Statement by Medicare Rights Center President Joe Baker on the Release of the Medicare Trustees Report

The release of the Medicare Trustees Report today makes clear the importance of the Affordable Care Act (ACA) to the solvency of the Medicare trust fund. The ACA provides added support to Medicare as the economy recovers and contributions to the trust fund begin to increase.

We must remember that preserving Medicare means not only maintaining the solvency of the trust fund, but also maintaining the value of the benefit and the financial and health protections the program provides to the people it serves. Half of people with Medicare live on incomes below $20,000 per year. Proposals such as premium support or spending caps artificially strengthen Medicare’s financial outlook by shifting unaffordable out-of-pocket costs to people with Medicare, leaving access to services in question.

But Medicare is not the problem. The problem is growing costs in the health care sector overall, and shifting costs from one party to another does nothing to address this issue. The ACA achieves savings without cutting benefits or increasing consumer costs, through promoting prevention, paying for quality over quantity, and improving care coordination that can help people with Medicare, including those with multiple chronic conditions, stay healthier. It is solutions like these that we must support to make Medicare stronger.

World Report on Disability

The WHO/World Bank is launching its first World report on Disability (See description below) in the U.S. on September 12 & 13 . DoubleTree Hotel Crystal City, Arlington , VA. September 12 & 13, 2011. (The international launch is at the UN on June 9 when the Report will be released.) The September 12-13 U.S. launch/symposium is free but you must register. For registration, please go to http://cirrie.buffalo.edu/conferences/2011/

The Center for International Rehabilitation Research Information and Exchange (CIRRIE) will conduct a two-day symposium, September 12 & 13, 2011, on the World report on disability, which is being released by the World Health Organization (WHO) and the World Bank on 9 June, 2011. This USA launch event will be conducted in cooperation with WHO, the Pan American Health Organization, the World Bank, the Interagency Committee on Disability Research, and the United States International Council on Disabilities.

What is the World report on disability?

The World report on disability summarizes the best available scientific evidence on disability and makes recommendations for action in support of the implementation of the Convention on the Rights of Persons with Disabilities. The product of a multi-year effort by over 300 contributors from all parts of the world, the World report provides documented evidence of the social and economic status of persons with disabilities, the state of disability services, the problems and good practices, as well as recommendations for needed research and development. It will also include the first update of WHO's global disability prevalence estimates for more than thirty years. For the topics discussed, it represents the best single source of knowledge on disability at the global scale.

What is the purpose of this symposium?

The objective of the September meeting is to introduce the report to U.S. audiences. WHO has encouraged member states to conduct national events to disseminate the report to key stakeholders in each country, especially policy makers and practitioners. The U.S. launch is aimed at moving the report's recommendation forward through U.S. policy, practice and advocacy. The symposium will examine the implications of the World report for the U.S. domestically and internationally.

What will the symposium be like?

The first morning will feature representatives of international organizations and U.S. federal government agencies that develop and implement disability policies and fund research related to disability, as well as representatives of disability rights organizations. The next day and a half will be devoted to the presentation and discussion of the eight chapters of the Report. Discussion will focus on the implications of each chapter for the U.S. , both domestically and internationally.

The chapters in the World report comprise:

• Understanding disability
• Disability - a global picture
• General healthcare
• Rehabilitation
• Assistance and support
• Enabling Environments
• Education
• Work and employment

Who should attend the symposium?

This meeting will be of interest to all those who wish to deepen their knowledge of the global state of disability, with particular reference to the U.S. These include policy makers, practitioners, researchers and persons with disabilities. There is no registration fee, but participants will be required to register and registration will be capped at 120 persons on a first-come-first-served basis.

Further information about the program, the speakers and logistics will be forth coming on the conferences website (http://cirrie.buffalo.edu/conferences/2011/).

CIRRIE is supported by a grant from the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education.

GAO Launches Flickr Page

Image via WikipediaThe U.S. Government Accountability Office’s (GAO) latest step into the world of new and social media communication is an agency presence on the image-sharing website Flickr. The GAO Flickr page features selected photos and graphics from GAO reports that are searchable, viewable, and downloadable by visitors to the site.

“GAO continues to seek out new, innovative ways to convey our findings,” said Gene L. Dodaro, Comptroller General of the United States and head of the GAO. “The images in our reports help tell the story of government accountability by making complex concepts and data more understandable. Our Flickr page will allow us to highlight selected images and share them more easily with Congress and the public.”

