Health

Study: Many Medicare Cataract Patients Given Needless Tests

Published

10 years ago

April 16, 2015

MARILYNN MARCHIONE, AP Chief Medical Writer

Millions of older people are getting tests they don’t need to prove they are healthy enough to have cataracts removed, a new study finds. The excess testing before this quick, ultra-safe eye procedure is costing them and Medicare a bundle, and many patients don’t know they can question it, doctors say.

“They should ask, ‘Is it really necessary?'” and how much it will cost them in co-insurance — usually 20 percent under Medicare, said one study leader, Dr. R. Adams Dudley of the University of California, San Francisco.

It’s amazing “how much harm a doctor can do with the wiggle of their pen or a check in a box” to order these tests, he said. “In just seconds they can spend tons of people’s time and money.”

Removing cataracts that cloud vision is the most common elective operation for older adults, done 1.7 million times each year in the United States. It’s an outpatient procedure that takes about 18 minutes and requires only numbing eye drops, not general anesthesia.

“This is one of the lowest-risk surgery procedures you can have,” with less than a 1 percent risk of major heart problems or death, said Dr. Catherine Lee Chen, a UCSF anesthesiologist who led the study.

Yet many doctors order preoperative tests such as blood work, chest X-rays, electrocardiograms and even advanced heart and lung tests to ensure a patient can withstand the procedure.

Major studies found that about half of Medicare recipients were getting such tests before cataract removal, and that routine testing did not improve outcomes or safety. In 2002, several medical groups issued guidelines advising against it.

Chen did the study to see if the situation had improved since then, and found it had not. Looking at Medicare records on more than 440,000 patients who had cataracts removed in 2011, researchers found that 53 percent had at least one test in the month before surgery.

About 13 percent of patients were given one test; 11 percent had two, 10 percent had three, 7 percent had four, and a whopping 13 percent had five or more tests.

The biggest factor in whether tests were ordered was the eye doctor, not characteristics of the patients or their health risks. About 36 percent of eye doctors ordered tests on three-fourths or more of their patients, and 8 percent did so for every patient.

“It could be the policy at their surgery center,” Chen said, yet researchers found that whether the procedure was done at a hospital outpatient center versus somewhere else made little difference in testing rates.

The study is in Thursday’s New England Journal of Medicine.

The results are surprising, said Ellen Meara, a professor at the Dartmouth Institute for Health Policy and Clinical Practice.

“It suggests a lot of unnecessary testing,” and that patients should be questioning it, she said.

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Gov. Newsom Goes to Washington to Advocate for California Priorities

Gov. Gavin Newsom traveled to Washington, D.C., for meetings with senior Biden-Harris Administration officials and members of California’s congressional delegation. During the week, he pushed for increased resources to improve public safety and quality of life in California.

Published

1 week ago

November 26, 2024

Oakland Post

Gov. Newsom visits the White House on Nov. 14. Photo courtesy of Gov.Ca. Gov

By Bo Tefu, California Black Media

Gov. Gavin Newsom traveled to Washington, D.C., for meetings with senior Biden-Harris Administration officials and members of California’s congressional delegation.

During the week, he pushed for increased resources to improve public safety and quality of life in California.

“California is continuing our work to secure additional tools and resources to improve access to health care, clean air and water, and secure critical funding to support communities recovering from disasters,” said Newsom.

At the White House, Newsom met with President Joe Biden and key officials, advocating for disaster relief funding, healthcare expansion, and environmental protection. He also engaged in discussions with senior Biden-Harris officials, including Interior Secretary Deb Haaland, to address water quality improvements and the San Luis Dam project, which will support water supplies for two million Californians.

“Building on our strong partnership with the Biden-Harris Administration, California is working closely with the White House over the next two months to deliver the critical protections and resources our communities need,” Newsom said.

On Capitol Hill, Newsom met with California Senators Alex Padilla and Adam Schiff, along with other Congressional leaders, to emphasize the need to approve pending disaster funding, healthcare programs, and environmental protections. He also previewed California’s upcoming special session to proactively address potential federal challenges when President-elect Donald Trump is sworn into office.

