Private plans show success in controlling Medicare costs

Private Medicare coverage such as Medicare Advantage and prescription-drug coverage are keeping costs in check while satisfying beneficiaries, officials say, winning praise from both political parties. Premiums have recently declined or remained steady, and insurance companies have introduced innovations meant to make care more affordable. The New York Times (tiered subscription model)

Study suggests delirium episodes could lead to dementia

Episodes of delirium may put older patients at higher risk for dementia and cognitive decline, according to a University of Cambridge study published in the journal Brain. Researcher Daniel Davis said delirium “may be actually causing brain damage” that can lead to dementia, but often is not diagnosed in a hospital setting. MedPage Today (free registration) (8/12)

Use of Retail Medical Clinics Continues to Grow

Fast-growing retail medical clinics are attracting older patients and are delivering more preventive care, particularly flu shots and other vaccinations, according to a study by the RAND Corporation. Visits to retail medical clinics increased from 8% to 19% of all visits from 2007 to 2009.

More than 44% of visits to the clinics occurred on the weekend or other times when doctor’s offices are usually closed, according to the study published online by the journal Health Affairs. Retail clinics are promoting new services, such as caring for diabetes and other chronic illnesses. Dr. Ateev Mehrotra of RAND said, “If demand for primary medical care drives longer wait times to see a doctor, as it has following health care reform in Massachusetts, then this could drive greater demand for convenient alternatives such as retail clinics.”

The clinics, which are usually staffed by nurse practitioners, offer basic health care at clearly posted prices. Doctor groups have said that retail clinics could disrupt patients’ relationships with their primary care doctors and interrupt continuity of care. The criticism has increased since some clinic operators began offering care for chronic illnesses, such as asthma and high blood pressure.

But retail clinics account for only a small slice of outpatient medical care compared to the estimated 117 million emergency room visits and 577 million visits to doctors’ offices each year. Visits to retail medical clinics for vaccinations increased sharply from 2007 to 2009. Another recent study published by RAND researchers found that vaccination visits to the three major retail clinic chains quadrupled to more than 1.9 million in 2009. Most of the inoculations given were for influenza.

“The number of vaccinations provided at retail clinics could grow even larger if providers started counseling patients about the need for inoculations when they visit the clinics for other care,” said Lori Uscher-Pines, an associate policy researcher at RAND.

In the latest study, researchers found that the proportion of retail clinics visits that patients made for acute medical problems dropped from 78% to 51%. There was a corresponding increase in visits for preventive care, making up more than 47% of visits by 2009. Researchers say that patients who have no primary care doctor or have a weak relationship with their doctor are more likely to seek care at a retail clinic.

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Last Updated 08/10/2022

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