The GAO Flickr page can be found at http://www.flickr.com/photos/usgao/. Flickr has over 51 million registered members who upload about 3,000 images per minute. Over 5 billion images are available for viewing on the site, including those posted by government entities such as the Library of Congress, NASA, and the White House.

New Book Based on UN Confab Hails Intergenerational Solidarity

Intergenerational Solidarity: Strengthening Economic and Social Ties" (Palgrave Macmillan)is now availableThe book emerged from a 2007 Expert Group Meeting of the United Nations' Department of Economic and Social Affairs Division for Social Policy and Development (in which Generations United participated). 

A snapshot review: "Based on solid arguments and rigorous analysis, this book is a splendid example of the high value that solidarity among generations carries  for everyone in society, making it a truly shared society, a society for all." -Wim Kok, former Prime Minister of the Netherlands.

U.S. GAO - Long-Term Care Hospitals: Differences in Their Oversight Compared to Other Types of Hospitals and Nursing Homes

Full Report (PDF, 51 pages) Accessible Text

Summary

This report formally transmits the briefing highlighting differences in the oversight of long-term care hospitals (LTCH), other types of hospitals, and nursing homes. This report is a partial response to a congressional request letter and was used to brief congressional staff on November 29, 2010. We provided a draft of this report to the Department of Health and Human Services (HHS) and to The Joint Commission (TJC)--an accrediting organization that oversees the majority of LTCHs.

U.S. Government's 2010 Financial Reprot Shows Significant Financia Mangement & Fiscal Chanllenges

Image via WikipediaThe U.S. Government Accountability Office (GAO) cannot render an opinion on the 2010 consolidated financial statements of the federal government, because of widespread material internal control weaknesses, significant uncertainties, and other limitations. 

"Even though significant progress has been made since the enactment of key financial management reforms in the 1990s, our report on the U.S. government's consolidated financial statement illustrates that much work remains to be done to improve federal financial management.  Shortcomings in three areas again prevented us from expressing an opinion on the accrual-based financial statements," said Gene Dodaro, Acting Comptroller General of the United States.

The main obstacles to a GAO opinion were: (1) serious financial management problems at the Department of Defense (DOD) that made its financial statements unauditable, (2) the federal government's inability to adequately account for and reconcile intragovernmental activity and balances between federal agencies, and (3) the federal government's ineffective process for preparing the consolidated financial statements.

In addition GAO was unable to render an opinion on the 2010 Statement of Social Insurance because of significant uncertainties, primarily related to the achievement of projected reductions in Medicare cost growth. The consolidated financial statements discuss these uncertainties, which relate to reductions in physician payment rates and to productivity improvements, and provide an illustrative alternative projection to illustrate the uncertainties. 

Dodaro also cited material weaknesses involving an estimated $125.4 billion in improper payments, information security across government, and tax collection activities. He noted that three major agencies-DOD, the Department of Homeland Security, and the Department of Labor-did not get clean opinions. Nineteen of 24 major agencies did get clean opinions on all their statements.

"Given the federal government's fiscal challenges, it's imperative that Congress, the administration, and federal managers have reliable, useful, and timely financial and performance information. Improved accuracy and transparency in financial reporting are urgently needed," Dodaro said.

Dodaro commended the commitment and professionalism of the Inspectors General across government who are responsible for auditing the annual financial statements of individual federal entities each year.

The fiscal year 2010 Financial Report of the United States Government, which includes financial information from the 24 major federal departments and agencies along with GAO's audit report, is being released today by the Treasury Department. The report is also available on GAO's web site at http://www.gao.gov/financial.html.

AoA Proposes Revisions to the State Program Report

SUMMARY:
The Administration on Aging(AoA) is announcing that the proposed collection of information has been submitted to the Office of
Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995.

FY 2011 reporting year and thereafter, while the current reporting, OMB Approval Number 0985–0008, will be extended to the end of the FY 2010 reporting cycle. The proposed FY 2011 version may be found on the AoA web site link entitled Proposed SPR for Review available at http://www.aoa.gov/AoARoot/Program_Results/docs/SPRDraft_form_2010_draft.pdf.

