GAO Finds Need to Improve Response Accuracy of 1-800-MEDICARE Helpline Call Center; Reps Need Better Script Content to Improve Answers
The Government Accountability Office (GAO) recently released a report that raises questions about the accuracy of the information provided through the CMS Medicare telephone helpline (1-800-MEDICARE) and recommends steps to improve monitoring of the accuracy of answers as well as the information available.
The Medicare helpline is open 24 hours a day, 7 days a week. Home health agencies and hospices have indicated that incorrect understandings of coverage criteria by beneficiaries or their families could be related to inaccuracy of responses from the helpline. Because this resource provides a starting point for consumers and their families to understand a very complicated Medicare program, CMS has indicated it will focus on efforts to improve the helpline's accuracy and accessibility. The GAO report is Medicare: Accuracy of Responses from the 1-800-MEDICARE Helpline Should Be Improved and is available at http://www.gao.gov/new.items/d05130.pdf.
Nurses (Again) Named as Most Ethical and Honest Professionals
For the third year in a row, and the fifth time in the past 6 years, nurses were named the most ethical and honest professionals as judged by the American public, according to the annual Gallup survey of professions.
At the top, 79% of Americans gave nurses high or very high marks. Other categories, in order, were grade school teachers, pharmacists, military officers, doctors, police officers, clergy, judges, and day care providers. This ranking is not a one-time event or anomaly; nurses have held the top position in the opinion of Americans for five of the past 6 years. In 2001, nurses finished in second place, beaten only by firefighters in the wake of the September 11 attacks.
Source: Gallup Poll, Honesty and Ethical Standards of Professions Survey, 2004 at http://www.gallup.com.
Training Video Available
A video of a training presentation broadcast via satellite and Web cast by the Centers for Medicare and Medicaid Services is now available from the National Technical Information Service. Designed for home care staff and regional and state agencies, the program's goal was to provide a better understanding on the current state of science in wound care, accurate coding for OASIS wound items, and required assessments between days 55 and 60.
Topics for the broadcast include: "State of Science in Wound Care Management," "Accurate Coding for OASIS Wound Items," and "Required Assessments with SCIC After Inpatient Stay Between Day 55 and 60."
More information available at: http://www.ntis.gov.
Detailed Guidance on Hospice Consultation Services Issued
CMS has released detailed guidance on the Medicare Modernization Act provision allowing hospices to bill for a hospice consultation for persons who have not elected the hospice benefit. Although the provision is very limited, it provides an opportunity to do outreach to patients who would qualify for hospice but who may need more assistance in understanding the program before they make an election.
This is a one-time benefit that allows the hospice physician to evaluate patient needs for pain and symptom management, counsel the patient about hospice, and advise about advanced care planning. Payment is made to the hospice for the services of their medical director or other employed physicians, and the patient's attending physician must make the referral. Nonphysicians may not provide the services. More details on this service can be found in the CMS manual transmittal, available at: http://www.cms.hhs.gov/Manuals/pm_trans/R28BP.pdf.
List of Priority Conditions for Research Under Medicare Modernization Act Released
The Agency for Healthcare Research and Quality (AHRQ) has announced a $15 million initiative to develop state-of-the-art information about the effectiveness of interventions, including prescription drugs, for 10 top conditions affecting Medicare beneficiaries. The list of 10 priority conditions was developed with input from the public and stakeholders through testimony at a May 21 listening session and written comments submitted to the Department of Health and Human Services. The priority conditions identified for study are ischemic heart disease; cancer; chronic obstructive pulmonary disease/asthma; stroke, including control of hypertension; arthritis and nontraumatic joint disorders; diabetes mellitus; dementia, including Alzheimer's disease; pneumonia; peptic ulcer/dyspepsia; and depression and other mood disorders. For more information, see http://www.ahrq.gov.
How Good Are Your CPR Skills?
Cardiopulmonary resuscitation (CPR) often is performed inadequately by doctors, paramedics, and nurses, according to two recently published studies of resuscitation efforts during cardiac arrest. These studies determined that whether performed in the hospital or on the way, CPR guidelines frequently are not followed.
Wik, L., Kramer-Johansen, J., Myklebust, H., Enge, B., Sorebo, H., et al. (2005). Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest.Journal of the American Medical Association, 293, 299-304.
This study involved 176 adults with out-of-hospital cardiac arrest treated by paramedics and nurse anesthetists in Sweden, Norway, and England. Among commonly cited problems: Rescuers did not push hard enough or frequently enough on the victim's chest to restart the heart, and they breathed air into the lungs too often-either mouth to mouth or through breathing tubes. Chest compressions were done only half the time, and most were too shallow.
Abella, B., Alvarado, J., Myklebust, H., Edelson, D., Barry, A., O'Hearn, N., et al. (2005). Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest.Journal of the American Medical Association, 293, 305-310.
In this study involving 67 adult patients at the University of Chicago, doctors and nurses failed to follow at least one CPR guideline 80% of the time. Failure to follow several guidelines was common.