Weekly Exenatide Misses Endpoint in Key Trial

By John Gever, Senior Editor, MedPage Today

An investigational once-weekly formulation of the injectable diabetes drug exenatide (Bydureon) failed to show noninferiority to daily liraglutide (Victoza), the trial's sponsors said.

In the open-label trial called DURATION-6, patients taking 2 mg of exenatide weekly showed a 1.3-point reduction in glycated hemoglobin (HbA1c) levels after 26 weeks, compared with a 1.5-point decrease in patients receiving liraglutide at 1.8 mg daily, according to a joint statement from Eli Lilly, Alkermes, and Amylin Pharmaceuticals, which are co-developing the once-weekly drug.

"Bydureon did not meet the prespecified primary endpoint of noninferiority to Victoza," the statement said.
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Congress Delves into Medicare Fraud

Success Factors in Five High-Quality, Low-Cost Health Plans - The Commonwealth Fund

Authors: Robert A. Berenson, M.D., and Teresa A. Coughlin, M.P.H.
Contact: Robert A. Berenson, M.D., The Urban Institute, rberenson@urban.org
Editor: Deborah Lorber

Downloads

• Full Report (922K PDF)

Overview

In this report, the authors conducted case studies of five health plans that received high scores on quality and resource utilization, using data collected by the National Committee for Quality Assurance. The focus of this study was to understand how health plans with delivery systems that include a significant network of independent, community physicians achieve high performance. Plan leaders identified several factors they believe contribute to being a high-performing plan: building a physician–plan partnership, establishing the plan as a resource for physician practices, providing physician quality and cost data on performance, and emphasizing a local area orientation. Because employers are primarily responsible for arranging the health insurance coverage for their employees, there is market pressure for health plans to work with broader networks than they would otherwise want, which in turn interferes with the factors that lead to high performance.

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AoA March eNewsletter

The latest edition of the AoA eNewsletter is posted online. Below is the Table of Contents.  You can read the March eNews in its entirety by clicking on:  http://www.aoa.gov/AoARoot/Press_Room/Enews/index.aspx.

While you are there, please check out AoA’s new website (www.aoa.gov) – tell us what you think! After reviewing our website please scroll down to the Feedback Section at the bottom of the home page to leave your comments.

Table of Contents

AoA News

    Older Americans Month 2011 Materials Now Available
               
    Profile of Older Americans: 2010 Now Available
               
    AoA’s March Widget Highlights AoA’s Nutrition Program
               
    SMP Recent Events and Upcoming Activities
               
Other HHS News
   
    Webinar on Healthy Eating Advice:  The New Dietary Guidelines for
    Americans, 2010
               
    HHS and DOJ to Convene Fraud Prevention Summit in Detroit
               
    New Report Details Affordable Care Act Resources and Flexibility for
    States
               
    New NIH Cookbook Encourages Families to Eat Healthfully
               
    Medicare Part D Benefit Update
               
Funding Opportunity
   
    AoA and NIA Joint Initiative to Improve the Health and Well-Being of Older
    Americans by Translating Research into Practice
               
More News
   
    FinCEN Advisory Warns of Elder Financial Exploitation
   
    USCIS Expands Outreach to the Aging Network for Help in Dissemination of
    Information
               
    KCMU Release New Resources on Medicaid Long-Term Services and Supports
   
    Free Webinar to Help Nursing Homes Prepare to be Clinical Placement Sites
    for Nursing Students
               
    National Observances

Submit a Story!

Conferences   

Medicaid Prevention Grants

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The Centers for Medicare and Medicaid Services (CMS) is pleased to announce the invitation to States to apply for participation in the Medicaid Incentives for Prevention of Chronic Diseases Program authorized by section 4108 of the Affordable Care Act.  This nationwide program will test and evaluate the effectiveness of a program to provide financial and non-financial incentives to Medicaid beneficiaries of all ages who participate in prevention programs to address at least one of the following prevention goals: tobacco cessation, controlling or reducing weight, lowering cholesterol, lowering blood pressure, and avoiding the onset of diabetes or improving the management of the condition; and demonstrating changes in health risk and outcomes, including the adoption of healthy behaviors.

This new funding opportunity does not require States to match the incentive payment with State funds.  Beneficiary incentives available through section 4108 may be used by States to complement other chronic condition health initiatives, such as the currently available Health Home Medicaid State plan option provided by section 2703 of the Affordable Care Act.  Approved administrative and program expenditures for successful applicants will be reimbursed through grant funds from the $100 million dollars appropriated under section 4108 of the Affordable Care Act for this program and evaluation.  The Office of the Governor or the State Medicaid Agency may apply for funding under this grant opportunity, however CMS will accept only one application per State and encourages State offices and agencies to work collaboratively to develop one application packet.

All applications must be submitted electronically through http://www.grants.gov

The solicitation and further application requirements may be obtained at http://www.cms.gov/MIPCD/
 
An applicant’s teleconference is scheduled for March 8, 2011 from 2:30 to 4:30 PM eastern time and may be accessed by calling the operated assisted toll-free dial-in number: (800)837-1935, and the Conference ID is: 2314.

