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Mayo Clinic is urging the Centers for Medicare and Medicaid Services to keep the complexity and diversity of health care and patients in mind as it shifts physician payments from volume-based reimbursement to one based on the value of the care provided.
Mayo on Tuesday submitted written comments to the agencyÂ regarding implementation of a new physician payment system under a law passed earlier this year. Â The Medicare Access and CHIP Reauthorization Act of 2015 repeals and replacesÂ Sustainable Growth Rate-based physician payments with a system designed to reward value and high-quality health care.Â Mayo Clinic has long sought repeal of the SGR, viewing it as unworkable and ineffective.
âAs CMS begins a historic shift from a volume-driven reimbursement system to one based on the value of care provided, bold creative thinking is required to ensure that Medicare beneficiaries have access to the full spectrum of health care, from primary care to highly complex specialized care,â says Robert Nesse, M.D., Mayo's senior director for payment reform.
You can read Mayo's letter to CMS here.
JOURNALISTS: For interviews with Dr. Nesse, please contact Sharon Theimer in Mayo Clinic Public Affairs at 507-284-5005 or email@example.com.
November is Pancreatic Cancer Awareness Month.
Do you have questions about pancreatic cancer diagnosis and treatment, including chemotherapy, radiation and surgery? Share them with Mayo Clinic gastrointestinal surgical oncologist Mark Truty, M.D., in two chats Thursday.
Dr. Truty will take part in a Mayo Clinic chat Nov. 12 on Periscope at noon Eastern. For details on how to view the Periscope chat and ask questions, please go to: http://connect.mayoclinic.org/discussion/on-periscope-qa-with-mark-truty-m-d-about-pancreaticcancer/.
Then at 1 p.m. Eastern, Dr. Truty will participate in a Twitter chat held by the National Cancer Institute and the Pancreatic Cancer Action Network. To view and participate in the Twitter chat, please use hash tag #Pancancer. More details are available here.
JOURNALISTS: For interviews with Dr. Truty, please contact Sharon Theimer in Mayo Clinic Public Affairs at firstname.lastname@example.org or 507-284-5005.
Rheumatoid arthritis patients are twice as likely as the average person to develop heart disease, but a new study shows that efforts to prevent heart problems and diagnose and treat heart disease early may be paying off. Despite the heightened danger, deaths from cardiovascular disease among people with rheumatoid arthritis are declining, the research found. The study was among Mayo Clinic research being presented at the American College of Rheumatologyâs annual meeting in San Francisco.
Other Mayo studies discussed at the conference chronicled a significant increase in gout; examined rare intestinal microbes in rheumatoid arthritis patients; and discovered that people with rheumatoid arthritis use opioid painkillers at a higher rate than the general public, but that it isnât related to disease severity.
In the study on rheumatoid arthritis and heart disease, researchers looked at heart disease deaths within 10 years of rheumatoid arthritis diagnosis among two groups of people: 315 patients diagnosed with rheumatoid arthritis from 2000 to 2007 and 498 patients diagnosed with rheumatoid arthritis in the 1980s and 1990s. They also looked at heart disease deaths among 813 people without the rheumatic disease. Roughly two-thirds of patients studied were women, and the average age was 60.
They found a significantly lower rate of deaths from heart disease in the more recently diagnosed rheumatoid arthritis patients than in those diagnosed earlier: 2.8 percent and 7.9 percent, respectively.
Media contact: Sharon Theimer in Mayo Clinic Public Affairs, 507-284-5005 or email@example.com.
CA 19-9 tumor marker test especially important for early-stage patients, Mayo finds
NAPA, Calif. â Only 1 in 5 U.S. pancreatic cancer patients receive a widely available, inexpensive blood test at diagnosis that can help predict whether they are likely to have a better or worse outcome than average and guide treatment accordingly, a Mayo Clinic study shows. People who test positive for elevated levels of a particular tumor marker tend to do worse than others, but if they are candidates for surgery and have chemotherapy before their operations, this personalized treatment sequence eliminates the elevated biomarkerâs negative effect, researchers found.
