It was among the governments most controversial health care guidelines: Doctors should stop performing a cancer screening theyve provided for decades.

(Toby Melville - Reuters) The screening at hand is the Prostate-Specific Antigen, or PSA test used to screen men for prostate cancer. Last week, the Preventive Services Task Force came out with a recommendation that doctors not perform the screening, contending that it does more harm than good.

The PSA test produces a high level of false positives, with about 80 percent proving not to be cancer. Studies find it does not save lives, largely because prostate cancer often grows too slowly to ever cause medical harm.

The recommendation was certainly divisive: One in two doctors agree with it, according to a new survey published in the Archives of Internal Medicine. Nearly all doctors, however, agree on one thing: Regardless of the guidelines validity, they did not plan to follow it in practice.

Only 1.8 percent of primary care doctors said they would no longer provide routine PSA tests. The survey looked at primary care doctors in Maryland affiliated with the Johns Hopkins Community Physicians. Among that group, 49 percent agreed that ending the PSA test made sense, while 36 percent disagreed.

Researchers asked the doctors what seems like the most obvious question here: If you agree with the guidelines, why not follow them? Three-quarters of the doctors said it had to do with their patients, who expected doctors to continue providing the tests. Two-thirds said they didnt have the time to explain the changes it was faster just to perform the best while a quarter worried that patients would think their health care was being rationed.

The results suggest that...the USPSTF recommendations may encounter significant barriers to adoption, the researchers conclude. To the extent that PSA screening should be reduced, it may be necessary to address patient perceptions about screening, to allow adequate time for screening discussions, and to reduce concerns regarding malpractice litigation.

Part of the challenge may have a lot to do with how we think about medicine. Screenings are supposed to lead to early detection, treatment and, eventually, a cure. As my colleague Brian Vastag writes, we dont hear much in the way to contradict that narrative: No one says: I got a PSA test. It was high, so I got a biopsy. The biopsy caused pain for weeks and made me bleed. But I didnt have cancer. Good thing I got that test.

Beyond the PSA test, the results of this survey also speak to some larger challenges for a growing movement to end unnecessary health care. A few months ago, a group called Choosing Wisely issued a list of 45 procedures that doctors often perform but dont think they should, because they provide little to no benefit.

That list was well-received by medical communities, seen as a laudable way to lower health care costs without reducing quality of medicine. It does, however, leave a lingering question of enforcement: How do you make sure that doctors stop performing the procedures they dont think are necessary? As this study suggests, theres a whole host of obstacles that stand between identifying a specific procedure as wasteful and actually reducing its use in our health care system.

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Many doctors think PSA tests don’t work. But they’ll keep doing them anyway.

Story by Stephanie Snyder

Low-income children in rural California communities are in jeopardy of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say.

The governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the states Childrens Health Insurance Program, to Medi-Cal a program aimed at serving the states poorest families, seniors and disabled residents.

While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could severely limit access to health care for those on the outskirts.

In the more rural areas or outlying areas, there would be quite a loss or quite a strain, said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the American Academy of Pediatrics. Access to care would be a huge issue.

And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they have not already agreed to serve Medi-Cal patients, Cohen said.

The governors proposal not only forces Healthy Families patients to move to Medi-Cal, but it also would require doctors to accept Medi-Cals monthly reimbursement an average cut of nearly 20 percent.

Healthy Families doctors receive a monthly average of $103 per patient. They would receive an average of $84 per patient if they decide to make the switch to Medi-Cal, but California Medical Association spokeswoman Molly Weedn said the reimbursement often can be much less.

Rates that physicians are reimbursed for a Medi-Cal patient are less than what a large pizza costs, she said. Its really incredible that a physician can be reimbursed $18, $20 (per month).

A survey referenced by the Legislative Analysts Office asked pediatricians who now provide care to Healthy Families patients, but not Medi-Cal patients, if they would be willing to make the switch. The February report said 29 percent would not and 46 percent were not sure.

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Kids' access to health care a concern under Brown's budget

Though the health care overhaul faces an uncertain fate next month before the U.S. Supreme Court, preparations for the massive rollout of its medical care coverage might already be leaving a legacy of improved customer service.

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Obamacare May Be Helping Improve Insurers' Notoriously Poor Customer Service

MANCHESTER Granite Healthcare Network, a collaboration among five hospital systems, is partnering with Cigna Health Care on a new accountable care organization.

