Mary Ellen Schneider

New Bone-Health Goals for 2020

The federal government has issued its new goals for improving public health by 2020, and they include a reduction of the proportion of adults diagnosed with arthritis who find it “very difficult” to perform certain joint-related activities. “Healthy People 2020” focuses on four such activities: walking one-quarter mile; walking up 10 steps without resting; stooping, bending, or kneeling; and using fingers to handle small objects. The federal government is seeking a 10% improvement in each of these areas. For example, 2008 data from the Centers for Disease Control and Prevention showed that 15.2% of adults who have arthritis found it very difficult to walk one-quarter mile. The new goal is to bring that figure down to 13.7%. The complete “Healthy People 2020” objectives are available online at

www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

Arthritis Is Lowest in Hawaii

Only 23% of women in Hawaii report having been diagnosed with arthritis, giving the state the lowest prevalence of the condition among women. On the other end of the spectrum is Alabama, where 38% of women have been diagnosed with arthritis. The figures are part of a new report from the National Women's Law Center, which graded each state on how well it meets women's health needs. The report, the fifth produced by the group and the first since 2007, gave the nation an overall grade of “unsatisfactory.” The nation improved on only 1 of 26 indicators of women's health, rising from “unsatisfactory” to “satisfactory minus” in cholesterol screening for women.

Hospital Adverse Events Common

More than 13% of Medicare beneficiaries hospitalized in late 2008 experienced at least one adverse event causing lasting harm during their stays. Among them, 1.5% experienced an event that contributed to their deaths, according to a report from the Health and Human Services Office of the Inspector General. Another 13% of hospitalized beneficiaries experienced temporary harm, such as hypoglycemia, the report found. The combination of events cost Medicare an estimated $324 million in October 2008, the month the report covered. Physicians reviewing the data said that 44% of the adverse events, such as hospital-acquired infections, and temporary-harm events were clearly or probably preventable.

TNF-Alpha Inhibitors in Early RA

The tumor necrosis factor–alpha inhibitor etanercept (Enbrel) is prescribed more often during the early phases of rheumatoid arthritis than is its competitor adalimumab (Humira), according to an analysis that was performed by the health care research firm Decision Resources. However, just 2% of RA patients receive etanercept as a first-line treatment within a year of their diagnosis, whereas about 1% of newly diagnosed patients receive adalimumab. Decision Resources also found that, as a second-line treatment, etanercept is prescribed for 8.6% of newly diagnosed RA patients, compared with 5.7% of patients receiving adalimumab. “Physician familiarity with Enbrel likely contributes to Enbrel's higher patient share in newly diagnosed RA patients. Enbrel has been on the market longer,” Madhuri Borde, Ph. D., of at Decision Resources said in a statement.

Medicare Reduces Bad Payments

Following a pledge to reduce waste, fraud, and abuse in Medicare, the Centers for Medicare and Medicaid Services said in a statement that it has already reduced the error rate for claims since 2009 and is on track to cut it 50% by 2012. Improper payments don't necessarily represent fraud and abuse, the CMS said. Instead, most such errors stem from insufficient documentation and the provision of medically unnecessary services. In 2009, the fee-for-service error rate was more than 12%, or an estimated $35.4 billion in improper claims, according to the report. In 2010, the rate has fallen to less than 11%, or an estimated $34.3 billion. The agency said that it continues to work with providers across the country to help them “eliminate errors through increased and improved training and education outreach.”

Industry-Physician Ties Persist

Although most physicians continue to have financial relationships with industry, the percentage has declined significantly since 2004, according to a study led by Harvard Medical School researchers in Boston. They reported in the Archives of Internal Medicine that although fewer physicians are accepting gifts such as drug samples and food, most continue to do so. About 64% take drug samples, compared with 78% in 2004, and 71% accept free food and beverages, compared with 80% in 2004. However, the number of physicians accepting payments for consulting, speaking, or enrolling patients in clinical trials has fallen by half since 2004, according to the study. Only 18% of physicians said they accept reimbursements for meeting expenses, compared with 35% in 2004, and just 14% receive payments for professional services, compared with 28% in 2004. “These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the researchers concluded. “However, given that 83.8% of physicians have [physician-industry relationships], it is clear that industry still has substantial financial links with the nation's physicians.”

