NEW YORK CITY: Medicaid HMO Docs’ Asthma Care Ranked
"Thousands of New Yorkers with severe asthma are receiving deficient medical care from doctors in [HMOs] hired under a state program," the New York Daily News reports. According to a study conducted for the state Health Department by IPRO, a Long Island-based consulting firm, HMOs are "failing to give asthma sufferers essential treatment." The study included 2,362 asthmatic "children and adults enrolled in managed care under New York's Medicaid program ... who suffered asthma attacks severe enough to send them to the hospital during 1994 or 1995." Results of the IPRO study show that "[n]early 70% of the asthma sufferers did not receive the key medicines designed to control the underlying lung inflammation that causes asthma," which according to Scott Schroeder, pediatric asthma expert at Montefiore Medical Center in the Bronx, "is now the standard of care." The study also showed that "two-thirds of the patients surveyed never had a followup visit with a doctor after they suffered an attack that sent them to the hospital," and only 3% were given directions on how to use a peak flow meter, an inexpensive instrument that measures lung capacity, "essential for diagnosing asthma and determining its severity," the study said. The study also showed that less than 20% of chronic asthmatics had been tested for asthma-causing "triggers." Other doctors who were shown the study felt that the "managed care system often works against the patients' best interest and can even make them sicker," the Daily News reports.
State Response
Reacting to the study results, state officials said "the problems were being addressed and that the inadequacies mirrored those found in nonsubsidized medical care providers as well." According to Dr. Foster Geston, medical director of the state's Office of Managed Care, the study shows "the need for state-of-the-art treatment to become common clinical practice in both Medicaid managed care and commercial health care programs" (Flynn/Sugarman/Robbins, 3/1).
In Related News
U.S. Rep. Nita Lowey (D-NY) "is launching a campaign to allow New York City to use federal funds to combat the growing" asthma problem, the New York Daily News reports. Lowey wants to use education funding to "detect and monitor asthma among school children and dole out more money to purchase asthma equipment and hire nurses." Lowey also wants to help fund and "expand asthma awareness prevention and treatment programs" by appropriating an additional $10 million to the National Institutes of Health and the Centers for Disease Control and Prevention. If Lowey's plan is adopted, "New York City officials could dip into a $442 million education pot to fund asthma programs" (Galvin, 3/2).