The findings will be presented at the Western Surgical Association annual meeting Nov. 7-10 in Napa.
âThis is another argument for giving chemotherapy before surgery in all pancreatic cancer patients and ending the old practice of surgery followed by chemo,â says senior author Mark Truty, M.D., a gastrointestinal surgical oncologist at Mayo Clinic in Rochester, Minn. âThe study answers an important clinical question and applies to every pancreatic cancer patient being considered for surgery.â
The Mayo study, which used the National Cancer Data Base, is the first on the subject based on national data and is the largest of its kind, Dr. Truty says.
JOURNALISTS: For interviews with Dr. Truty, please contactÂ Sharon Theimer in Mayo Clinic Public Affairs at 507-284-5005 or firstname.lastname@example.org. [...]
November is Pancreatic Cancer Awareness Month
Pancreatic cancer has long proved the least survivable of the most common forms of cancer, in part because it tends to spread before symptoms appear. Surgery has offered the longest remissions, but for many people with advanced cancer, an operation wasnât an option. Now, thanks to improvements in chemotherapy, radiation and surgery, even this most recalcitrant of cancers is starting to budge, says Mark Truty, M.D., a Mayo Clinic gastrointestinal surgeon.
Dr. Truty and his colleagues are now performing complex tumor removal operations on pancreatic cancer patients who in the past would have been considered inoperable â and they are seeing survival times rise significantly.
âWe know that patients who go through our preoperative protocol and to the operating room do significantly better than average, compared to historical outcomes. Weâre looking at three- to four-fold improvement in overall survival,â Dr. Truty says. âIn the past few years, we have done operations that were never performed before. With improved chemotherapy and radiation therapy, weâre now beginning to push the envelope surgically.â
Journalists: Video and audio cuts of Dr. Truty are available in the downloads.
For interviews with Dr. Truty, please contact Sharon Theimer in Mayo Clinic Public Affairs at 507-284-5005 or email@example.com.
Dr. Truty explains who is a candidate for pancreatic cancer surgery, the types of operations, recovery times and outcomes:
ROCHESTER, Minn. âÂ Opioid painkiller addiction and accidental overdoses have become far too common across the United States. To try to identify who is most at risk, Mayo Clinic researchers studied how many patients prescribed an opioid painkiller for the first time progressed to long-term prescriptions. The answer: 1 in 4. People with histories of tobacco use and substance abuse were likeliest to use opioid painkillers long-term.
The findings are published in the July issue of the medical journal Mayo Clinic Proceedings.
While the study identified past or present nicotine use and substance abuse as top risk factors for long-term use of opioids, all patients should proceed with caution when offered opioid painkiller prescriptions, says lead author W. Michael Hooten, M.D., an anesthesiologist at Mayo Clinic in Rochester.
âFrom a patient perspective, it is important to recognize the potential risks associated with these medications. I encourage use of alternative methods to manage pain, including non-opioid analgesics or other nonmedication approaches,â Dr. Hooten says. âThat reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.â
MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: firstname.lastname@example.orgÂ [...]
"The federal premium subsidies will continue to reduce the cost of insurance for the millions of Americans who receive them and continue to improve access to health care,â says John Noseworthy, M.D., CEO of Mayo Clinic, which has campuses in Minnesota, Florida and Arizona. âIt is important that we not step back from our commitment to health insurance coverage for all Americans.â
MEDIA CONTACT:Â Sharon Theimer, Mayo Clinic Public Affairs, email@example.com / 507-284-5005.
WASHINGTON â Mayo Clinic is participating in the White House Forum on Excellence and Innovation through Diversity in the STEM Workforce. Participants will meet tonight and Tuesday to discuss their organizationsâ efforts to increase diversity among science, technology, engineering and math professionals. Sharonne Hayes, M.D., director of diversity and inclusion at Mayo, calls medicine the âextra Mâ in STEM; as an academic medical center focused on health care, research and education, Mayo offers a wide range of STEM-related employment and is working to increase diversity.