New Bone-Health Goals for 2020

The federal government has issued its new goals for improving public health by 2020, and they include a reduction of the proportion of adults diagnosed with arthritis who find it “very difficult” to perform certain joint-related activities. “Healthy People 2020” focuses on four such activities: walking one-quarter mile; walking up 10 steps without resting; stooping, bending, or kneeling; and using fingers to handle small objects. The federal government is seeking a 10% improvement in each of these areas. For example, 2008 data from the Centers for Disease Control and Prevention showed that 15.2% of adults who have arthritis found it very difficult to walk one-quarter mile. The new goal is to bring that figure down to 13.7%. The complete “Healthy People 2020” objectives are available online at

www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

Arthritis Is Lowest in Hawaii

Only 23% of women in Hawaii report having been diagnosed with arthritis, giving the state the lowest prevalence of the condition among women. On the other end of the spectrum is Alabama, where 38% of women have been diagnosed with arthritis. The figures are part of a new report from the National Women's Law Center, which graded each state on how well it meets women's health needs. The report, the fifth produced by the group and the first since 2007, gave the nation an overall grade of “unsatisfactory.” The nation improved on only 1 of 26 indicators of women's health, rising from “unsatisfactory” to “satisfactory minus” in cholesterol screening for women.

Hospital Adverse Events Common

More than 13% of Medicare beneficiaries hospitalized in late 2008 experienced at least one adverse event causing lasting harm during their stays. Among them, 1.5% experienced an event that contributed to their deaths, according to a report from the Health and Human Services Office of the Inspector General. Another 13% of hospitalized beneficiaries experienced temporary harm, such as hypoglycemia, the report found. The combination of events cost Medicare an estimated $324 million in October 2008, the month the report covered. Physicians reviewing the data said that 44% of the adverse events, such as hospital-acquired infections, and temporary-harm events were clearly or probably preventable.

TNF-Alpha Inhibitors in Early RA

The tumor necrosis factor–alpha inhibitor etanercept (Enbrel) is prescribed more often during the early phases of rheumatoid arthritis than is its competitor adalimumab (Humira), according to an analysis that was performed by the health care research firm Decision Resources. However, just 2% of RA patients receive etanercept as a first-line treatment within a year of their diagnosis, whereas about 1% of newly diagnosed patients receive adalimumab. Decision Resources also found that, as a second-line treatment, etanercept is prescribed for 8.6% of newly diagnosed RA patients, compared with 5.7% of patients receiving adalimumab. “Physician familiarity with Enbrel likely contributes to Enbrel's higher patient share in newly diagnosed RA patients. Enbrel has been on the market longer,” Madhuri Borde, Ph. D., of at Decision Resources said in a statement.

Medicare Reduces Bad Payments

Following a pledge to reduce waste, fraud, and abuse in Medicare, the Centers for Medicare and Medicaid Services said in a statement that it has already reduced the error rate for claims since 2009 and is on track to cut it 50% by 2012. Improper payments don't necessarily represent fraud and abuse, the CMS said. Instead, most such errors stem from insufficient documentation and the provision of medically unnecessary services. In 2009, the fee-for-service error rate was more than 12%, or an estimated $35.4 billion in improper claims, according to the report. In 2010, the rate has fallen to less than 11%, or an estimated $34.3 billion. The agency said that it continues to work with providers across the country to help them “eliminate errors through increased and improved training and education outreach.”

Industry-Physician Ties Persist

Although most physicians continue to have financial relationships with industry, the percentage has declined significantly since 2004, according to a study led by Harvard Medical School researchers in Boston. They reported in the Archives of Internal Medicine that although fewer physicians are accepting gifts such as drug samples and food, most continue to do so. About 64% take drug samples, compared with 78% in 2004, and 71% accept free food and beverages, compared with 80% in 2004. However, the number of physicians accepting payments for consulting, speaking, or enrolling patients in clinical trials has fallen by half since 2004, according to the study. Only 18% of physicians said they accept reimbursements for meeting expenses, compared with 35% in 2004, and just 14% receive payments for professional services, compared with 28% in 2004. “These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the researchers concluded. “However, given that 83.8% of physicians have [physician-industry relationships], it is clear that industry still has substantial financial links with the nation's physicians.”

New Bone-Health Goals for 2020

The federal government has issued its new goals for improving public health by 2020, and they include a reduction of the proportion of adults diagnosed with arthritis who find it “very difficult” to perform certain joint-related activities. “Healthy People 2020” focuses on four such activities: walking one-quarter mile; walking up 10 steps without resting; stooping, bending, or kneeling; and using fingers to handle small objects. The federal government is seeking a 10% improvement in each of these areas. For example, 2008 data from the Centers for Disease Control and Prevention showed that 15.2% of adults who have arthritis found it very difficult to walk one-quarter mile. The new goal is to bring that figure down to 13.7%. The complete “Healthy People 2020” objectives are available online at

www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

Arthritis Is Lowest in Hawaii

Only 23% of women in Hawaii report having been diagnosed with arthritis, giving the state the lowest prevalence of the condition among women. On the other end of the spectrum is Alabama, where 38% of women have been diagnosed with arthritis. The figures are part of a new report from the National Women's Law Center, which graded each state on how well it meets women's health needs. The report, the fifth produced by the group and the first since 2007, gave the nation an overall grade of “unsatisfactory.” The nation improved on only 1 of 26 indicators of women's health, rising from “unsatisfactory” to “satisfactory minus” in cholesterol screening for women.