AoA estimates the burden of this collection of information as follows: 2,828 hours

DATES: Submit written comments on the collection of information by May 14, 2010.

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BENEFICIARIES REMAIN VULNERABLE TO SALES AGENTS’ MARKETING OF MEDICARE ADVANTAGE PLANS

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The Centers for Medicare & Medicaid Services (CMS) contracts with private companies, known as plan sponsors, to provide health insurance plans under MA. Plan sponsors may market their MA plans through independent sales agents, who may market on their own or through a field marketing organization (FMO), or by employing their own sales agents.

Between June 2007 and June 2008, Congress held three hearings examining sales agents’ marketing of MA plans. During these hearings, witnesses testified that sales agents had marketed without licenses, portrayed themselves as Medicare employees, and misled Medicare beneficiaries about plan benefits. These types of aggressive, deceptive, and fraudulent marketing practices could result in Medicare beneficiaries enrolling in plans that do not meet their health care needs. Several members of Congress raised concerns about sales agents’ marketing to Medicare beneficiaries to the Office of Inspector General (OIG); one specifically requested that OIG examine the marketing practices of MA plans.

In July 2008, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), which prohibited or limited certain marketing activities by sales agents and plan sponsors. In September 2008, CMS published regulations implementing the MIPPA’s marketing provisions, including limiting sales agent compensation to independent sales agents. In addition, CMS regulations required that all sales agents be trained and tested annually and be State licensed. To examine selected MA plan sponsors’ compensation of sales agents and determine whether the selected plan sponsors ensured that their sales agents were qualified, we reviewed compensation, testing, and licensure data for a random sample of sales agents. We purposively selected the plan sponsors based on their size and the rate of marketing complaints they received. We also compared complaints regarding sales agent marketing reported to CMS from 2008 and 2009 to determine whether the number and topics of Medicare beneficiaries’ complaints changed after implementation of the sales agent marketing regulations.

FINDINGS
*All five plan sponsors using independent sales agents had compensation practices that resulted in inappropriate financial incentives.
*Five of the six selected plan sponsors did not ensure that all sales agents were qualified under CMS’s regulations.
*The number and topics of sales agent marketing complaints remained unchanged after implementation of sales agent marketing regulations. Read More/Download Report

Health Affairs Blog: New Census Estimates of Health Insurance Coverage

by Lisa Dubay

On the heels of the President’s speech on health care reform, the Census Bureau released to little fanfare new estimates of health insurance coverage from the Current Population Survey (CPS). Between 2007 and 2008, the number of individuals without health insurance rose from 45.7 million to 46.3 million, increasing the ranks of the uninsured by 683,000.

Read More

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• The Uninsured: The Best and Worst States (abcnews.go.com)
• Doing the Math on the Uninsured (meganmcardle.theatlantic.com)

Policy on Reporting of Coordinated Human Services Transportation Data

Notice of Final Policy on Reporting of Coordinated Human Services Transportation Data
to the National Transit Database.
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SUMMARY: This notice announces the Federal Transit Administration's (FTA) policy on the
reporting of coordinated human services transportation data to the National Transit Database (NTD).
On August 12, 2008, FTA proposed a new policy clarifying how transit providers reporting to
the NTD may include sponsored trips in their reports. FTA received two comments on the proposed
policy and is now formally adopting the new policy.

DATES: Effective Date: March 4, 2009.

A New Health Care Quality Improvement Resource: WhyNotTheBest.org

The Commonwealth Fund has launched a new Web site, WhyNotTheBest.org, that allows health care providers, researchers, and professionals to easily conduct side-by-side comparisons of 4,500 hospitals nationwide, track performance over time against numerous benchmarks, and download tools to improve health care quality. WhyNotTheBest.org allows you to:

• Find the top-performing hospitals in the country on 24 nationally recognized measures of health care quality, including care provided for heart attack, heart failure, and pneumonia, and prevention of surgical infection
• Compare a hospital against its peers
• Learn how to improve the quality of care delivery and patient satisfaction.

On the Web site, users can search publicly reported Centers for Medicare and Medicaid Services performance data by a number of hospital characteristics--including region, ownership, and size--and measure performance against top performers and state and national averages.

WhyNotTheBest.org provides more than data. Case studies of high-performing hospitals and a library of tools offer lessons and strategies on ways to improve care. Featured tools include materials created by the Institute for Healthcare Improvement, the Agency for Healthcare Research and Quality, the American Heart Association, and top hospitals around the country.