It's really a great initiative for us, Rachel Rowe, executive director of Granite Healthcare Network, said.

It's the first time Granite Healthcare Network is entering into a partnership with an insurer to provide better health for communities, better care for patients and lower cost, she said.

It also is the first time Cigna has partnered in an accountable care model with multiple organizations, spokesman Mark Slitt said.

Most prior agreements were with a primary care doctor's office, an integrated delivery system including doctors and facilities or a multi-speciality practice.

This is a little bit of a twist, he said.

Granite Healthcare Network is made up of Concord Hospital, Elliot Hospital, LRGHealthcare (Lakes Region General and Franklin Regional hospitals), Southern New Hampshire Health System (Southern New Hampshire Medical Center) and Wentworth-Douglass Hospital in Dover.

The hospitals are adopting analytical programs to improve care and reduce costs. Together, they cover nearly half the state's population.

An accountable care organization is a group of health care professionals that accepts responsibility to be held accountable for the population it serves. Cigna calls its model collaborative accountable care.

Care coordination is well-known to provide better outcome so we're looking forward to the opportunity to work with Cigna on that; Rowe said.

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New twist delivers health care

Low-income children in rural California communities are in jeopardy of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, according to state lawmakers, doctors and health advocates.

The governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the state's Children's Health Insurance Program, to Medi-Cal -- a program aimed at serving the state's poorest families, seniors and disabled residents.

While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could severely limit access to health care for those on the outskirts.

"In the more rural areas or outlying areas, there would be quite a loss or quite a strain," said Stuart Cohen, a San Diego pediatrician and California chairman-elect for the American Academy of Pediatrics. "Access to care would be a huge issue."

And there would not be much incentive for rural doctors at full capacity to continue caring for their Healthy Families children if they have not already agreed to serve Medi-Cal patients, Cohen said.

The governor's proposal not only forces Healthy Families patients to move to Medi-Cal, but it also would require doctors to accept Medi-Cal's monthly reimbursement -- an average cut of nearly 20%.

Healthy Families doctors receive a monthly average of $103 per patient. They would receive an average of $84 per patient if they decide to make the switch to Medi-Cal, but California Medical Association spokeswoman Molly Weedn said the reimbursement often can be much less.

"Rates that physicians are reimbursed for a Medi-Cal patient are less than what a large pizza costs," she said. "It's really incredible that a physician can be reimbursed $18, $20 [per month]."

A survey referenced by the Legislative Analyst's Office asked pediatricians who now provide care to Healthy Families patients, but not Medi-Cal patients, if they would be willing to make the switch. The February report said 29% would not and 46% were not sure.

Anthony Wright, executive director at Health Access California, a health care advocacy group, said there likely would be a disruption of care for Healthy Families patients in rural areas when their doctors face the decision of whether they can accept a smaller payment.

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State budget puts health care for kids at risk

YARDLEY, Pa.--(BUSINESS WIRE)--

Krames StayWell, the nations leading health care communication and engagement company, has announced its library of discharge instructions is now available directly through the MEDITECH Electronic Health Record (EHR), a leader in health care IT. Known for its application of health literacy design principles, the Krames StayWell database of discharge instructions is designed to facilitate transitions between different care environments and ultimately, patients homes, to support better outcomes and avoid costly re-admissions. The discharge instructions library in MEDITECH is available in English and Spanish.

Krames content is recognized for being patient-friendly and for helping providers educate patients at the point of care, explained Robert True, manager of business development at MEDITECH. Helping to provide superior patient care is at the core of MEDITECHs mission. Creating easy access to Krames content enables us to meet that goal, and we are committed to making it happen.

John George, senior vice president of sales at Krames StayWell, added, Establishing this collaboration was important for us, because so many of our clients use the MEDITECH EHR. They want to reap its documentation and workflow benefits, without sacrificing the benefits driven by Kramesbetter communication between providers and patients for improved outcomes and satisfaction. Now, our clients can benefit from both.

As we head into Stage 2 and Stage 3 of Meaningful Use, health care organizations must offer robust, EHR-based education and engagement solutions to their communities, George continued. Together, Krames StayWell and MEDITECH are laying the groundwork for today and tomorrows needs.