Hospital Adverse Events Common

More than 13% of Medicare beneficiaries hospitalized in late 2008 experienced at least one adverse event causing lasting harm during their stays. Among them, 1.5% experienced an event that contributed to their deaths, according to a report from the Health and Human Services Office of the Inspector General. Another 13% of hospitalized beneficiaries experienced temporary harm, such as hypoglycemia, the report found. The combination of events cost Medicare an estimated $324 million in October 2008, the month the report covered. Physicians reviewing the data said that 44% of the adverse events, such as hospital-acquired infections, and temporary-harm events were clearly or probably preventable.

TNF-Alpha Inhibitors in Early RA

The tumor necrosis factor–alpha inhibitor etanercept (Enbrel) is prescribed more often during the early phases of rheumatoid arthritis than is its competitor adalimumab (Humira), according to an analysis that was performed by the health care research firm Decision Resources. However, just 2% of RA patients receive etanercept as a first-line treatment within a year of their diagnosis, whereas about 1% of newly diagnosed patients receive adalimumab. Decision Resources also found that, as a second-line treatment, etanercept is prescribed for 8.6% of newly diagnosed RA patients, compared with 5.7% of patients receiving adalimumab. “Physician familiarity with Enbrel likely contributes to Enbrel's higher patient share in newly diagnosed RA patients. Enbrel has been on the market longer,” Madhuri Borde, Ph. D., of at Decision Resources said in a statement.

Medicare Reduces Bad Payments

Following a pledge to reduce waste, fraud, and abuse in Medicare, the Centers for Medicare and Medicaid Services said in a statement that it has already reduced the error rate for claims since 2009 and is on track to cut it 50% by 2012. Improper payments don't necessarily represent fraud and abuse, the CMS said. Instead, most such errors stem from insufficient documentation and the provision of medically unnecessary services. In 2009, the fee-for-service error rate was more than 12%, or an estimated $35.4 billion in improper claims, according to the report. In 2010, the rate has fallen to less than 11%, or an estimated $34.3 billion. The agency said that it continues to work with providers across the country to help them “eliminate errors through increased and improved training and education outreach.”

Industry-Physician Ties Persist

Although most physicians continue to have financial relationships with industry, the percentage has declined significantly since 2004, according to a study led by Harvard Medical School researchers in Boston. They reported in the Archives of Internal Medicine that although fewer physicians are accepting gifts such as drug samples and food, most continue to do so. About 64% take drug samples, compared with 78% in 2004, and 71% accept free food and beverages, compared with 80% in 2004. However, the number of physicians accepting payments for consulting, speaking, or enrolling patients in clinical trials has fallen by half since 2004, according to the study. Only 18% of physicians said they accept reimbursements for meeting expenses, compared with 35% in 2004, and just 14% receive payments for professional services, compared with 28% in 2004. “These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the researchers concluded. “However, given that 83.8% of physicians have [physician-industry relationships], it is clear that industry still has substantial financial links with the nation's physicians.”

Physicians will not face a scheduled 25% pay cut under the Medicare Physician Fee Schedule in 2011, thanks to last-minute action by Congress and the President.

On Dec. 15, President Obama signed a 1-year pay fix into law. The law will eliminate the scheduled deep fee-schedule cut and instead keep Medicare physician fees at their current rate throughout 2011. The law will also extend several Medicare payment provisions throughout 2011, including the 5% increase in payments for certain mental health services.

The legislation (H.R. 4994) was approved by the Senate on Dec. 8 and by the House on Dec. 9.

The fee fix will be paid for by small changes to the Affordable Care Act. Under the ACA, if an individual who receives a tax credit to purchase health insurance has a higher income than what they originally reported, he or she must refund the tax credit, but only up to $250 for individuals and $400 for families who are at or below 400% of the Federal Poverty Level.

Under HR. 4994, the Medicare and Medicaid Extenders Act of 2010, those amounts would be replaced by an income-based tiered repayment structure, saving the federal government about $19 billion over 10 years, according to the Senate Finance Committee.

Nancy-Ann DeParle, director of the White House Office of Health Reform, said that while signing the 1-year pay fix into law was important, the President favors a permanent solution to the Sustainable Growth Rate formula used to pay physicians under Medicare. “After years of temporary measures, the President believes it's time for a permanent solution,” Ms. DeParle wrote in a blog post on Dec. 15.

“Over the next year, the President and his team will work with Congress to address this matter once and for all. We all agree that this formula needs to be changed. Now's the time to get it done,” she added.

The American Medical Association praised Congress and the President for averting the Medicare cuts and giving the program some stability by passing a 1-year fix, as opposed to the short-term approach Congress took throughout 2010. Like the president, the AMA is also pushing Congress for a long-term solution.

“This 1-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program,” AMA President Cecil B. Wilson said in a statement.

