�鶹Ů��

An $18 billion merger of medical firms suffers from a lack of logic. Healthcare data miner IMS is uniting with Quintiles, a manager of drug trials. Each will own about half the combined company, and other than some cost savings, the reasons for combining are a bit hazy. The presence of buyout shop TPG on both sides may offer some clues. (Robert Cyran, 5/3)

With its estimate that between 44 000 and 98 000 patients die in hospitals each year as the result of medical errors, the National Academy of Medicine’s (NAM’s; formerly the Institute of Medicine’s) report To Err Is Human: Building a Safer Health System propelled a wave of activity. Health care professionals, professional societies, large employer groups, patient advocacy organizations, and researchers voiced the need to reduce the estimated high toll of medical errors and adverse events. (Tejal K. Gandhi, Donald M. Berwick and Kaveh G. Shojania, 5/3)

Mosquitoes were not a concern in Kentucky in February, when the World Health Organization declared the mosquito-borne Zika virus a global public health emergency and President Barack Obama asked Congress for $1.9 billion to combat the disease. For the past two months, the Republicans who control Congress — prominent among them, Kentuckians Hal Rogers in the key role of House Appropriations chairman and Mitch McConnell, the majority leader of the Senate — have responded to the Zika threat by doing nothing — except blame the White House. (5/2)

It was a field day last week for health wonks in Washington. The CMS issued two major rules—one final, one proposed—that will shape how nearly half the nation's healthcare tab gets spent over the next decade. A few weeks ago, I wrote glowingly about burgeoning state Medicaid experiments aimed at delivering better care to the nation's poor and long-term disabled. Many of those programs are run by private managed-care organizations (MCOs), which now oversee spending for a majority of state Medicaid budgets. (Merrill Goozner, 4/30)

It has been more than 15 years since To Err Is Human, the landmark report by the Institute of Medicine (IOM), revealed the substantial morbidity and mortality related to medical errors in the United States. Two recent developments have refocused policy makers on getting patient safety right. The first are data suggesting that deaths associated with medical errors may exceed 400 000 annually, although this number is controversial, with questions about the degree to which medical errors truly caused each of these deaths and how many deaths were attributable to a medical error when death was inevitable. Regardless, medical error is likely a major cause of death and disability in the United States. The second is the Affordable Care Act, which has, through programs like Value-Based Purchasing and Hospital-Acquired Conditions penalties, made patient safety a financial priority for hospitals. While greater focus on safety is a welcome development, there is little reason to believe that added attention alone will lead to safer care. (Ashish Jha and Peter Pronovost, 5/3)

The term “provider” first appeared in the modern health care lexicon as a shorthand referring to delivery entities such as group practices, hospitals, and networks. More recently, its use has expanded to encompass physicians, nurse practitioners (NPs), physician assistants (PAs), and perhaps others, especially those engaged in delivery of primary care. On one level, this expansion is both logical and convenient, as it reflects the importance of a multidisciplinary approach to modern primary care delivery, extending beyond the traditional dyad of patient and physician. Being designated as a “primary care provider” also denotes qualifying for payment of services rendered, a designation long sought and highly valued by advanced-practice nurses and PAs. Although useful in these contexts, the term “provider” has the potential for adverse consequences for primary care, calling into question the wisdom of its expanded use. (Allan H. Goroll, 5/3)

In a stunningly reckless move, the Obama Food and Drug Administration recently relaxed standards for administering the abortion pill RU-486, allowing it to be used to abort children who are more developed in the womb and, shockingly, requiring even less physician supervision of a drug that has hospitalized and even killed women. (Lila Rose, 5/4)

Every spring, major breast cancer charities like Susan G. Komen and the Avon Foundation encourage people to raise money by walking. Each year, multiple organizations put on hundreds of walks, raising tens of millions of dollars. Since the 1980s, they’ve argued that these efforts are key to ending a devastating disease. About their three-day event, Komen proclaims: “This isn’t just a walk. It’s the journey to the end of breast cancer.” (Karuna Jagger, 5/4)