have been gathered at European level by HERO, and at global level by the Global Task Force on Radiotherapy for Cancer Control, convened by the board of the Union for International Cancer Control (UICC), and chaired by Professor Mary Gospodarowicz, University of Toronto, Toronto, Canada. "Radiotherapy is an essential part of any successful cancer control programme," says Prof Lievens. "ESTRO and our partners in GIRO consider it our duty to use the knowledge we have gained over many years to help others who have been less fortunate. We are determined to make this project work for the benefit of all."


News Article | May 15, 2017
Site: www.businesswire.com

PRINCETON, N.J.--(BUSINESS WIRE)--Certara®, the leading provider of decision support technology and consulting services for optimizing drug development and improving health outcomes, today announced that it has appointed Sandy Allerheiligen, PhD, to the newly-created role of Senior Vice President of Health Economics and Education. “Budget restrictions are a reality for governments, payers and patients alike and drug value is going to play a growing role in drug development and patient access decisions,” said Certara Chief Executive Officer Edmundo Muniz, MD, PhD. “Sandy is an expert at applying quantitative methods and systems pharmacology to experimental and real-world data to create drug-disease models that enable sponsors to make smart decisions. Her teams’ models are already used to inform drug discovery, preclinical, clinical and patient access decisions. At Certara, we are going to broaden the scope of that work and include payers in the discussion. We are excited to have Sandy as a senior leader on our team,” said Dr. Muniz. “In the past, sponsors had to clear three hurdles to get a drug approved; they had to prove product safety, efficacy, and quality. Now, they need to overcome a fourth hurdle and demonstrate the product’s value to patients to ensure patient access and reimbursement,” said Dr. Allerheiligen. “Sponsors will have to negotiate with every health authority and payer and prove the value for patients. Model-informed drug development (MIDD) will provide sponsors with the quantitative data they need to make a successful case. I am delighted to join Certara because its vision will enable MIDD to reach its full potential.” Previously, Dr. Allerheiligen served as Vice President of Data Sciences and Predictive and Economic Modeling, Center for Observational and Real-world Evidence at Merck, a role to which she was appointed in 2015. She joined Merck in 2010 as Vice President of Modeling and Simulation, and was promoted to Vice President of Quantitative Pharmacology & Pharmacometrics within PPDM in 2013. Prior to that, Dr. Allerheiligen was Global Senior Director of Pharmacokinetics, Pharmacodynamics, and Trial Simulation; Senior Director of Drug Disposition, and Distinguished Fellow and Chief Scientific Officer of Quantitative Pharmacology at Eli Lilly & Company. Dr. Allerheiligen received her PhD in Pharmaceutics from the University of Texas, Austin. She completed her postdoctoral fellowship in Gastroenterology and served as Clinical Assistant Professor of Clinical Pharmacology at The University of Texas Health Science Center at San Antonio. As an active member of the industry, Dr. Allerheiligen is a Fellow of the American Association of Pharmaceutical Sciences and has served on several National Institutes of Health Working Groups focused on modeling and simulation. She is a member of the American Association of Pharmaceutical Scientists, American Association of Clinical Pharmacology and Therapeutics, and the International Society of Pharmacometrics, which honored her with its 2016 Leadership Award. Certara is a leading decision support technology and consulting organization committed to optimizing drug development and improving health outcomes. Certara’s solutions, which span drug discovery through patient care, use the most scientifically-advanced modeling and simulation technologies and regulatory strategies to increase the probability of regulatory and commercial success. Its clients include hundreds of global biopharmaceutical companies, leading academic institutions, and key regulatory agencies. For more information, visit www.certara.com.