Physicians will not face a scheduled 25% pay cut under the Medicare Physician Fee Schedule in 2011, thanks to last-minute action by Congress and the President.

On Dec. 15, President Obama signed a 1-year pay fix into law. The law will eliminate the scheduled deep fee-schedule cut and instead keep Medicare physician fees at their current rate throughout 2011. The law will also extend several Medicare payment provisions throughout 2011, including the 5% increase in payments for certain mental health services.

The legislation (H.R. 4994) was approved by the Senate on Dec. 8 and by the House on Dec. 9.

The fee fix will be paid for by small changes to the Affordable Care Act. Under the ACA, if an individual who receives a tax credit to purchase health insurance has a higher income than what they originally reported, he or she must refund the tax credit, but only up to $250 for individuals and $400 for families who are at or below 400% of the Federal Poverty Level.

Under HR. 4994, the Medicare and Medicaid Extenders Act of 2010, those amounts would be replaced by an income-based tiered repayment structure, saving the federal government about $19 billion over 10 years, according to the Senate Finance Committee.

Nancy-Ann DeParle, director of the White House Office of Health Reform, said that while signing the 1-year pay fix into law was important, the President favors a permanent solution to the Sustainable Growth Rate formula used to pay physicians under Medicare. “After years of temporary measures, the President believes it's time for a permanent solution,” Ms. DeParle wrote in a blog post on Dec. 15.

“Over the next year, the President and his team will work with Congress to address this matter once and for all. We all agree that this formula needs to be changed. Now's the time to get it done,” she added.

The American Medical Association praised Congress and the President for averting the Medicare cuts and giving the program some stability by passing a 1-year fix, as opposed to the short-term approach Congress took throughout 2010. Like the president, the AMA is also pushing Congress for a long-term solution.

“This 1-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program,” AMA President Cecil B. Wilson said in a statement.

Physicians will not face a scheduled 25% pay cut under the Medicare Physician Fee Schedule in 2011, thanks to last-minute action by Congress and the President.

On Dec. 15, President Obama signed a 1-year pay fix into law. The law will eliminate the scheduled deep fee-schedule cut and instead keep Medicare physician fees at their current rate throughout 2011. The law will also extend several Medicare payment provisions throughout 2011, including the 5% increase in payments for certain mental health services.

The legislation (H.R. 4994) was approved by the Senate on Dec. 8 and by the House on Dec. 9.

The fee fix will be paid for by small changes to the Affordable Care Act. Under the ACA, if an individual who receives a tax credit to purchase health insurance has a higher income than what they originally reported, he or she must refund the tax credit, but only up to $250 for individuals and $400 for families who are at or below 400% of the Federal Poverty Level.

Under HR. 4994, the Medicare and Medicaid Extenders Act of 2010, those amounts would be replaced by an income-based tiered repayment structure, saving the federal government about $19 billion over 10 years, according to the Senate Finance Committee.

Nancy-Ann DeParle, director of the White House Office of Health Reform, said that while signing the 1-year pay fix into law was important, the President favors a permanent solution to the Sustainable Growth Rate formula used to pay physicians under Medicare. “After years of temporary measures, the President believes it's time for a permanent solution,” Ms. DeParle wrote in a blog post on Dec. 15.

“Over the next year, the President and his team will work with Congress to address this matter once and for all. We all agree that this formula needs to be changed. Now's the time to get it done,” she added.

The American Medical Association praised Congress and the President for averting the Medicare cuts and giving the program some stability by passing a 1-year fix, as opposed to the short-term approach Congress took throughout 2010. Like the president, the AMA is also pushing Congress for a long-term solution.

“This 1-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program,” AMA President Cecil B. Wilson said in a statement.

The federal government cannot require individuals to purchase health insurance under the recently passed Affordable Care Act, according to a ruling by a U.S. District Court judge in Richmond, Va.

In his decision, Judge Henry E. Hudson wrote that it is outside the constitutional powers of Congress to regulate whether a person purchases a product. As a result, his decision effectively severs section 1501 – the Minimum Essential Coverage provision – from the Affordable Care Act but leaves the remainder of the health reform law intact.

The case, Commonwealth of Virginia v. Kathleen Sebelius, was brought by Virginia Attorney General Ken Cuccinelli.

Mr. Cuccinelli was asking the court to grant an injunction against the implementation of the entire health reform law if the individual mandate was deemed to be unconstitutional.

The U.S. Department of Justice is expected appeal the decision, which could end up in the Supreme Court.

However, if Judge Hudson's ruling stands, the removal of the individual mandate could create serious problems for the overall implementation of the Affordable Care Act.

In defending the law, lawyers for the federal government noted that the success of other portions of the law, such as the provision barring insurers from discriminating against people based on pre-existing medical conditions, depends on the ability to insure all Americans.

This is the first time that opponents of the law have been successful in challenging a portion of the Affordable Care Act. Other challenges to the law in Michigan and Virginia have been dismissed.