WHO:Â Â Â Sharonne Hayes, M.D., director of diversity and inclusion at Mayo Clinic in Rochester, Minn.Â Â
WHAT: Â The White House Forum on Excellence and Innovation through Diversity in the STEM Workforce, sponsored by the White House Office of Science and Technology Policy and the White House Council on Women and Girls. Participants will discuss the state of diversity in science, technology, engineering and math jobs, how to measure it, and challenges and best practices as organizations work to increase diversity.
WHERE: Eisenhower Executive Office Building, Washington.
WHEN:Â Â Monday, June 22, from 5 p.m. to 7 p.m. ET; Tuesday, June 23, from 8:30 a.m. to 5 p.m. ET. Dr. Hayes will be available for phone interviews during and after the forum.
For an interview with Dr. Hayes, please contact Sharon Theimer at 507-284-5005 or firstname.lastname@example.org.
Andre Pearson, a heart failure patient who has been at Mayo Clinic since March, initially was too ill to leave the Rochester, Minn., hospital to go to his daughterâs wedding in California. He had resigned himself to watching it online. But a few days before the Saturday evening ceremony, with Mr. Pearson doing well, his care team decided to explore whether it might be possible for him to make the trip after all. With the right game plan in place, they determined that it was. A Mayo staff member accompanied him, and Mr. Pearson surprised his daughter, Alexandra, by arriving the evening before the wedding in Indio, Calif., and promising to walk her down the aisle.
"I can't help but cry, but it's tears of joy," Mr. Pearson said Thursday, after learning that he had received medical clearance to leave the hospital for the wedding and his travel plans were under way.
When Mr. Pearson, 61, of Omaha, Neb., arrived at Mayo in late March, it looked like he might have only a year to live. The ordained pastor was too ill to qualify for a heart transplant, and his kidneys were failing. After surgery in which Mayo surgeons repaired his heart valve and, for the first time at Mayo, implanted both a left ventricular assist device and a temporary right ventricular assistÂ device to help his heart pump, followed by ongoing dialysis and physical rehabilitation, Mr. Pearson is now well enough that he will likely return home within the next month.
After that, he will be evaluated for a possible heart transplant. His kidneys are recovering as well, so he may not need dialysis long-term. His lead cardiac surgeon, David L. Joyce, M.D., credits Mr. Pearsonâs tenacity for his recovery.
"Really, if you were just to look at everything on paper, you would say, `There's really nothing here we can offer.' Then when you meet Mr. Pearson and you realize what he's capable of, then you start to think outside the box a little bit," Dr. Joyce says. "That's when we came up with the idea of using a new device for supporting the right heart (the right ventricular assist device). He was kind of a pioneer and willing to take on that uncertainty, and it actually worked out beautifully."
Mr. Pearson is the brother of former Dallas Cowboy Drew Pearson, famous in Minnesota for catching a "Hail Mary" pass against the Minnesota Vikings. Not knowing that Andre Pearsonâs brother was Drew Pearson, Dr. Joyce told him before surgery that it would be a bit of a Hail Mary pass; Mr. Pearson and his wife, Gina Pearson, then remarked that they know all about those.
Journalists: Video of Mr. Pearson surprising his daughter and walking her down the aisle and of Mr. Pearson and Dr. Joyce discussing his medical case and the "Hail Mary Pass" is available in the downloads. For interviews, please contact Sharon Theimer in Mayo Clinic Media Relations at email@example.com or 507-284-5005. [...]