Dr. Patti Peeples, Founder and CEO of HealthEconomics.Com and Principal Researcher at HE Institute delivered the Keynote Address on "Snatched from the Headlines! Establishing and Defending Pharmaceutical Price and Value: What Medical Publication Professionals Should Know" at the International Society of Medical Publication Professionals 13th Annual Meeting on March 3, 2017 in National Harbor, Maryland. Other keynote speakers include Deborah A. Zarin, MD, Director, ClinicalTrials.Gov and Senior Scientist, National Institutes of Health; Kay Dickersin, PhD, Professor and Director, Center for Clinical Trials, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins and Director, US Cochrane Center (USCC); and, Thomas Sullivan, President, Rockpointe Corporation, Editor, Policy and Medicine, Founder, Association of Clinical Researchers and Educators. In her keynote address, Dr. Peeples shared lessons learned from her decades of experience on the front lines of demonstrating drug value to major payer stakeholders using health economics and outcomes research (HEOR) evidence, as well as research on rational decision-making and group decisions (called GroupThink) that can be affected by politics and other societal influences. Using examples in the lay press focusing on public and governmental reaction to prices of pharmaceutical products, Dr. Peeples provided insights into how medical publication professionals and ISMPP can educate and support the communications experts who are responsible for writing the evidence-based results of clinical and real-world research that demonstrates drug value to providers, patients, and policy-makers. Given the increasing costs of pharmaceuticals and changes in healthcare delivery and policy, including the American Health Care Act (AHCA) of 2017, Peeples' Keynote Address offered critical recommendations on how to provide market access based on optimized outcomes and costs that consider cost-effectiveness, affordability, market access, and value to all parties involved. Peeples also moderated a subsequent Panel with industry leaders entitled "Communicating Value to Payers, Physicians and Patients: HEOR Panel Discussion". Dr. Patti Peeples is an internationally-known speaker, researcher, health economist, pharmacist, and entrepreneur, and has published extensively in cost-effectiveness of healthcare interventions. She leads the company, HealthEconomics.Com, a global digital portal that serves as the CONNECTED COMMUNITY(tm) for more than 20,000 professionals involved in healthcare pricing and reimbursement. She serves on multiple Boards of Directors for non-profit groups and is on the Editorial Advisory Board of two major journals in healthcare value. She holds a PhD in Health Economics, an MS in Pharmaceutical Hospital Administration, and is a registered pharmacist. She frequently serves as a Keynote Speaker, Conference Chair, and Moderator. This year’s ISMPP Conference featured dozens of A-list speakers across a wide range of healthcare, pharmaceutical, and medical verticals and industries from Europe, Asia, and North America. The event featured an array of Panel Discussions, Keynotes and Break-Out Sessions.


SAN DIEGO--(BUSINESS WIRE)--XIFIN Inc., the healthcare information technology company revolutionizing the business of healthcare diagnostics, will co-present a session with the University of Chicago on collaborative diagnostic workflows at the Cambridge Healthtech Institute’s Fifth Annual Digital Pathology conference, a track at the 24th International Molecular Medicine Tri-Conference being held February 20-22 at the Moscone Convention Center in San Francisco. David McClintock, M.D., Medical Director, Pathology Informatics, University of Chicago, and Chrystal Adams, associate vice president, XIFIN, Inc., will present “Improving Patient Care Through a Diagnostic Collaboration Workflow.” The session, scheduled for Monday, Feb. 20th at 4:10 PM PST, will highlight the need for collaborative and coordinated patient care and discuss how to leverage technology to facilitate an aggregated workflow and communication among diagnostic specialists to inform clinical decision making and support value-based care. Kyle Fetter, MBA, vice president & general manager of diagnostic services operations, XIFIN, Inc. will also present a session on Thursday, February 23 at 10:00 AM titled, “Novel Diagnostic Technologies: Coverage Today and Coverage in the Future.” The session will highlight how early stage and wearable diagnostic device companies can overcome hurtles to commercialization and reimbursement and position themselves for success. The Fifth Annual Digital Pathology conference will offer a range of topics that demonstrate the current activities and effectiveness of digital alternatives for pathology practices, and share insights from distinguished faculty. Technology developments and implementation strategies will be presented in a forum that encourages collaboration and knowledge sharing. With its Health Economics Optimization platform as a foundation, XIFIN ProNet MDT facilitates the cloud-based exchange of diagnostic images, clinical data and other patient encounter information to support real-time multi-disciplinary collaboration through a shared clinical workflow. This live shared environment helps clinicians collaborate on complex cases, expedite treatment decisions and increase efficiency. XIFIN ProNet also provides an Internet exchange and turnkey online tool that provides pathologists key capabilities and a powerful consultation platform. Digital slide scanner- and viewer-independent, pathologists can upload whole slide, DICOM, and other medical images to the cloud where they are available on-demand from a single access point, saving both time and money. Representatives from XIFIN will be available at booth #500 throughout the conference to meet with attendees and discuss how the company is helping healthcare organizations leverage diagnostic information for connected health. XIFIN is a healthcare information technology company that leverages diagnostic information to improve the quality and economics of healthcare. The company’s health economics optimization platform is a connected health solution that facilitates connectivity and workflow automation for accessing and sharing clinical and financial diagnostic data, linking healthcare stakeholders in the delivery and reimbursement of care. To learn more, visit www.XIFIN.com or follow XIFIN on Twitter and LinkedIn.