The federal government cannot require individuals to purchase health insurance under the recently passed Affordable Care Act, according to a ruling by a U.S. District Court judge in Richmond, Va.

In his decision, Judge Henry E. Hudson wrote that it is outside the constitutional powers of Congress to regulate whether a person purchases a product. As a result, his decision effectively severs section 1501 – the Minimum Essential Coverage provision – from the Affordable Care Act but leaves the remainder of the health reform law intact.

The case, Commonwealth of Virginia v. Kathleen Sebelius, was brought by Virginia Attorney General Ken Cuccinelli.

Mr. Cuccinelli was asking the court to grant an injunction against the implementation of the entire health reform law if the individual mandate was deemed to be unconstitutional.

The U.S. Department of Justice is expected appeal the decision, which could end up in the Supreme Court.

However, if Judge Hudson's ruling stands, the removal of the individual mandate could create serious problems for the overall implementation of the Affordable Care Act.

In defending the law, lawyers for the federal government noted that the success of other portions of the law, such as the provision barring insurers from discriminating against people based on pre-existing medical conditions, depends on the ability to insure all Americans.

This is the first time that opponents of the law have been successful in challenging a portion of the Affordable Care Act. Other challenges to the law in Michigan and Virginia have been dismissed.

The federal government cannot require individuals to purchase health insurance under the recently passed Affordable Care Act, according to a ruling by a U.S. District Court judge in Richmond, Va.

In his decision, Judge Henry E. Hudson wrote that it is outside the constitutional powers of Congress to regulate whether a person purchases a product. As a result, his decision effectively severs section 1501 – the Minimum Essential Coverage provision – from the Affordable Care Act but leaves the remainder of the health reform law intact.

The case, Commonwealth of Virginia v. Kathleen Sebelius, was brought by Virginia Attorney General Ken Cuccinelli.

Mr. Cuccinelli was asking the court to grant an injunction against the implementation of the entire health reform law if the individual mandate was deemed to be unconstitutional.

The U.S. Department of Justice is expected appeal the decision, which could end up in the Supreme Court.

However, if Judge Hudson's ruling stands, the removal of the individual mandate could create serious problems for the overall implementation of the Affordable Care Act.

In defending the law, lawyers for the federal government noted that the success of other portions of the law, such as the provision barring insurers from discriminating against people based on pre-existing medical conditions, depends on the ability to insure all Americans.

This is the first time that opponents of the law have been successful in challenging a portion of the Affordable Care Act. Other challenges to the law in Michigan and Virginia have been dismissed.

Dr. Shakeeb Chinoy, a pediatrician in Grand Rapids, Mich., earned two top honors from the American Medical Association in 2010 for his work on public policy issues.

In March, Dr. Chinoy of the department of pediatrics at Michigan State University, East Lansing, was awarded the Excellence in Medicine Leadership Award from the AMA Foundation. As the philanthropic arm of the AMA, the foundation honors physicians who demonstrate outstanding leadership in advocacy, community service, and education. The awards were presented in Washington, in association with Pfizer Inc.

Dr. Chinoy was one of only four early-career physicians who won the award. He caught the AMA's attention for his study of the possible association between health care costs and medical liability laws. In a study presented to the Pediatric Academic Society, Dr. Chinoy and his colleagues at the University of Michigan, Ann Arbor, compared health care costs between states that had enacted caps on noneconomic damages in medical liability suits and those that had not.

The researchers compared hospitalization rates and hospital costs among the states. Dr. Chinoy said that he and his colleagues were surprised when the study revealed that states with tort reform didn't necessarily have lower costs. However, Dr. Chinoy said he thinks that more time may be needed to reveal any impact from newer tort reform laws. He added that he hopes to study this question within the next few years.

Aside from medical liability reform, Dr. Chinoy is interested in preventive care and helping children lead healthier lifestyles, he said.

His other 2010 honor from the AMA was the group's Community Service Award for his role in developing a program to help overweight children get fit by making dietary and lifestyle changes.

Dr. Chinoy said he encourages children to get active by offering them free sports physicals.

As a member of the legislative and government affairs committee of the Michigan chapter of the American Academy of Pediatrics, he also has advocated state laws and regulations that benefit children, from legislation mandating car seat use to that funding the state's immunization registry. Of pediatric patients he said, “Just taking care of them when they're sick is only half the job.”

Surgeon General Regina Benjamin with Dr. Shakeeb Chinoy at an AMA awards presentation: Dr. Chinoy won two AMA awards in 2010 for public policy work.

Source Mary Ellen Schneider/Elsevier Global Medical News

Dr. Shakeeb Chinoy, a pediatrician in Grand Rapids, Mich., earned two top honors from the American Medical Association in 2010 for his work on public policy issues.

