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U.S. Residents To Pay Greater Share Of Employer-Sponsored Health Insurance Coverage In 2009, Report Finds
U.S. residents enrolled in employer-sponsored health plans will contribute an average of 41% of their health care costs in 2009, the largest share to date, according to a study released on Monday by the Seattle-based actuarial consulting firm Milliman, the Minneapolis Star Tribune reports. The report looked at employer-sponsored preferred provider organizations plans in 14 metropolitan cities. Researchers found that total medical costs for a typical family of four in 2009 are expected to reach $16,771, up by 7.4% from 2008. Employers are expected to pay $9,947 of that, and employees are expected to contribute $4,004 through health plan premiums and another $2,820 through out-of-pocket costs such as copayments and deductibles. In addition, the report found that consumption of medical services is expected to be flat this year for the first time ever. Kate Fitch, a consultant at Milliman, attributed the slowdown to better disease management and wellness programs. However, per unit medical costs are up, and hospital outpatient care had the highest growth in 2009 (Yee, Minneapolis Star Tribune, 5/18).The report also found variations in medical costs by city. Miami had the highest health costs for a family of four at an average of $20,282 in 2008, almost 21% higher than the national average, followed by New York City at $19,684. Phoenix had the lowest at $14,857 (Dorschner, Miami Herald, 5/19).The report is available online.

Des Moines Register Examines Planned Parenthood Of Greater Iowa 75 Years After Founding
The Des Moines Register on Friday profiled Planned Parenthood of Greater Iowa, which marks its 75th anniversary this year. Established in 1934 as the Iowa Maternal Health League, PPGI now includes 17 clinics offering a range of reproductive health services, as well as an education and re center. The organization originally was founded by four women with a mission of providing birth control for low-income married women. Over the years, it frequently "has been on the forefront of advances in reproductive history," according to the Register. For example, in the early 1960s, PPGI became the first provider in the Midwest to offer the oral contraceptive Ortho-Novum, leading to a more than 350% increase in its number of patients.Although antiabortion-rights advocates often discuss Planned Parenthood in relation to abortion services, the vast majority of its services are not abortion-related. Jill June, president and CEO of PPGI, said that although the organization"s services have greatly expanded since its founding, the "needs people have for the services we provide and the challenges we face in meeting those needs haven"t changed." She added, "People still face unintended pregnancies despite great technological advances in birth control and efforts to make contraception more available and to normalize contraception use" (Challender, Des Moines Register, 5/22).
News of the day
AMA Backs House Reform Bill, Other Groups, Businesses Eye Reform Positions
The American Medical Association has backed the House bill that carries mandates on employers and individuals, a government-run health plan and reforms to Medicare and Medicaid, Politico reports.
Nutrition

Less Invasive CT-Scan Based Colorectal Cancer Screening Method Shows Good Accuracy

Computed tomographic (CT) colonography may offer patients at increased risk of colorectal cancer an alternative to colonoscopy that is less-invasive, is better-tolerated and has good diagnostic accuracy, according to a study in the June 17 issue of JAMA. Colorectal cancer (CRC) accounts for approximately 210,000 deaths each year in Europe. CT colonography is a procedure in which a detailed picture of the colon is created by an x-ray machine linked to a computer. It has been shown to be sufficiently accurate in detecting colorectal neoplasia (abnormal growth of cells) and is now considered a valid alternative for CRC screening in the general population. Individuals at increased risk of CRC include those with a first-degree family history of advanced colorectal neoplasia and those with positive results from fecal occult blood tests (FOBTs). "However, adherence to follow-up colonoscopy in these individuals is suboptimal. Being less invasive and thus more tolerable, CT colonography may increase acceptability and adherence to screening, but little information is available on its performance," the authors write. Daniele Regge, M.D., of the Institute for Cancer Research and Treatment, Candiolo, Turin, Italy, and colleagues assessed the accuracy of CT colonography in detecting advanced colorectal neoplasia in asymptomatic individuals at increased risk of CRC using colonoscopy as the reference standard. The multicenter study included individuals at increased risk of CRC due to either family history of advanced neoplasia in first-degree relatives, personal history of colorectal adenomas (benign tumors), or positive results from FOBTs. Each participant underwent CT colonography followed by colonoscopy on the same day. Of 1,103 participants, 937 were included in the final analysis: 373 cases in the family-history group, 343 in the group with personal history of adenomas, and 221 in the FOBT-positive group. The prevalence of advanced neoplasia was 7.5 percent in the family-history group; 11.1 percent in the post-polypectomy group (had a polyp removed); and 50.2 percent in the FOBT-positive group. Overall, CT colonography identified 151 of 177 participants with advanced neoplasia 6 mm or larger (sensitivity, 85.3 percent) and correctly classified results as negative for 667 of 760 participants without such lesions (specificity, 87.8 percent). The positive and negative predictive values were 61.9 percent and 96.3, respectively. The negative predictive value ranged between 84.9 percent in the FOBT-positive group and 98.5 percent in the family-history group. The authors write that these results "suggest a potentially effective use of CT colonography as an alternative to colonoscopy for screening individuals with family history of advanced colorectal neoplasia. Computed tomographic colonography has been shown to be better accepted than colonoscopy and has a negligible risk of serious adverse events; thus, it may help increase the low adherence reported for individuals who are candidates for screening, which is the main negative factor affecting its efficacy in reducing mortality from CRC." Editor"s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. Editorial: Computed Tomographic Colonography for Patients at High Risk of Colorectal Cancer - Trading Accuracy for Access and Compliance Emily Finlayson, M.D., M.S., of the University of Michigan, Ann Arbor, comments on these findings in an accompanying editorial. "While the use of CT colonography as a screening and surveillance modality is still a matter of debate, the study by Regge et al suggests that CT colonography may be an acceptable alternative to colonoscopy in patients with a history of adenoma and those with a family history of colorectal neoplasm. The question remains whether clinicians are willing to accept a study with decreased sensitivity for the potential of increased adherence with recommended screening and surveillance guidelines. With the majority of individuals in the United States who meet criteria for colorectal cancer screening and surveillance not undergoing recommended procedures, an imperfect test that has a lower risk profile and greater acceptance among patients seems to be an appealing solution." American Medical Association (AMA)


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