"There are many report cards that measure quality of care, but WhyNotTheBest.org is unique in that it allows providers to benchmark performance against leaders and track improvements, and it provides credible tools to help providers achieve better performance," said Anne-Marie Audet, M.D., Vice President, Quality Improvement and Efficiency, at The Commonwealth Fund.

All information, including tools, can be saved to a "My Profile" page for later use. Over time, new measure sets and functionality, such as an Improvement Calculator to track progress toward benchmarks, will be added. IPRO, a not-for-profit health care evaluation and quality improvement organization, conducted all data analysis and Web development for the site.

ADVERSE EVENTS IN HOSPITALS: OVERVIEW OF KEY ISSUES

The DHHS Office of the Inspector General has released a new report examining the key issues regarding adverse events in hospitals. SUMMARY The extensive range of entities involved in researching and addressing adverse events shows that reducing the incidence of adverse events is a high priority. Stakeholders described the current environment among hospitals and policymakers as being on the threshold of accelerated progress. They point to a large body of research as improving understanding, including recognition of the critical role of hospital systems in guarding against adverse events. Additionally, new policies, such as denying hospitals higher payment for admissions complicated by certain adverse events and public disclosure of events, strengthen hospital incentives to develop safer practices. These advancements in clinical understanding, combined with heightened controls, hold promise for reducing the incidence of adverse events in hospitals and improving the quality of care. KEY ISSUES Issue 1: Estimates of adverse event incidence vary widely Issue 2: Nonpayment policies are gaining prominence Issue 3: Hospitals rely on staff to report adverse events Issue 4: Hospitals report adverse events to oversight entities Issue 5: Public disclosure has benefits but raises concerns Issue 6: Hospitals may be slow to apply practices Issue 7: Interviews and literature reveal strategies Link to Full Report

GAO Report: Medicare Part D Information & Annual Election Period

What GAO Found: Sponsors, pharmacists, beneficiary advocates, and counselors GAO interviewed expressed concern that CMS’s model ANOC for the 2008 AEP did not effectively communicate drug plan changes to enrollees. They noted that it contained language at a reading level too high for some beneficiaries as well as too much, often irrelevant, information. To help ensure their enrollees understood how plan changes would affect them personally, two study sponsors mailed additional information detailing specific changes in coverage and costs for drugs the beneficiary took in the past year. Despite GAO’s previous recommendation that CMS ensure that its Part D materials meet communications guidelines, CMS’s process for developing its model ANOC did not include a systematic evaluation of its effectiveness. However, CMS officials reported that they recently initiated an evaluation of their annual Medicare beneficiary materials for the 2010 AEP that will examine reading levels, effectiveness, and length, among other factors. Such an evaluation is important in light of changes CMS has made for the 2009 AEP, which have raised further concerns among stakeholders. It is unclear whether alternative formats for communicating plan changes to beneficiaries will be considered. Although CMS and plan sponsors made improvements to the enrollment process, CMS data showed that about 15 percent of beneficiaries who chose to switch plans in the 2008 AEP were not fully enrolled in their new plan by January 1. Modifications to the enrollment process for the 2008 AEP reduced the time needed to enroll beneficiaries in a new plan to a median of 5 days. However, the volume of applications submitted late in the AEP contributed to beneficiaries being at risk of not having access to their new coverage by January 1. In fact, among the beneficiaries who submitted applications after December 15, 40 percent were not completely processed until after the effective date of their new coverage. As a result, stakeholders reported that beneficiaries, pharmacies, and sponsors faced various operational challenges, including the risk of inaccurate charges and additional administrative burden. Some stakeholders we interviewed for our study said that creating an interval for enrollment processing between the end of the AEP and the effective date of coverage would help ensure that beneficiaries switching plans would have their coverage in place on January 1. What GAO Recommends To improve the AEP, GAO recommends that CMS strengthen its evaluation of its model materials by reviewing alternative formats to communicate plan changes. Additionally, Congress should consider authorizing the Secretary of Health and Human Services to amend the AEP schedule to include a processing interval between the end of the AEP and the effective date of new coverage. In commenting on our draft, CMS stated that it concurs with our recommendation and will consider reviewing other ANOC formats.