In March, Dr. Chinoy of the department of pediatrics at Michigan State University, East Lansing, was awarded the Excellence in Medicine Leadership Award from the AMA Foundation. As the philanthropic arm of the AMA, the foundation honors physicians who demonstrate outstanding leadership in advocacy, community service, and education. The awards were presented in Washington, in association with Pfizer Inc.

Dr. Chinoy was one of only four early-career physicians who won the award. He caught the AMA's attention for his study of the possible association between health care costs and medical liability laws. In a study presented to the Pediatric Academic Society, Dr. Chinoy and his colleagues at the University of Michigan, Ann Arbor, compared health care costs between states that had enacted caps on noneconomic damages in medical liability suits and those that had not.

The researchers compared hospitalization rates and hospital costs among the states. Dr. Chinoy said that he and his colleagues were surprised when the study revealed that states with tort reform didn't necessarily have lower costs. However, Dr. Chinoy said he thinks that more time may be needed to reveal any impact from newer tort reform laws. He added that he hopes to study this question within the next few years.

Aside from medical liability reform, Dr. Chinoy is interested in preventive care and helping children lead healthier lifestyles, he said.

His other 2010 honor from the AMA was the group's Community Service Award for his role in developing a program to help overweight children get fit by making dietary and lifestyle changes.

Dr. Chinoy said he encourages children to get active by offering them free sports physicals.

As a member of the legislative and government affairs committee of the Michigan chapter of the American Academy of Pediatrics, he also has advocated state laws and regulations that benefit children, from legislation mandating car seat use to that funding the state's immunization registry. Of pediatric patients he said, “Just taking care of them when they're sick is only half the job.”

Surgeon General Regina Benjamin with Dr. Shakeeb Chinoy at an AMA awards presentation: Dr. Chinoy won two AMA awards in 2010 for public policy work.

Source Mary Ellen Schneider/Elsevier Global Medical News

Dr. Shakeeb Chinoy, a pediatrician in Grand Rapids, Mich., earned two top honors from the American Medical Association in 2010 for his work on public policy issues.

In March, Dr. Chinoy of the department of pediatrics at Michigan State University, East Lansing, was awarded the Excellence in Medicine Leadership Award from the AMA Foundation. As the philanthropic arm of the AMA, the foundation honors physicians who demonstrate outstanding leadership in advocacy, community service, and education. The awards were presented in Washington, in association with Pfizer Inc.

Dr. Chinoy was one of only four early-career physicians who won the award. He caught the AMA's attention for his study of the possible association between health care costs and medical liability laws. In a study presented to the Pediatric Academic Society, Dr. Chinoy and his colleagues at the University of Michigan, Ann Arbor, compared health care costs between states that had enacted caps on noneconomic damages in medical liability suits and those that had not.

The researchers compared hospitalization rates and hospital costs among the states. Dr. Chinoy said that he and his colleagues were surprised when the study revealed that states with tort reform didn't necessarily have lower costs. However, Dr. Chinoy said he thinks that more time may be needed to reveal any impact from newer tort reform laws. He added that he hopes to study this question within the next few years.

Aside from medical liability reform, Dr. Chinoy is interested in preventive care and helping children lead healthier lifestyles, he said.

His other 2010 honor from the AMA was the group's Community Service Award for his role in developing a program to help overweight children get fit by making dietary and lifestyle changes.

Dr. Chinoy said he encourages children to get active by offering them free sports physicals.

As a member of the legislative and government affairs committee of the Michigan chapter of the American Academy of Pediatrics, he also has advocated state laws and regulations that benefit children, from legislation mandating car seat use to that funding the state's immunization registry. Of pediatric patients he said, “Just taking care of them when they're sick is only half the job.”

Surgeon General Regina Benjamin with Dr. Shakeeb Chinoy at an AMA awards presentation: Dr. Chinoy won two AMA awards in 2010 for public policy work.

Source Mary Ellen Schneider/Elsevier Global Medical News

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool, called Physician Compare, is available online at www.medicare.gov/find-a-doctor. The tool is modeled after the Hospital Compare Web site (www.hospitalcompare.hhs.gov), which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool, called Physician Compare, is available online at www.medicare.gov/find-a-doctor. The tool is modeled after the Hospital Compare Web site (www.hospitalcompare.hhs.gov), which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool, called Physician Compare, is available online at www.medicare.gov/find-a-doctor. The tool is modeled after the Hospital Compare Web site (www.hospitalcompare.hhs.gov), which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

[Doctors, Patients May Benefit From Medicare Hospital Database]

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

[Doctors, Patients May Benefit From Medicare Hospital Database]

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Medicare officials on Dec. 30 launched a new online tool that allows consumers to locate physicians in their communities and get information about their specialties, degrees, and other training.

The new tool is called Physician Compare. It is modeled after Hospital Compare, which allows consumers to compare hospitals based on quality data and patient evaluations. Currently, the Physician Compare Web site contains mostly practice information. However, it does let consumers know if the practice reported quality data to the Centers for Medicare and Medicaid Services under the Physician Quality Reporting System, a voluntary program for reporting quality metrics on Medicare patients. More than 200,000 physicians and other health care providers reported data to the CMS under the voluntary system in 2009.