The Krames StayWell-MEDITECH collaboration ensures we engage people in their health self-management, to improve outcomes and overall well-being, while improving safety and lowering costs.

MEDITECH clients interested in accessing Krames StayWell discharge instructions through their EHR can contact their Krames StayWell representative at (800) 203-7902.

About Krames StayWell

Krames StayWell is the largest provider of patient education, consumer health information, and population health management communications in the country. Combining extensive technology and content assets with vast consumer insights and a strategic approach, Krames StayWell is uniquely qualified to engage consumers across the entire spectrum of their health care experience. Our best-in-class health communication solutions integrate print, interactive, and mobile formats at multiple touch points to attract and retain consumers, improve health outcomes, and lower costs. We deliver measurable results for hospitals, health care professionals, health plans, employers, retail pharmacies, government agencies, and association clients with world-class design, commitment to health literacy principles, and a focus on custom development. For more information, please visit http://www.kramesstaywell.com.

About MEDITECH

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Krames StayWell Announces Collaboration with MEDITECH

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Health Care Horror Stirred By Political Ads

stethoscope and pen resting on a sheet of medical lab test results, with patient file and x-ray or mri film

By RICARDO ALONSO-ZALDIVAR, Associated Press

WASHINGTON (AP) They're throwing granny off a cliff!

That's the not-so-subtle message Republicans and Democrats appear to be converging on for political ads on health care this year, featuring heavy doses of what each party alleges the other one plans to do to wreck Medicare.

From cost controls in President Barack Obama's health care law to GOP Rep. Paul Ryan's privatization plan for future Medicare recipients, there's something about health care that makes it a breeding ground for the wildest allegations.

[Photo Gallery: Republican Presidential Candidate Mitt Romney.]

Families feel vulnerable to the catastrophic costs of serious illness, and few understand the labyrinth of private and government insurance, allowing partisans to play to their worst fears. Add to that the belief among political pros that health care worries can drive the votes of seniors.

"It is easy to deceive on the issue because the knowledge base of the electorate when it comes to the complexities of health care is relatively low," said Kathleen Hall Jamieson, an expert on political communication at the University of Pennsylvania's Annenberg Center.

It would be hard to top Sarah Palin's now-debunked assertion that "death panels" lurked in the recesses of Obama's law, but don't be surprised if that happens this year.

"Many people believe crazy things about health care because they want to believe them," said Drew Altman, president of the nonpartisan Kaiser Family Foundation. Some of today's outlandish claims remind him of fears about fluoridated drinking water in the 1950s.

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Political Ads Stir Health Care Horror

WASHINGTON - They're throwing granny off a cliff!

That's the not-so-subtle message Republicans and Democrats appear to be converging on for political ads on health care this year, featuring heavy doses of what each party alleges the other one plans to do to wreck Medicare.

From cost controls in President Barack Obama's health care law to GOP Rep. Paul Ryan's privatization plan for future Medicare recipients, there's something about health care that makes it a breeding ground for the wildest allegations.

Families feel vulnerable to the catastrophic costs of serious illness, and few understand the labyrinth of private and government insurance, allowing partisans to play to their worst fears. Add to that the belief among political pros that health care worries can drive the votes of seniors.

"It is easy to deceive on the issue because the knowledge base of the electorate when it comes to the complexities of health care is relatively low," said Kathleen Hall Jamieson, an expert on political communication at the University of Pennsylvania's Annenberg Center.

It would be hard to top Sarah Palin's now-debunked assertion that "death panels" lurked in the recesses of Obama's law, but don't be surprised if that happens this year.

"Many people believe crazy things about health care because they want to believe them," said Drew Altman, president of the nonpartisan Kaiser Family Foundation. Some of today's outlandish claims remind him of fears about fluoridated drinking water in the 1950s.

Sound far-fetched? It's already started.

A few months ago, former Republican presidential candidate Rick Santorum lent credence to an unfounded rumor that the Obama administration would deny advanced medical treatment to stroke patients over the age of 70, allowing only comfort care. It didn't seem to matter that two doctors' groups and the Health and Human Services Department were shooting down the rumor.

And as for throwing granny off a cliff, two political ads are already depicting just that , one from the left and one from the right. Both dramatizations are getting steady attention on the Internet.

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SPIN METER: Political ads stir health care horror