GAO Performance & Accountability Report FY 2008

The Government Accountability Office has released the report on its performance during FY2008. According to the table "Agencywide Summary of Annual Measures and Targets", the agency met all but one of its performance measure targets. Full report

Senior Center Practices

In the states and territories senior centers offer older Americans a comfortable place to participate in activities, socialize with their peers, and share a meal. Senior centers, supported by funding from various sources including the State Unit on Aging, are often coordinated by Area Agencies on Aging. Although all states have senior centers, they vary greatly. Several states and territories are developing statewide standards for their senior centers. Implementation of state standards ensures that each senior center offers appropriate and consistent services. Senior center standards often regulate hours of operation, set forth requirements for nutrition programs, provide for handicap accessibility, and prescribe social, health and wellness activities.

Medicare Drug Plans Fraud & Abuse, Compliance Plans

Medicare Drug Plan Sponsors' Identification of Potential Fraud and Abuse (OEI-03-07-00380) Oversight of Prescription Drug Plan Sponsors' Compliance Plans (OEI-03-08-00230) Both the fraud and abuse report and the compliance plan report are part of OIG's continuing work focusing on oversight of the Part D program. Because prescription drug plan (PDP) sponsors are the first line of defense against Part D fraud and abuse, a crucial aspect of protecting Part D integrity is ensuring that PDP sponsors have comprehensive and effective compliance programs to detect and deter fraud, waste, and abuse. In two reviews, we examined PDP sponsors' identification of potential fraud and abuse incidents and CMS' oversight of PDP sponsors' compliance plans. We identified concerns related to both PDP sponsors' roles in protecting Part D integrity and CMS's limited oversight of PDP sponsors' implementation of Part D safeguards. We recommended several actions to strengthen the oversight of Part D integrity. In the fraud and abuse review, OIG found that 24 of 86 PDP sponsors did not identify any potential fraud and abuse incidents in the first 6 months of 2007. Seven PDP sponsors identified 90 percent of all incidents of potential fraud and abuse. Inappropriate billing was the most prevalent type of potential fraud and abuse incident identified. Also, not all of the sponsors that identified potential fraud and abuse incidents conducted inquiries, initiated corrective actions, or made referrals for further investigation. Therefore, OIG recommends that CMS: (1) review Part D plan sponsors to determine why certain sponsors have especially high or low volumes of potential fraud and abuse; (2) determine whether the Part D plan sponsors that identified potential fraud and abuse initiated inquiries and corrective actions as required by CMS, and made referrals for further investigation as recommended by CMS; (3) require Part D plan sponsors to maintain and routinely report information related to the results of sponsors' fraud and abuse programs; and (4) use this required information to help determine the effectiveness of sponsors' fraud and abuse programs. In response to our first recommendation, CMS described its intentions to follow up with its Medicare Drug Integrity Contractors, revise reporting requirements, and provide guidance to PDP sponsors on incident tracking. CMS also concurred with our second recommendation but did not indicate whether it concurred with our third or fourth recommendations. We reviewed CMS's oversight of PDP sponsors' compliance plans in followup to a 2006 OIG report and found that CMS conducted only one audit of a PDP sponsor's compliance plan in 2007. This was a focused audit; none of CMS's 17 routine audits included a compliance plan review. Although CMS originally planned to begin routine compliance plan audits in January 2007, as of early August 2008, CMS had not conducted any routine audits of PDP sponsors' compliance plans. Further, CMS instructed all PDP sponsors to complete a compliance plan self-assessment, but OIG found that CMS did not verify sponsors' responses. The self-assessment was based on requirements and recommendations in Chapter 9 of the "Prescription Drug Benefit Manual;" however, not all of the compliance plan requirements in Chapter 9 were included in the self-assessment. CMS followed up with 23 PDP sponsors that attested that they had not implemented one or more of the compliance plan requirements in the self-assessment. However, CMS did not request supporting documentation to confirm that these PDP sponsors corrected their compliance plans. OIG recommends that CMS conduct audits to verify that PDP sponsors' compliance plans meet requirements. Specifically, these audits should cover all compliance plan requirements contained in both regulations and Chapter 9 of the "Prescription Drug Benefit Manual." CMS may also want to assess implementation of its compliance plan recommendations. CMS concurred with our recommendation and stated that it will begin audits of Part D sponsors' compliance plans in the near future. These audits will consist of a limited number of desk audits; however, as more resources become available, CMS stated it would include more audits, onsite reviews, and other more comprehensive fraud prevention activities.