[Doctors, Patients May Benefit From Medicare Hospital Database]

"The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other health care workers," Dr. Donald Berwick, CMS administrator, said in a statement. "This helps to pave the way for consumers" to have information about physicians as they do for nursing homes, home health agencies, and health and drug plans, Dr. Berwick noted.

In 2011, officials at the CMS plan to add information to Physician Compare about whether doctors are participating in the voluntary electronic prescribing program. Under the Affordable Care Act, the CMS is required to expand the Web site to include information on quality of care and patient experience data by 2013.

Root cause analysis has become a staple at most hospitals, but Dr. Adrienne Green is working to make sure that the lessons learned in these sessions last long after the case is presented in a hospital conference room.

As the chair of the Patient Safety Committee at the University of California, San Francisco (UCSF), Medical Center, Dr. Green wants to take the root cause analysis process to the next step: finding ways to ensure that systems changes implemented after the root cause analysis are sustained over the long term and disseminated throughout the hospital.

“We’re working on figuring out ways to disseminate our learnings, making sure that the changes that need to be spread get spread throughout the hospital, and trying to figure out a way to follow up on the sustainability of our improvements,” said Dr. Green, a hospitalist and the associate chief medical officer at UCSF.

Dr. Green, whose portfolio as associate chief medical officer includes working to improve door to floor time for admitted patients and reducing preventable readmissions, said she is excited about taking root cause analysis in a new direction. “I really enjoy working to bring physicians together with other disciplines within the medical center to fix systems,” she said.

The root cause analysis process has been in place at UCSF for more than 5 years. The analyses are conducted under the auspices of the Patient Safety Committee, whose members, together with local experts and front-line providers involved in an event, review serious events, reportable events, and near misses. The whole process has become more structured and rigorous over time, Dr. Green said.

Part of that evolution has involved generating action items at the close of each root cause analysis and assigning someone who is accountable for implementing each one. Those individuals then report back to the committee 6-8 weeks later, depending on the seriousness of the event. And they keep coming back until the committee is satisfied that the original problem has been addressed.

Over the last year, Dr. Green and her colleagues conducted a review of selected changes to determine if they were maintained over time. They found that about half of the changes that had been implemented through root cause analysis had been sustained, while others “had morphed, and some had just completely fallen by the wayside,” Dr. Green said.

For other hospitalists looking to revamp their root cause analysis process, Dr. Green recommends imposing a firm structure and holding regular meetings. At UCSF, they meet every Wednesday. While this is time consuming, Dr. Green says it’s the best way to keep up with the initial analyses and the follow-up. She also recommends that hospitals adopt structured templates for documenting the root cause analysis and the resulting action items.

Dr. Green cautioned physicians who chair these committees not to try to do it all on their own. She relies heavily on her patient safety coordinator to analyze events and incident reports, help coordinate the initial root cause analysis and follow-up, and “play detective” when needed.

Another element that is critical to a successful root cause analysis process is to build a committee of experts who can ask challenging questions and command the respect of the hospital’s physicians and staff. Then people know that if they’ve promised something to the committee, they need to deliver it, Dr. Green said. “That comes through having the right people at the table.”

Root cause analysis has become a staple at most hospitals, but Dr. Adrienne Green is working to make sure that the lessons learned in these sessions last long after the case is presented in a hospital conference room.

As the chair of the Patient Safety Committee at the University of California, San Francisco (UCSF), Medical Center, Dr. Green wants to take the root cause analysis process to the next step: finding ways to ensure that systems changes implemented after the root cause analysis are sustained over the long term and disseminated throughout the hospital.

“We’re working on figuring out ways to disseminate our learnings, making sure that the changes that need to be spread get spread throughout the hospital, and trying to figure out a way to follow up on the sustainability of our improvements,” said Dr. Green, a hospitalist and the associate chief medical officer at UCSF.

Dr. Green, whose portfolio as associate chief medical officer includes working to improve door to floor time for admitted patients and reducing preventable readmissions, said she is excited about taking root cause analysis in a new direction. “I really enjoy working to bring physicians together with other disciplines within the medical center to fix systems,” she said.

The root cause analysis process has been in place at UCSF for more than 5 years. The analyses are conducted under the auspices of the Patient Safety Committee, whose members, together with local experts and front-line providers involved in an event, review serious events, reportable events, and near misses. The whole process has become more structured and rigorous over time, Dr. Green said.

Part of that evolution has involved generating action items at the close of each root cause analysis and assigning someone who is accountable for implementing each one. Those individuals then report back to the committee 6-8 weeks later, depending on the seriousness of the event. And they keep coming back until the committee is satisfied that the original problem has been addressed.