The closing date for this Funding Opportunity Announcement is May 2, 2011.   

CMS Proposed Community First Choice Rule

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On February 25th, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule in the Federal Register to implement a new Community First Choice Option.  Under Section 2401 of the Affordable Care Act, this proposed rule establishes a new State option to provide home and community-based attendant services and supports through a new section of 1915 (k) to the Social Security Act.  The goal of this new option is to give States additional resources to make community living a first choice.

Starting in October, this option will allow States to receive a six percent increase in federal matching funds for providing community-based attendant services and supports to people with Medicaid.  Over the next three years—through 2014—States could see a total of $3.7 billion in new funds to provide these services.  Under this new option, States will provide consumer controlled, person-centered home and community-based attendant supports to individuals on a statewide basis.  The person-directed plans and services will be developed in a manner that is most integrated and appropriate to the individual’s needs, without regard to age, type or nature of disability, severity of disability, or form of home and community-based attendant services and supports the individual requires in order to lead an independent life. 

To find out more about the Community First Choice option and to review the proposed rule implementing this section, please visit: http://www.gpo.gov/fdsys/pkg/FR-2011-02-25/pdf/2011-3946.pdf

Comments for this proposed rule are due to CMS by April 26, 2011. 

Medicare Considers Paying for STD Screening

By Emily P. Walker, Washington Correspondent, MedPage Today

The Centers for Medicare and Medicaid Services (CMS) is considering whether to pay for sexually transmitted disease testing for elderly and disabled Medicare beneficiaries.

Medicare already pays for HIV tests, but a National Coverage Analysis (NCA) posted by CMS on Thursday announced that the agency is considering whether to include coverage for testing for chlamydia, gonorrhea, hepatitis B, and syphilis, and to pay for counseling to prevent sexually transmitted diseases (STDs).

Most of the tests would be aimed at detecting infections in high-risk groups, such as pregnant disabled women.

Medicare covers about 39 million people over the age of 65, and nearly eight million people with disabilities who are younger than 65.

The announcement comes as sexually transmitted disease rates among the elderly are increasing. Nearly one-quarter of people living with HIV in the U.S. are older than 50, and rates of chlamydia among men ages 45 to 64 tripled from 1996 to 2006, and doubled among women in the same age group, according to statistics from the CDC.

Researchers explain the increase in a number of ways, including that the elderly are more susceptible to disease, far less likely to use condoms than younger people, and excluded from virtually every STD-prevention educational program.

And then there's the Viagra explanation.
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More Evidence That Alzheimer's Disease May Be Inherited From Your Mother

Results from a new study contribute to growing evidence that if one of your parents has Alzheimer's disease, the chances of inheriting it from your mother are higher than from your father. The study is published in the March 1, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology.

"It is estimated that people who have first-degree relatives with Alzheimer's disease are four to 10 times more likely to develop the disease themselves compared to people with no family history," said study author Robyn Honea, DPhil, of the University of Kansas School of Medicine in Kansas City.

For the study, 53 dementia-free people age 60 and over were followed for two years. Eleven participants reported having a mother with Alzheimer's disease, 10 had a father with Alzheimer's disease and 32 had no history of the disease in their family. The groups were given brain scans and cognitive tests throughout the study.

The researchers found that people with a mother who had Alzheimer's disease had twice as much gray matter shrinkage as the groups who had a father or no parent with Alzheimer's disease. In addition, those who had a mother with Alzheimer's disease had about one and a half times more whole brain shrinkage per year compared to those who had a father with the disease. Shrinking of the brain, or brain atrophy, occurs in Alzheimer's disease.

"Using 3-D mapping methods, we were able to look at the different regions of the brain affected in people with maternal or paternal ties to Alzheimer's disease," said Honea. "In people with a maternal family history of the disease, we found differences in the break-down processes in specific areas of the brain that are also affected by Alzheimer's disease, leading to shrinkage. Understanding how the disease may be inherited could lead to better prevention and treatment strategies."

The study was supported by the National Institute on Aging and the National Institute of Neurological Disorders and Stroke.

Story Source: The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Academy of Neurology.
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Debate Over Institutions Flares As Feds Seek Comment - Disability Scoop

By Shaun Heasley

A government agency’s proposal to “eliminate congregate care” for people with disabilities is stirring strong reaction from advocates on both sides of the debate over institutions.

The issue came to the forefront as the Administration on Developmental Disabilities works to finalize a five-year strategic plan.

The federal agency plays an influential role over the state councils on developmental disabilities and the protection and advocacy organizations throughout the country in addition to other programs benefiting Americans with disabilities.

After holding listening sessions in five cities, the agency drew up a list of priorities — touching on everything from access to competitive employment to strengthening family support — which will be used to establish the final plan.

But a recommendation to support closing the nation’s remaining institutional care facilities seems to be evoking the greatest response in the final days of an online public comment period, which ends Friday.
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Generations United Webinar: Intergenerational Programs - Evaluation of Shared Site Programs

Thursday, March 17, 2011 1:00 PM - 2:00 PM EDT

Join Generations United to learn ways to evaluate your intergenerational programs and activities. This session will feature a presentation by a noted expert in the field, followed by questions and conversation on this subject.

