The Patient Protection and Affordable Care Act was signed into law in March 2010. The latest tracking poll conducted by the Henry J. Kaiser Family Foundation found that despite ongoing efforts by the federal government to educate the American public about the law, more than half of those responding to the poll (52%) still say they do not have enough information about the law to fully understand how it will affect them; 47% say they do understand the impact of healthcare reform on their lives.

Among women with invasive breast cancer and sentinel node metastasis, the use of sentinel lymph node dissection (SLND) alone was shown to be noninferior in terms of survival compared with the standard treatment, axillary lymph node dissection (ALND), according to results of a recent study [JAMA. 2011;305(6):569-575].

Mortality rates from colorectal cancer can be reduced with utilization of fecal occult blood testing (FOBT). The low-risk test is only effective when patients who have an abnormal result are followed up with a complete evaluation with a colonoscopy or barium enema plus sigmoidoscopy, which has clinically significant risks.

A new cost-utility analysis investigating the use of aspirin and proton pump inhibitors (PPIs) in coronary heart disease (CHD) prevention found that treatment with aspirin was less costly and more effective than no treatment at all for middle-aged men across a wide range of CHD and gastrointestinal (GI) tract bleeding risk factors; however, adding a PPI was cost-prohibitive for those with an average GI bleeding risk. The results of the study were recently published in the Archives of Internal Medicine [2011;171(3):218-225].

The most frequently diagnosed cancer in the United States is skin cancer. The most common forms of the disease are basal cell carcinoma and squamous cell carcinoma; together the 2 forms account for >1 million new cases each year. The most fatal form of skin cancer is malignant melanoma; there were an estimated 68,720 Americans diagnosed with malignant melanoma in 2009, with approximately 8650 associated deaths. Skin cancer is a significant public health problem in this country.

It has been well documented that racial disparities exist in healthcare, but little is known about disparities in rates of hospital readmissions between black patients and white patients. Reducing readmissions has gained attention as a policy focus because of the potential to reduce costs while improving quality of care.

Guidelines from the American Heart Association/American Stroke Association endorse carotid artery stenting (CAS) as a reasonable alternative to carotid endarterectomy (CEA) for the treatment of carotid artery occlusive disease. The guidelines endorse CAS when it is performed by operators with established periprocedural morbidity and mortality of 4% to 6% (class IIa).

A Canadian study of patients hospitalized with coronary artery disease has reported that a combination of automatic referral for cardiac rehabilitation upon hospital discharge and liaison referral through healthcare providers improved referral rates for cardiac rehabilitation. The study was described in Archives of Internal Medicine [2011;171(3):235-241].

Cardiac rehabilitation has been proven to be effective in coronary artery disease patients but is still underutilized due to low rates of referral, according to the study authors.

A new analysis of creatine kinase (CK-MB) and troponin levels in patients who received coronary artery bypass graft (CABG) surgery found that elevated levels of the myocardial enzymes within 24 hours after surgery were associated with an increased intermediate and long-term mortality risk for patients. The results of the analysis, which compiled data from 7 different studies, were recently reported in the Journal of the American Medical Association [2011;305(6):585-591].

End-of-life care using the hospice model seeks to control pain, promote patient and family-centered care and autonomy, and address spiritual needs as death nears. Since hospice care was added as a Medicare entitlement in 1983, the proportion of Americans using hospice has seen a steady increase.

Arlington, Virginia—For the past few years, information technology (IT) initiatives have become a hot topic in the healthcare industry, with advocates pointing out the benefits of using technology to improve care and run more efficient practices. Although progress has been slow, the federal government and states are providing incentives for providers to adopt electronic health records (EHRs) and other IT-related products.

Arlington, Virginia—Medicaid health plans and providers could benefit with the formation and potential proliferation of accountable care organizations (ACOs) in the next few years, according to Bob Wychulis, chief executive officer of Amerigroup Community Care of New York.

Arlington, Virginia—In New Jersey, 75% of the state’s Medicaid beneficiaries are enrolled in 1 of 4 managed care plans. Since the enactment of the Affordable Care Act (ACA) in March 2010, the state and plans have worked together to understand the law’s implications and adapt to the new regulations.

Karen Brodsky, director in the Office of Managed Health Care in New Jersey’s Department of Human Services, addressed these issues during a keynote session at the Medicaid Managed Care Summit titled On the Ground: Implementing the Affordable Care Act.

Arlington, Virginia—Providing long-term care (LTC) services to the aging population will become increasingly challenging as 76 million baby boomers approach retirement age. The Urban Institute estimates that 21 million of these individuals will require LTC services for daily-living activities by 2040, which is more than double the number of individuals requiring LTC services in 2000. This poses considerable challenges for many states, where Medicaid has already become the largest expense, making up, on average, ≥20% of states’ budgets.

National Harbor, Maryland—When treating patients who suffer from chronic pain, clinicians must consider biologic, psychological, and social factors that contribute to the condition. In addition, according to presenters at the AAPM meeting, successful pain management should take into consideration the fact that pain perception involves sensory, affective, and cognitive elements.

These topics were discussed during a satellite symposium titled Comprehensive Chronic Pain Management: Improving Physical and Psychological Function.

National Harbor, Maryland—With advances in technology, physicians are constantly gaining access to more data about their patients. However, many providers have not embraced the idea of tracking and using the information.

During a session at the AAPM meeting titled Using Outcomes Data to Improve Patient Care, healthcare professionals emphasized that utilizing the data in an effective manner can help decrease errors, cut costs, and lead to medical advances.

National Harbor, Maryland—According to a retrospective descriptive analysis of a database of commercially insured US residents, the cost and consumption of duloxetine was lower for patients taking the drug for pain compared with patients taking the medication for major depressive disorder (MDD). The results were presented at the AAPM meeting during a poster session titled Daily Average Consumption and Pharmacy Costs of Duloxetine in Mood and Pain among US Commercially Insured Patients.