Over the last year, Dr. Green and her colleagues conducted a review of selected changes to determine if they were maintained over time. They found that about half of the changes that had been implemented through root cause analysis had been sustained, while others “had morphed, and some had just completely fallen by the wayside,” Dr. Green said.

For other hospitalists looking to revamp their root cause analysis process, Dr. Green recommends imposing a firm structure and holding regular meetings. At UCSF, they meet every Wednesday. While this is time consuming, Dr. Green says it’s the best way to keep up with the initial analyses and the follow-up. She also recommends that hospitals adopt structured templates for documenting the root cause analysis and the resulting action items.

Dr. Green cautioned physicians who chair these committees not to try to do it all on their own. She relies heavily on her patient safety coordinator to analyze events and incident reports, help coordinate the initial root cause analysis and follow-up, and “play detective” when needed.

Another element that is critical to a successful root cause analysis process is to build a committee of experts who can ask challenging questions and command the respect of the hospital’s physicians and staff. Then people know that if they’ve promised something to the committee, they need to deliver it, Dr. Green said. “That comes through having the right people at the table.”

Root cause analysis has become a staple at most hospitals, but Dr. Adrienne Green is working to make sure that the lessons learned in these sessions last long after the case is presented in a hospital conference room.

As the chair of the Patient Safety Committee at the University of California, San Francisco (UCSF), Medical Center, Dr. Green wants to take the root cause analysis process to the next step: finding ways to ensure that systems changes implemented after the root cause analysis are sustained over the long term and disseminated throughout the hospital.

“We’re working on figuring out ways to disseminate our learnings, making sure that the changes that need to be spread get spread throughout the hospital, and trying to figure out a way to follow up on the sustainability of our improvements,” said Dr. Green, a hospitalist and the associate chief medical officer at UCSF.

Dr. Green, whose portfolio as associate chief medical officer includes working to improve door to floor time for admitted patients and reducing preventable readmissions, said she is excited about taking root cause analysis in a new direction. “I really enjoy working to bring physicians together with other disciplines within the medical center to fix systems,” she said.

The root cause analysis process has been in place at UCSF for more than 5 years. The analyses are conducted under the auspices of the Patient Safety Committee, whose members, together with local experts and front-line providers involved in an event, review serious events, reportable events, and near misses. The whole process has become more structured and rigorous over time, Dr. Green said.

Part of that evolution has involved generating action items at the close of each root cause analysis and assigning someone who is accountable for implementing each one. Those individuals then report back to the committee 6-8 weeks later, depending on the seriousness of the event. And they keep coming back until the committee is satisfied that the original problem has been addressed.

Over the last year, Dr. Green and her colleagues conducted a review of selected changes to determine if they were maintained over time. They found that about half of the changes that had been implemented through root cause analysis had been sustained, while others “had morphed, and some had just completely fallen by the wayside,” Dr. Green said.

For other hospitalists looking to revamp their root cause analysis process, Dr. Green recommends imposing a firm structure and holding regular meetings. At UCSF, they meet every Wednesday. While this is time consuming, Dr. Green says it’s the best way to keep up with the initial analyses and the follow-up. She also recommends that hospitals adopt structured templates for documenting the root cause analysis and the resulting action items.

Dr. Green cautioned physicians who chair these committees not to try to do it all on their own. She relies heavily on her patient safety coordinator to analyze events and incident reports, help coordinate the initial root cause analysis and follow-up, and “play detective” when needed.

Another element that is critical to a successful root cause analysis process is to build a committee of experts who can ask challenging questions and command the respect of the hospital’s physicians and staff. Then people know that if they’ve promised something to the committee, they need to deliver it, Dr. Green said. “That comes through having the right people at the table.”

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

[Virginia Judge Strikes Down Individual Health Insurance Mandate]

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

[National Health Spending Expected to Continue Growing for Next 10 Years]

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

[Virginia Judge Strikes Down Individual Health Insurance Mandate]

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

[National Health Spending Expected to Continue Growing for Next 10 Years]

Congress is set to leave for the year without funding one of the biggest pieces of legislation passed in 2010 - the Affordable Care Act.

[Virginia Judge Strikes Down Individual Health Insurance Mandate]

Democrats in the Senate had proposed allocating about $1 billion to implement ACA provisions in 2011, but their effort to pass the funding as part of an omnibus appropriations bill failed. With senators unable to agree on a number of appropriations issues, they scrapped the omnibus plan and on Dec. 21 passed a continuing resolution that will fund federal agencies at their 2010 levels through March 4. The short-term budget resolution also passed the House on Dec. 21.

The continuing resolution sets up a major budget battle between Democrats and Republicans in early 2011, when the GOP takes over the majority in the House. Many Republican lawmakers who opposed the Affordable Care Act have said they will vote not to fund implementation of the new law.

[National Health Spending Expected to Continue Growing for Next 10 Years]