NORWICH, 12-May-2017 — /EuropaWire/ — The University of East Anglia (UEA) is holding a free public meeting on Thursday 11 May to discuss the question “Is the Boat Full?”, looking at the relationship between immigration, austerity, inequalities and political attitudes. “The event is a follow-up on the very successful ‘Breaking Away, Not Breaking Apart’ debate we held last September discussing the post-referendum rise in racist threats and violence,” said Ulrike Theuerkauf, UEA Lecturer in Politics and International Development at the School of International Development (DEV). “This time we will explore these important relationships, which are already playing a role in the General Election campaigns, and hope to welcome as many people from beyond the campus as possible to join the discussion.” The evening begins with refreshments from 4.30-5pm in front of Lecture Theatre 1 at UEA. Alan Waters, Chair of Norwich City Council, will then chair the debate, which starts at 5pm in Lecture Theatre 4. Guest speakers are Dr Wanda Wyporska, Executive Director of the Equality Trust, who will discuss patterns of immigration, austerity and inequalities in the UK over the last decades; Dr Chris Skedgel, Senior Lecturer in Applied Health Economics at Norwich Medical School, who will discuss the effects of immigration and austerity on the NHS, and Julie Inns, Equality and Diversity Manager at Norfolk Constabulary, who will discuss how immigration and austerity have affected both inter-group relations and the work of the police in Norfolk. For further details or to register for the event, go to the UEA website. To find the right commentator for your story, email press@uea.ac.uk, telephone +44 (0) 1603 593496


News Article | February 27, 2017
Site: motherboard.vice.com

Seema Verma, President Donald Trump's nominee to head the Centers for Medicare and Medicaid Services, has built a career on finding ways to break down the government's role in health care. So it wasn't all that surprising when, at her nomination hearing, Verma said she doesn't think insurance companies should be required to provide maternity care coverage. "Some women might want maternity coverage and some women might not want it, might not choose it, might not feel like they need that," Verma told senator Debbie Stabenow (D-Michigan). "So I think it's up to women to make the decision that works best for them and their families." The comment offered a glimpse of how the Trump administration may impact women's health care in the US. Trump and Republican members of Congress have pledged to repeal the Affordable Care Act which, among many other provisions, made maternal health and reproductive health coverage mandatory. But they haven't been very clear on what they plan to introduce to replace the ACA. Comments from Verma, along with executive moves from the White House, and a spattering of bills that have been introduced, give us an idea of what to expect when it comes to women's healthcare. "This gives us an idea of what that plan might look like," said Nadereh Pourat, the director of the Health Economics and Evaluation Research Program at the UCLA Center for Health Policy Research. "You cannot replace [the ACA] with something cheaper that gives you the same benefits or more. That's not possible." Pourat said it's been clear from the beginning that repealing and replacing the ACA would mean some cuts to health care, but there's a lot of uncertainty of what that looks like. Part of the problem is that many Republicans think the ACA is too costly, both for the government and individuals, and want to reel it in. But Pourat told me many of these cuts actually end up costing taxpayers more in the long run, including removing mandatory maternity coverage which can cost families up to $50,000 for one birth. Having maternity coverage mandatory does mean a slight increase in insurance costs across the board, but making it optional means those who need it most might not be able to afford this "extra" coverage. If they then get pregnant, even middle class Americans may not be able to afford paying out of pocket for maternity care, which puts the pregnancy at risk, Pourat said. In most other developed countries, including Canada, the UK, and France, maternal health is covered and guaranteed. "Maternity benefits are not something anyone should think about making optional. It's shortsighted and it could have huge negative implications," Pourat told me. "All you need is to have a few children born with disabilities and you're talking about long-term suffering and costs, very big costs, for the taxpayer. It's a fallacy in this argument that we're going to save money by not providing it." Meanwhile, it's not just expecting mothers who could be impacted. The GOP has continued to threaten to cut federal funding for Planned Parenthood, which provides reproductive health care like birth control to millions of women and men. And while President Trump and his cabinet can't single-handedly change a lot of these laws, they're signalling their mandate to a GOP congress that's already starting to follow suit. Bills have been introduced to allow states to withdraw funding from Planned Parenthood and repeal the ACA. Some of this is par for the course when it comes to the Republican party. GOP congresses typically mean a shifting of more power back to the state level, and state governments can potentially protect some women's healthcare by introducing their own laws—like the three states that now allow pharmacists to prescribe birth control—to counteract the action in the capitol. In the meantime, there's a lot of uncertainty, and the few hints we're getting of what's to come could mean far higher health care price tags for women. Get six of our favorite Motherboard stories every day by signing up for our newsletter .


