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From the September 1996 ACP Observer, copyright 1996 by the American College of Physicians.

AMA designing accreditation process for physicians

Just as JCAHO accredits hospitals and NCQA accredits health plans, the AMA wants to become the organization responsible for accrediting physicians.

The AMA announced plans this summer to replace "the current duplicative and fragmented patchwork of existing [physician quality] assessment programs" with a new "comprehensive program" that will establish a universally accepted standard of physician excellence.

The Board of Trustees at its June meeting in Chicago approved plans for the "AMA Program for Physician Accreditation."

AMA officials said they are trying to address the problem physicians face as managed care organizations build provider panels and develop physician profiles. Each managed care organization is trying to determine physician quality in different ways.

By having one organization-the AMA-develop a standard set of measures of physician quality, AMA officials said, "physicians will be freed from duplicative credentialing processes and office visit protocols, which use disparate evaluation criteria and often reach different conclusions about the quality and efficiency of a physician's care."

AMA officials expect development of the program to take several years.

Are Medicare HMO patients really healthier?

A new study challenges the conventional wisdom that Medicare patients who get their health care through HMOs are significantly healthier than those who remain in fee-for-service Medicare.

The study, conducted by Price Waterhouse and released by the American Association of Health Plans (AAHP), found that while more fee-for-service patients had chronic heart conditions (27% compared with 18%), slightly more HMO patients had other chronic health conditions that can be even costlier. These conditions included diabetes (16% of Medicare HMO-enrollees compared with 12% in fee-for-service), asthma (14% compared with 13%) and stroke (4% compared with 3%).

Overall, the study found that Medicare HMO patients report feeling somewhat healthier than their counterparts in fee-for-service plans. Nearly a quarter of Medicare HMO members reported they were in "excellent" health, compared with 21% of fee-for-service beneficiaries.

From this report AAHP concludes that HMOs are not being overcompensated by the current Medicare risk formula, which pays HMOs 95% of the estimated cost of caring for similar patients in the same geographic area under fee-for-service Medicare. Critics of the current system have charged that Medicare HMOs are being overpaid because they are caring for a much healthier group of Medicare beneficiaries. AAHP (formerly GHAA/AMCRA) represents HMOs, PPOs and other managed care health plans.

FDA warns of spontaneous latex combustion

Prompted by four fires in different states caused by the spontaneous combustion of powder-free latex patient examination gloves, the FDA has issued safe storage guidelines.

The guidelines state that latex gloves should not be stored in large quantities in conditions of extreme heat. The following are some of the specific recommended precautions:

  • Avoid keeping a large inventory, and rotate stock using "first-in-first-out" practices.
  • Remove shrink-wrap from pallets of stacked cartons.
  • Break stacks apart to facilitate cooling ventilation.
  • Periodically check latex gloves for characteristics suggesting deterioration, such as brittleness, tackiness or an acrid chemical odor. Any gloves that appear to be deteriorating should not be used, the FDA said.

The fires, all of which occurred in warehouses, involved large quantities of non-sterile, powder-free, chlorinated latex gloves stored on pallets. They were labeled "Made in China."

For more information from the FDA, call 800-899-0381 or access the FDA web page at http://www.fda.gov/cdrh/cdrhhome.

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