Everyone is encouraged to participate in this webinar, both seasoned and novice professionals working in or interested in shared sites and/or intergenerational programming. Generations United wants to hear from you!

You must register to receive the conference call information. To optimize this virtual learning opportunity, please log-on to your computer and call the 1-800 number on your phone. If you are away from your desk, you will still be able to participate by phone only. Register Here

Senator McCain on Social Security- NCPSSM Truth Squad

The Truth Is...

Social Security is not bankrupt.  The Social Security Trust Fund holds a $2.6 trillion surplus, contributed by American workers and invested, sensibly, in one of the world's safest investment vehicles - U.S. Treasury notes. However, fiscal conservatives don't want to honor that debt so they pretend it's worthless or non-existent.  That $2.6 trillion was real money when Americans paid it in payroll taxes and real money when the federal government borrowed it. It's also real money when Washington needs to pay it back.  Social Security is not a Ponzi scheme by any definition; it is a pay-as-you-go program which has been self-funded by American workers not the federal government . CBPP, Understanding the Trust Funds

Govs vs. Feds: Who Will Play The 'Power Card' In The Medicaid Struggle? - Kaiser Health News

  by Grace-Marie Turner, President of the Galen Institute

Medicaid is the rope in the current tug of war between the states and the federal government over health reform. So far, the feds think they are winning. But don't discount the strength and endurance of the states -- and especially the governors.

States are facing severe budget pressures. The 2009 stimulus package provided short-term cash to the states to shore up Medicaid -- the jointly funded federal-state health program for lower-income people. But in exchange, states had to agree to maintain their 2010 Medicaid eligibility levels or risk losing all federal matching funds.

In January, 33 governors and governors-elect wrote to President Barack Obama and congressional leaders requesting "flexibility and relief" from the "excessive constraints placed on us by healthcare-related federal mandates." States say they need to trim their Medicaid rolls now because they already are swimming in red ink and this circumstance will only get worse -- partly because stimulus funding that initially helped many of them pay for the added enrollment ends in June. And, while Health and Human Services Secretary Kathleen Sebelius has responded by sending her agency's Medicaid experts to the states to help them explore options to trim Medicaid spending, she is still urging states to do everything they can to keep Medicaid enrollment at current levels before the health law’s changes take effect in 2014.

These pleas for flexibility are bipartisan.

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Social Security Press Office: Statement of Michael J. Astrue, Commissioner of Social Security, on the President's Fiscal Year 2012 Budget Request

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For over seventy-five years, Social Security has provided hundreds of millions of Americans with an economic safety net. As the baby boomers retire and reach their disability-prone years, Social Security's workloads continue to grow. In addition, the economic downturn has greatly increased the demand for our services. Despite this dramatic growth in our work, through increased employee productivity, new initiatives, and improved funding we have reversed a trend of declining service and an increasing backlog in our disability workloads.

The President's budget request of $12.522 billion for Social Security's administrative expenses will allow us to maintain staffing in our front-line components, fund ongoing activities, and cover our inflationary increases. It will allow us to reduce our hearings and initial disability claims backlogs, and to continue to reverse the decline in our program integrity work. Program integrity work not only pays for itself, but also produces considerable savings to the taxpayers.

Full funding by Congress of the President's budget request is critical. This budget request is the minimum the agency needs to continue to reduce key backlogs and to increase deficit-reducing program integrity work. It will allow us to build on the considerable progress we have achieved, progress that is vital to the millions of people who depend on our services and to the American taxpayer.
For more information about the President's 2012 budget request for Social Security, visit www.socialsecurity.gov/budget.

Moderate Exercise May Improve Memory in Older Adults

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A new study in older adults shows that brisk walking can increase the size of a brain region involved in memory formation. The finding suggests that moderate physical exercise can help protect the brain as we age.

The brain region called the hippocampus begins to shrink in older adults as part of the normal aging process. This can contribute to forgetfulness, memory loss and increased risk of dementia. Physical fitness is known to be associated with both increased hippocampus size and improved cognitive ability. However, it was unclear how exercise might affect people who’d already had some hippocampus deterioration as a result of aging.
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OMB Director Says Social Security Will Be Fine - Washington Whispers (usnews.com)

By Paul Bedard

Jacob Lew, director of the Office of Management and Budget, has a bit of advice to those who say the Social Security sky is falling: Calm down. “People who sit around saying bad things are going to happen,” says the self-described optimist, “tend to contribute to self-fulfilling prophecies.” A budget pro who has studied Social Security for three decades, Lew is not worried about running out of cash. “At the moment, we look out and we see it solidly funded until 2037, and we think it is important to make the commitment to current retirees and workers, who are future retirees, that the system will be sound,” he says. “There is no need to deal with Social Security.”

OMB Director Says Social Security Will Be Fine - Washington Whispers (usnews.com)