Longer looks: Life of a Medicare demo project; Broken hearts; AIDS funding

Dec 2 2011

Every week, reporter Jessica Marcy selects interesting reads from around the Web.

American Medical News: Medicare Demonstration Projects: From Idea To Implementation
Today's Medicare demonstration project might determine how physicians interact with the program tomorrow, so naturally such projects generate a lot of buzz in the health care community. Lately, some of that buzz has been about how demos might provide part of the solution for Medicare's payment problems. At a conceptual level, Medicare demonstration projects appear well-suited to the payment reform issue. Federal officials and health professionals agree that the current fee-for-service system based on the sustainable growth rate formula is not working, but there is no consensus on what to do about it. Testing alternatives on a smaller scale could help determine how the system should be replaced without the need to commit to a concrete plan from the outset. …. CMS hopes the innovation center, authorized last year by the health system reform law, provides even more opportunities for doctors to realize the promise of the Medicare demonstration project in finding a better way to pay physicians (Charles Fiegl, 11/28).

TIME: Why Are Women More Vulnerable To Broken Hearts?
Women are a lot more likely to suffer a broken heart than men, researchers say. The good news is that it probably won't kill you. In the first national study of its kind, researchers at the University of Arkansas looked at rates of "broken heart syndrome" -; when a sudden shock or prolonged stress causes heart attack-like symptoms or heart failure -; and found that it overwhelmingly affects women. Women are at least seven times more likely than men to suffer the syndrome, and older women are at greater risk than younger ones, according to data presented Wednesday at the American Heart Association conference in Orlando. Broken heart syndrome can happen in response to shocking or suddenly emotional events -; both positive ones like winning the lottery, or negative ones like a car accident or the unexpected death of a loved one (Meredith Melnick, 11/17).

Salon/Global Post: The New AIDS Crisis: Funding
Thirty years after the discovery of AIDS, scientists believe for the first time that they now have the tools to beat back the deadly virus. The evidence is found in HIV prevention research conducted here on the shores of Lake Victoria and in several other parts of sub-Saharan Africa, long the epicenter of AIDS. The most notable research discovery stems from the HIV Prevention Trials Network 052 clinical trial, a U.S.-funded, nine-country study that found early treatment reduced the risk of HIV transmission to an uninfected partner by 96 percent. … This collision of scientific advances vs. economic realities also comes at a heightened political moment of the U.S.'s own making: Secretary of State Hillary Rodham Clinton earlier this month called for an "AIDS-free generation," and the United States' actions on AIDS will be in the spotlight during next July's International AIDS Society conference in Washington, D.C., which is being held in the U.S. for the first time in 22 years due to the Obama administration's decision last year to end U.S. entry restrictions on people who have HIV (John Donnelly, 11/30).

Huffington Post: A Roadmap For Achieving An AIDS-Free Generation
The announcement of a roadmap to achieve an AIDS-free generation is a fitting way to commemorate the 30th anniversary of the reporting of the first cases of AIDS in 1981. For the first time in the history of the epidemic, the possibility of an AIDS-free generation is in sight. … As our global HIV/AIDS efforts expand internationally, we must do more to control the epidemic in the United States as well. In August, the Centers for Disease Control and Prevention (CDC) released a report stating that the number of new HIV infections has remained unchanged over the past decade -; 50,000 each year, and there are still more than 18,000 deaths annually from HIV-related causes. ... And while there has been significant progress in decreasing the number of new infections and deaths from the disease in the developing world, an AIDS amnesia has occurred in America with many people -; especially youth unaware that the illness is a persistent health threat in the U.S. (Susan Blumenthal and Melissa Shive, 11/30).

O, The Oprah Magazine: What Happens When You Start Recording Every Little Detail of Your Health?
I spend, on average, 128 minutes in REM sleep per night. I require a minimum of 1,400 calories per day to stay alive. My resting heart rate hovers around 57 beats per minute but spikes to 65 when I'm answering e-mail or talking to my husband on the phone. I know all this because I recently spent two weeks following my body's statistics with as many devices, Web services, and phone apps as i could manage at once. … It took only a few days to confirm that yes, self-monitoring does indeed change the way you behave. This is due to what's known as the Hawthorne effect: the tendency to act differently when you know you're being watched (Catherine Price, December 2011).

Slate: The Doctor Will See Your Genome Now
Just over 10 years ago, the sequencing of the first human genome was announced at a White House press conference. In the decade since, the practical application of genomic information has been disappointingly slow. That is about to change. We are rapidly -; much faster than many anticipated-;approaching the widespread clinical use of whole-genome sequencing. WGS involves the complete sequencing of all 6 billion-plus base pairs of DNA in our individual genomes. Just 10 years ago, it cost $100 million to sequence an entire genome. Today, WGS is commercially available for less than $10,000, and several companies are racing to get the cost below $1,000 within the next few years. The $1,000 price tag is the magical flip point at which the National Institutes of Health and many experts in the field believe WGS will be economically feasible for routine use in medical care. Though we haven't reached that $1,000 milestone yet, WGS is already being rapidly adopted across the country (Gary Marchant and Rachel Lindor, 11/25).