Four to nine factors contributed to each `never event,â study finds
ROCHESTER, Minn. â Why are major surgical errors called ânever events?â Because they shouldnât happen â but do. Mayo Clinic researchers identified 69 never events among 1.5 million invasive procedures performed over five years and detailed why each occurred. Using a system created to investigate military plane crashes, they coded the human behaviors involved to identify any environmental, organizational, job and individual characteristics that led to the never events. Their discovery: 628 human factors contributed to the errors overall, roughly four to nine per event. The study results are published in the journal Surgery.
The never events included performing the wrong procedure (24), performing surgery on the wrong site or wrong side of the body (22), putting in the wrong implant (5), or leaving an object in the patient (18). All of the errors analyzed occurred at Mayo; none were fatal.
The Mayo Rochester campus rate of never events over the period studied was roughly 1 in every 22,000 procedures. Because of inconsistencies in definitions and reporting requirements, it is hard to find accurate comparison data, but a recent study based upon information in the National Practitioner Data Bank estimated that the rate of such never events in the United States is almost twice that in this report, approximately 1 in 12,000 procedures.
Journalist: Sound bites of Dr. Bingener discussing the study are available in the downloads. [...]
Mayo Clinic President and CEO John Noseworthy, M.D., submitted the following written testimony to the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies on Wednesday on the fiscal 2016 federal budget:
Introduction.Â On behalf of the Mayo Clinic, thank you for the opportunity to submit testimony regarding Fiscal Year (FY) 2016 appropriations.Â For the reasons enumerated below, Mayo requests no less than $32 billion in FY 2016 funding for the National Institutes of Health (NIH).Â NIH-funded research is an essential national investment that increases understanding of human disease, spurs the development of novel diagnostics and therapies, and uncovers new strategies to prevent disease and to improve health. Because NIH is the largest source of biomedical research funding not only in the United States but also in the world, the failure of NIH funding to keep pace with medical inflation decreases support for and the conduct of basic research; inevitably, this compromises the realization of those crucial scientific breakthroughs that enhance health, lengthen life, and reduce disease and disability. Â âImportant secondary benefits of medical research such as job creation, regional and global economic activity, international competitiveness, intellectual property and commercializable products are likely adversely impacted as well.âÂ While NIH funding is certainly not Mayoâs only Labor-HHS funding priority, it is on behalf of these research efforts that we focus on NIH funding in our testimony today.
MEDIA CONTACT:Â Sharon Theimer, Mayo Clinic Public Affairs, firstname.lastname@example.org / 507-284-5005 [...]
Over the past decade, numerous studies have shown that many Americans have low vitamin D levels and as a result, vitamin D supplement use has climbed in recent years. Vitamin D has been shown to boost bone health and it may play a role in preventing diabetes, cancer, cardiovascular disease and other illnesses. In light of the increased use of vitamin D supplements, Mayo Clinic researchers set out to learn more about the health of those with high vitamin D levels. Â They found that toxic levels are actually rare.
Their study appears in the May issue of Mayo Clinic Proceedings.
A vitamin D level greater than 50 nanograms per milliliter is considered high. Vitamin D levels are determined by a blood test called a serum 25-hydroxyvitamin D blood test. A normal level is 20-50 ng/mL, and deficiency is considered anything less than 20 ng/mL, according the Institute of Medicine (IOM).
Rochester, Minn. â Which breast cancer patients need to have underarm lymph nodes removed? MayoÂ Clinic-led research is narrowing it down. A new study finds that not all women with lymph node-positive breast cancer treated with chemotherapy before surgery need to have all of their underarm nodes taken out. Ultrasound is a useful tool for judging before breast cancer surgery whether chemotherapy eliminated cancer from the underarm lymph nodes, the researchers found. The findings are published in the Journal of Clinical Oncology.
In the past, when breast cancer was discovered to have spread to the lymph nodes under the arm, surgeons routinely removed all of them. Taking out all of those lymph nodes may cause arm swelling called lymphedema and limit the armâs range of motion.