CHICAGO - "Opting-out" of the Medicare rule that requires anesthesia to be administered with physician supervision has little or no impact on access to either inpatient or outpatient surgery, according to a study published in Health Economics Review. Researchers also found the opt-out policy does not reduce costs, and in some cases may be associated with higher costs related to inpatient surgical care. The study did not address why opting-out might increase costs. The researchers said several factors may contribute to this unexpected finding, including that nurse anesthetists may take longer to perform the same services, and working without physician supervision may lead to worse surgery outcomes, which requires additional treatment. "The findings of this study underscore the point that before we make a policy or pass a new rule, we first need to rigorously study what the potential effects might be," said study lead author John Schneider, Ph.D., CEO of Avalon Health Economics. "A lot of states thought that by opting-out of the federal requirement, they would be increasing access to care. It turns out that simply opting-out is not a guarantee of increased access." Since 2001, 17 state governors have exercised the option to opt-out of a federal rule that physicians supervise the administration of anesthesia by nurse anesthetists, most citing increased patient access to anesthesia care as the rationale for the decision. The "opt out" provision was created due to a concern about a potential shortage of physician anesthesiologists, at least in some regions and states. The presumption was that allowing nurse anesthetists to practice without physician supervision would alleviate potential shortages, and enhance access to anesthesia care. Additionally, a lower professional service cost for nurse anesthetists practicing without physician supervision was presumed to lower anesthesia care costs. This is the fourth study in just over a year that looked into whether the adoption of the opt-out rule impacted access to anesthesia care. All four studies found that opt-out does not increase access to anesthesia care. One study found that across urgent diagnoses, opt-out was not associated with increased access to anesthesia services. Another study found opt-out was associated with little or no increased access to anesthesia care for common procedures. "The new study extends the literature on the impact of state opt-out policy by adding an assessment of its impact on costs of surgeries, and by assessing its impact on a wider variety of procedures requiring anesthesia services than in prior studies," the researchers wrote. To analyze the effect of the opt-out rule on inpatient surgery, researchers used the largest publicly available all-payer (including all types of public and private insurance) health care database in the United States, which included many opt-out and non-opt-out states. For outpatient surgery, they used a database of outpatient surgery and services provided by hospital-owned and nonhospital-owned surgery facilities. The outpatient analysis included three opt-out states (California, Colorado and Kentucky) and three non-opt-out states (Florida, Maryland and New Jersey). The analysis used data from multiple years of U.S. inpatient hospital discharges and outpatient surgeries. The outpatient database did not provide cost estimates for outpatient procedures, so the researchers were unable to evaluate the opt-out rule's effect on outpatient surgery costs. "Unlike previous opt-out studies, the design of this study allowed us to better isolate the effect of the opt-out policy across states and over time," said Dr. Schneider. "The primary intent of the opt-out rule was to improve access to anesthesia services by reducing barriers to utilize nurse anesthetists and increasing their scope of practice. In turn, the hypothesis is that the reduction in barriers will increase access to surgical care. In our study, we did not find evidence to support this belief," the researchers concluded. The study, "Assessing the Impact of State 'Opt-Out' Policy on Access to and Costs of Surgeries and Other Procedures Requiring Anesthesia Services," was funded by the American Society of Anesthesiologists. Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves. For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount.

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