Newsom’s discussions also focused on securing Medicaid waivers from the Center for Medicare & Medicaid Services (CMS) to enhance behavioral health services and reduce homelessness. The state seeks approval for the BH-CONNECT waiver, which would address behavioral health and homelessness, and the MCO Tax Waiver, which would provide over $20 billion for Medi-Cal to improve healthcare access.

Additionally, California is pushing for Clean Air Act waivers from the U.S. Environmental Protection Agency (EPA), which are crucial for enforcing air quality regulations. These measures are projected to prevent 11,000 premature deaths and provide $116 billion in health benefits over the next three decades, according to the Governor’s office.

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California Reports First Case of Mpox in the United States

On Nov. 16, the California Department of Public Health (CDPH), reported the first known case of clade 1 Mpox, previously known as Monkeypox, in the United States. However, the risk to the public remains low, according to the CDPH.

Published

1 week ago

November 26, 2024

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By Bo Tefu, California Black Media

On Nov. 16, the California Department of Public Health (CDPH), reported the first known case of clade 1 Mpox, previously known as Monkeypox, in the United States.

However, the risk to the public remains low, according to the CDPH.

“This case was confirmed in an individual who recently traveled from Africa and is related to the ongoing outbreak of clade I mpox in Central and Eastern Africa,” reads a statement the CDPH released.

According to the DDPH, “The affected individual received health care in San Mateo County based on their travel history and symptoms. The individual is isolating at home and recovering.”

Public health workers are also conducting a contact tracing exercise and reaching out to people who have been in close proximity to the affected person.

“The mpox specimens from the traveler are being sent to the CDC for further laboratory testing,” the CDPH press release continues.

Californians can take a number of steps to prevent Mpox. Here’s more information:

Preventing Mpox Infection

It appears clade I mpox spreads in a similar manner as clade II mpox, through close (skin-skin), intimate and sexual contact. The identification of a potentially more severe mpox version in the United States is a good reminder for individuals who have certain risk factors to take preventive action, including:

Getting vaccinated if you may be at risk for mpox. For the greatest protection, make sure you get both doses of the vaccine. Find mpox vaccine (JYNNEOS) near you.
Taking precautions if you were exposed to mpox. Get the mpox vaccine before symptoms develop and consider avoiding intimate contact with others for 21 days. Watch yourself for symptoms and get tested if they develop.
Preventing spread if you have been told you have mpox. Avoid contact with others until the rash is healed, clean and disinfect shared areas in the home, and notify people who may have been exposed.
Talking to your sexual partner(s).
Avoiding skin-to-skin contact with those who have a rash or sores that look like mpox.
Not sharing items with someone who has mpox.
Washing your hands often.
Protecting yourself when caring for someone with mpox by using masks, gowns and gloves.

Visit the CDPH website to learn more about Mpox with Sexual Health Toolkits and a Campaign Materials Page.

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California Department of Aging Offers Free Resources for Family Caregivers in November

In honor of National Family Caregivers Month this November, the California Department of Aging (CDA) is spotlighting a range of free resources to support caregivers of older adults and individuals with disabilities. Through its extensive network of Caregiver Resource Centers (CRCs) and Area Agencies on Aging (AAAs), the state provides essential tools to help caregivers manage their responsibilities while prioritizing their own health and well-being.

Published

1 week ago

November 26, 2024

Oakland Post

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By Bo Tefu, California Black Media

“Caregiving is a great act of love, and this month — and every day — we uplift California’s caregivers as the under-recognized backbone of our families and communities,” said Susan DeMarois, director of the CDA. DeMarois emphasized the need for caregivers to access available support to better balance their roles without compromising their own health.

California is home to more than 4.5 million unpaid family caregivers, who contribute an estimated $81 billion annually in economic value through their care. Most caregivers are women who balance work, family, and caregiving responsibilities, often at the cost of their physical and emotional health. Given California’s aging population, the demand for caregiver support is rapidly growing, underscoring the importance of these free resources.

Thousands of caregivers accessed these services in the 2022-2023 fiscal year, benefiting from tools like professional care management and respite support. The Aging in California Resource Guide, available in six languages, offers additional information on caregiver support.

Caregivers can learn more about available resources by visiting the CDA website at aging.ca.gov and connecting with local CRCs or AAAs to discover personalized services to support them in their caregiving journey.