The Daily Rise: Wednesday, April 13

Medicare’s Flawed Part B Drug Experiment

Rose Gerber, the director of patient advocacy and education at the Community Oncology Alliance, is standing up for patients, who could be harmed by Medicare’s flawed Part B experiment. In a piece published at Morning Consult, Gerber points out that the Centers for Medicare & Medicaid Services’s experiment with new payment models could undermine patients’ access to life-saving treatments.

“Even though physicians know which medications and treatments typically offer the best outcomes for any given disease, the reality is that patients respond differently. What worked for one might, unpredictably, fail for another,” Gerner writes. “The best hope for patients is the flexibility to change course when appropriate, and ready access to the prescription drugs and biologics developed to combat these complicated conditions.”

“Unfortunately, access to these lifesaving therapies could soon suffer at the hands of a Centers for Medicare & Medicaid Services’s (CMS) initiative that focuses on costs rather than patients and health care quality… I remain highly concerned that CMS’s proposal uses a cookie-cutter approach that fails to recognize the individual patient needs of America’s diverse Medicare population. Furthermore, by limiting access to prescription drugs and therapies, CMS is wedging itself between the patient and his or her physician – the only two individuals who should be making decisions about a patient’s course of care.

Read the entire piece and share it on Twitter.

Voices of Value

As part of our partnership with the magazine WOMEN, our Co-Founder and Executive Director Terry Wilcox shares Megan Sullivan’s patient story.

In 2014, after plummeting 50 feet from the side of a mountain at Yosemite National Park and jumping off her Vespa to avoid a car, Megan finished off the two-week string of bad luck with an unexpected skin cancer diagnosis. She was blindsided. After all, she went to see the dermatologist only because she had met her insurance deductible for the year and decided to get everything done that she needed to get done. Within a day her doctor called with the news. She had melanoma on her forehead, and it needed to be removed right away.

“In the 25-to-35 range, you just don’t think that you’re going to get skin cancer,” Megan says. “Now I always wear a hat and long sleeves when I’m climbing outside, and I reach for the 70+ SPF sunscreen and wear it daily. I am no longer worried about getting a tan—I’m preparing to live for another 80 years.”

Megan is joining forces with us for “Check Yourself to Protect Yourself ALL YEAR,” a national skin cancer screening initiative that stresses the importance of sun safety for people of every age and ethnicity throughout the year.

Learn more by reading the entire piece at WOMEN.

State Spotlight: CA Doctors on Probation

Physicians in California are not required to notfy patients if they’re on probation for drug abuse, sexual misconduct, patient negligence or harm. That warning comes from KQED’s Lisa Fine, who reports on a failed effort to change the state’s notification rules.

Insurance companies and hospitals already receive notice when physicians are placed on probation.

“Maybe if patients knew, they wouldn’t see the doctor,” Lisa McGiffert, Director of the Safe Patient Project at Consumers Union, told KQED. “Maybe they still would. But they are doing it with their eyes open.”

Last Friday, the Medical Board of California rejected a proposed change to the rule submitted by Consumers Union. However, the board agreed to review the topic and “potentially develop a plan to improve notification to patients of doctors on probation.”

Zika Virus: “Scarier” Than We Thought

Gregory Korte of USA Today reports that public health officials are increasingly concerned by the threat posed by a Zika outbreak in the United States. The Obama administration is urging Congress to dedicate $1.9 billion towards research and to combat the virus.

“Most of what we’ve learned is not reassuring,” said Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention. “Everything we look at with this virus seems to be a bit scarier than we initially thought.”

Thus far, approximately 350 people in the continental United States have contrcted the virus — with all of the cases coming from people who had recently traveled to countries that have a bigger Zika problem. Already, Zika virus is greater concern in U.S. territories, inclusing Puerto Rico, the Virgin Islands and American Samoa, where another 354 cases have been reported.

Researchers are most concerned for pregnant women, who are susceptible to “a broader array of birth defects throughout a longer period of pregnancy, including premature birth and blindness in addition to the smaller brain size caused by microcephaly.”

“This is a very unusual virus that we can’t pretend to know everything about it that we need to know,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “I’m not an alarmist and most of you who know me know that I am not, but the more we learn about the neurological aspects, the more we look around and say this is very serious.”

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