VA: Improved Staffing Methods and Alternate and Flexible Work Schedules Could Enhance the Recruitment and Retention of Nurses

Why GAO Did This Study Registered nurses (RNs) are the largest group of health care providers employed by VA’s health care system. RNs are relied on to deliver inpatient care, but VA medical centers (VAMC) face RN recruitment and retention challenges. VAMCs use a patient classification system (PCS) to determine RN staffing on inpatient units by classifying inpatients according to severity of illness to determine the amount of RN care needed. GAO reviewed VAMC inpatient units for (1) the usefulness of information generated by VA’s PCS; (2) key factors that affect RN retention; and (3) factors that contribute to delays in hiring RNs. GAO performed a Web-based survey of all VAMC nurse executives; interviewed VA headquarters officials and VAMC nursing officials, and conducted RN focus groups at eight VAMCs visited by GAO. The findings of GAO’s survey are generalizable to all nurse executives; however, findings from the focus groups at the eight VAMCs are not generalizable. VA nursing officials reported that VA’s ability to retain its RNs is adversely affected by two main factors. First, inpatient RNs reported that they spend too much time performing non-nursing duties such as housekeeping and clerical tasks. Second, even though VAMCs were authorized in 2004 to offer RNs two alternate work schedules that are generally desired by nurses—such as working three 12-hour shifts within a week that would be considered full-time for pay and benefits purposes—few nurse executives reported offering these schedules; therefore, few RNs work these schedules. What GAO Recommends GAO recommends that VA develop an action plan to implement a new nurse staffing system that ensures an accurate account of patient care needs and tasks performed by RNs and that VA assess the barriers to wider availability of alternate and flexible work schedules and explore ways to overcome these barriers. VA concurred with GAO’s findings and recommendations and plans to address GAO’s three recommendations.

Florida's Medicaid Reform: Informed Consumer Choice?

Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs article based on the Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries conducted during the first year of the state's reform effort. The study found that three-quarters of the enrollees who were unaware of their need to choose a plan said that they had not been told so by the state, suggesting that they either did not receive, did not read or did not understand the state's letter and other communications about their transition. The study, Florida's Medicaid Reform: Informed Consumer Choice?, was written by Teresa Coughlin, Sharon K. Long and Timothy Triplett of the Urban Institute; Samantha Artiga and Barbara Lyons of the Kaiser Family Foundation; and Paul Duncan and Allyson Hall of the University of Florida. The Foundation, in collaboration with the Urban Institute and the University of Florida, is conducting a follow-up survey in Florida to continue to track the experiences of beneficiaries in the reform program.In addition, the Foundation released a separate policy brief that provides an overview of the Florida Medicaid reform and a summary of available research findings to date from various evaluators of the program.

The Healthy Woman: A Complete Guide for All Ages

The Department of Health and Human Services Office on Women's Health has issued a new publication The Healthy Woman: A Complete Guide for All Ages.

This comprehensive official women's health resource covers a broad range of issues affecting women of all ages. From the Nation's leaders in women's health, the Guide covers topics ranging from violence against women to cancer and heart disease, providing easy-to-understand explanations as well as practical tips. Readers will also find personal health stories from women around the country, charts showing which medical tests are needed, and when, and ways to find more helpful information. As gatekeepers of their family's health, women will also find resources for caring for the men and children in their lives.

The guide is available through the U.S. Government Bookstore.

Television As A Health Educator

The Kaiser Family Foundation has released a report on the use of popular television programs to provide health education. In the study, the foundation collaborated with the writer's of Grey's Anatomy to develop a plot line containing a specific health education topic. This study documents the enormous potential of popular entertainment television to serve as a health educator—even on a show that has a “soap-opera”-like feel and a comedic bent. A very large proportion of viewers absorbed the information that was provided in Grey’s Anatomy, and many of them had retained that knowledge six weeks later. On the key fact presented in the show—that an HIV-positive pregnant woman who gets the proper treatment has more than a 90% chance of having a healthy baby—the proportion of viewers who were aware of that fact quadrupled, from 15% before the show to 61% after it aired, an increase of 46 percentage points. The full report