Now, many breast cancer patients receive chemotherapy before surgery. Thanks to improvements in chemotherapy drugs and use of targeted therapy, surgeons are seeing more women whose cancer is eradicated from the lymph nodes by the time they reach the operating room, says lead author Judy C. Boughey, M.D. a breast surgeon at Mayo Clinic in Rochester.
MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: email@example.com
Journalists:Â Sound bites with Dr. Boughey are available in the downloads.
Rochester, Minn. â If you havenât already experienced telemedicine, you may soon have the option. Technology is helping people connect with their physicians in new ways and from a distance, and interest is growing in updating state and federal policies to help make telemedicine available to more patients.
Mayo Clinic this week responded to a request from the House Energy and Commerce Committee for recommendations on how lawmakers can help this new health care option progress. Steve Ommen, M.D., medical director of Mayo Clinic Connected Care, explains telemedicine and outlines state and national moves that would help more patients take advantage of it:
Â What is telemedicine? Telemedicine most commonly refers to communication with or among a patientâs health care team via video connection, secure text messaging or another platform rather than in person. It can be used to schedule appointments, answer questions, handle routine checkups, allow physicians in different locations to consult about a patientâs case, collect vital signs or even to help examine and diagnose patients. To protect patient privacy, secure communication methods are used.
Mayo Clinic views development of telemedicine as an important next step to improve health care access, quality and efficiency across the country.
Journalists: Sound bites with Dr. Ommen are available in the downloads.
Rochester, Minn. â âPrecision medicineâ is becoming a national catchphrase after President Obama highlighted it in his State of the Union address.
But what exactly is it? Richard Weinshilboum, M.D., acting director of the Mayo Clinic Center for Individualized Medicine, describes this new, rapidly advancing frontier in medicine and outlines 10 changes that would speed development and help more patients benefit from a personalized approach to health care:
What is precision medicine? In precision medicine, also called individualized medicine or personalized medicine, physicians use knowledge about a personâs personal genetic makeup to help determine the best plan for disease prevention, diagnosis and treatment. The mapping of the human genome in 2003 by U.S. scientists jump-started medical genomics; the Human Genome Project was an immense international collaboration that took 13 years and cost $3.8 billion. The National Institutes of Healthâs National Human Genome Research Institute, which coordinated the project,Â estimatesÂ economic growth from that project at $798 billion.
"We are now poised to apply genomic technologies developed with the findings of the Human Genome Project into everyday patient care,â Dr. Weinshilboum says.
âHowever, if the U.S. is to remain the world leader in health care innovation and delivery, we need another national genomics effort that will accelerate scientific discovery and clinical implementation while continuing to encourage the rapid technological innovations and entrepreneurialism that have gotten us to this point."
MEDIA CONTACT: To schedule an interview with Dr. Weinshilboum or other Mayo Clinic individualized medicine experts, please contact Sam Smith or Robert Nellis in Mayo Clinic Public Affairs at 507-284-5005 orÂ firstname.lastname@example.org. [...]
Sepsis can be a dangerous complication of almost any type of infection, including influenza, pneumonia and food poisoning;Â urinary tract infections; bloodstream infections from wounds; and abdominal infections.Â Steve Peters, M.D.,Â a pulmonary and critical care physician at Mayo Clinic and senior author of a recent sepsis overview in the medical journal Mayo Clinic Proceedings, explains sepsis symptoms and risk factors, the difference between severe sepsis and septic shock, and how sepsis is typically treated:
What is sepsis?Sepsis occurs when chemicals released into the bloodstream to fight an infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.
âMany infections can cause it,â Dr. Peters says. âIt is most common with bacterial infections, but you can get sepsis from other types of bugs also.â
What are symptoms to watch for? A high fever; inability to keep fluids down; rapid heartbeat; rapid, shallow breathing; lethargy and confusion are among the signs. If sepsis is suspected, seek emergency care, Dr. Peters advises. Rapid intervention is critical.
Journalists: Soundbites with Dr. Peters are available in the downloads.
