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  • Kaiser Permanente: Hospitals Called to Improve Treatment for Heart Attacks
    Denver, Colorado
    November 13, 2006

    Hospitals Called to Improve Treatment After Heart Attack

    Kaiser Permanente Emergency Room Physician Among Researchers Pushing for Set of Strategies That Saves Lives


    Prompt treatment saves lives when patients arrive at hospitals having heart attacks. A new study has identified simple steps that hospitals can take to speed life-saving treatment. The research, which was led by Elizabeth Bradley and a team of researchers that included David Magid, MD, MPH, emergency medicine physician and researcher, was announced today by the New England Journal of Medicine at the American Heart Association’s annual conference.


    It outlines simple hospital strategies that work when patients arrive at the emergency department needing percutaneous coronary intervention or balloon therapy. The team is challenging hospitals to improve what has been dubbed “door-to-balloon” times.


    Those strategies include:


    Having emergency medicine physicians activate the catheterization lab (cath lab), the hospital room where the balloon treatment is performed.

    Activating the cath lab with one-call central page operators who can mobilize the entire medical team at once.

    Activating based on pre-hospital electrocardiograms while the patient is still en route to the hospital as opposed to waiting until the patient arrives.

    Having interventional cardiologists on location within 20 – 30 minutes.

    Using real-time data feedback with emergency department and cath lab staff.


    The study of 365 hospitals found that only a handful of hospitals use some of the strategies and none uses all. Researchers say implementing this simple set of effective and feasible strategies holds promise for substantially improving patient care.


    Balloon therapy has become the preferred approach to treating certain kinds of heart attacks. While, hospitals have been seeking ways to improve their door-to balloon times, overall performance at most hospitals lags behind the national standard of 90 minutes or less. Dr. Magid practices at Exempla Saint Joseph Hospital and as part of this study partnered with the hospital to adopt the life-saving strategies.


    Saint Joseph Hospital is one of the first hospitals in the country to make these important improvements. “The great point about these strategies is that most involve little or no cost to implement,” said Magid.


    “The study offers a terrific guide for hospitals to follow as they push to improve door-to-balloon times and the quality of care for patients.”


    This study is part of the Health Care Quality Improvement Project initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement projects to improve patient safety.


    It also is one of more than 100 research projects conducted every year by the Kaiser Permanente Colorado researchers.


    Kaiser Permanente is the largest private health care provider in Colorado. More than 475,000 members in the Denver/Boulder and Colorado Springs areas have access to Kaiser Permanente through an expanded suite of health care products.


    Kaiser Permanente physicians and care teams focus on prevention as well as curing disease, all in an effort to help patients live well and thrive.
  • Medicare Private Drug Plans Fail to Offer Accurate Information to Consumers, New Report
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    Sacramento, California
    October 16, 2006


    Report Finds Medicare Private Drug Plans Fail to Offer Accurate Information to Consumers - Consumer Groups call for dramatic reform before 2007 Part D enrollment opens on November 15


    With the next enrollment period for the Medicare Part D prescription drug benefit looming, California Health Advocates and the Medicare Rights Center are demanding that the Centers for Medicare & Medicaid Services (CMS) require Medicare private drug plans to provide timely and accurate information to people with Medicare who turn to the plans’ call centers for assistance. According to a new report issued today by the two consumer organizations, call center representatives for companies offering Part D coverage remain unable to answer basic consumer questions regarding how the benefit works.


    The report found that the call centers frequently could not provide the information people with Medicare needed to make appropriate enrollment decisions. In “Getting the Runaround: Problems with Obtaining Accurate Information from Part D Plans,” the two advocacy groups state that plan call centers are expected to serve as a crucial link to information about Part D coverage, but “independent surveys and anecdotal reports from counselors show serious lapses in the ability of Part D plans to provide accurate and timely information and to successfully guide people with Medicare seeking to access the benefit.”


    “Good advice is the only antidote to the convoluted prescription drug benefit that older and disabled Americans are forced to navigate,” said Robert M. Hayes, President of the Medicare Rights Center. “Too often a call to one of the private drug plans does more to mislead, than to help.”
    According to the report, CMS has failed to set adequate standards for the accuracy of information given by call centers.


    In preparation for the next enrollment period, the report recommends that CMS provide detailed requirements for the information customer service representatives (CSRs) must be able to provide, and take action to ensure those requirements are being met. “The level of frustration expressed by people contacting our office is acute,” remarked Clare Smith, President/CEO of California Health Advocates, “The plans must be required to put resources into the provision of responsive and reliable service to those seeking access to prescription drug benefits.”


    The report recommends that CMS ensure that the training and scripts provided to call center operators enables them to provide information about the following:

    Enrollment process

    How the specific plan works, including explanations of the coverage gap and important information for people eligible for the low-income subsidy

    Plan formulary, including which drugs are covered and specifics on any coverage restrictions and limitations


    The report also recommends strengthening Medicare private drug plans’ capacity to communicate with non- and limited-English speakers and designating staff as experts in specific subject matter, such as enrollment, premium/cost-sharing, and coverage appeals.