For interviews with Dr. Peters, please contact Sharon Theimer
Mayo Clinic Public Affairs at 507-284-5005 or email@example.com. [...]
Boston â A molecule in the blood shows promise as a marker to predict whether individual rheumatoid arthritis patients are likely to benefit from biologic medications or other drugs should be tried, a Mayo Clinic-led study shows. The protein, analyzed in blood tests, may help avoid trial and error with medications, sparing patients treatment delays and unnecessary side effects and expense. The research is among several Mayo Clinic studies presented at the American College of Rheumatology annual meeting in Boston.
Researchers tested blood samples taken before rheumatoid arthritis treatment was given. The patients then were treated with anti-inflammatory biologic drugs, tumor necrosis factor-alpha inhibitors, a new class of medications used for rheumatoid arthritis. They found that a protein made by the immune system, type 1 interferon, appears to serve as a valid marker to tell whether individual rheumatoid arthritis patients will respond to biologics, or other medications should be tried.
Journalists:Â Sound bites of Dr. Niewold are available in the downloads below.
ROCHESTER, Minn. â For many adults, the word scoliosisÂ conjures up childhood memories of lining up in gym class for anÂ examination by the school nurse. But scoliosis isn't just a pediatric condition. Curvature of the spine can develop in adults too, and the osteoporosis that can accompany menopauseÂ is a risk factor. Mayo Clinic orthopedic surgeonÂ Paul Huddleston, M.D.,Â explains how scoliosis develops,Â prevention and treatment options and a trend he is seeing in Baby Boomer women.
What is scoliosis?Â Scoliosis is a misshaping of the spine as seen from the front â where the spine seems shiftedÂ right or left â or from a side view,Â where the spine is bent too far forward or backward, or a combination of the two. It doesnât always cause pain: Schools started screening in elementary school or junior high in part because many children and their parents didnât know the children had it, Dr. Huddleston says.
Journalists: Sound bites with Dr. Huddleston are available in the downloads.Â Â Â Â
More than 8Â of 10 say they would make same choice again, Mayo Clinic study finds
ROCHESTER, Minn. â More women with cancer in one breast are opting to have both breasts removed to reduce their risk of future cancer. New research shows that in the long term, most have no regrets.Â Mayo Clinic surveyed hundreds of women with breast cancer who had double mastectomies between 1960 and 1993 and found that nearly all would make the same choice again. The findings are published in the journal Annals of Surgical Oncology.
The study made a surprising finding: While most women were satisfied with their decision whether they followed it with breast reconstruction or not, patients who decided against reconstructive surgery were likelier to say they would choose to have both breasts removed again. In the reconstructive surgery group, women who needed additional operations due to complications, breast implant-related issues or other reasons were likelier to regret their prophylactic mastectomy, though overall, most women with breast reconstructions were satisfied with their choices.
MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: firstname.lastname@example.org
Meeting non-medical needs ahead of operations can aid recovery, cut health care costs, study suggests
ROCHESTER, Minn. â How well patients recover from cancer surgery may be influenced by more than their medical conditions and the operations themselves. Family conflicts and other non-medical problems may raise their risk of surgical complications, a Mayo Clinic study has found. Addressing such quality-of-life issues before an operation may reduce patientsâ stress, speed their recoveries and save health care dollars, the research suggests. The study specifically looked at colon cancer patients, and found that patients with a poor quality of life were nearly three times likelier to face serious postoperative complications.
The findings are published in the Journal of Gastrointestinal Surgery.
âWe know that quality of life is a very complex thing, but we can now measure it and work with it almost like blood pressure,â says lead author Juliane Bingener, M.D., a gastroenterologic surgeon at Mayo Clinic in Rochester. âWe can say, âThis is good, this is in the normal range, but this one here, that is not good, and maybe we should do something.ââ
Quality of life as measured in the study is about more than happiness and how well people feel physically, Dr. Bingener says. It also includes the financial, spiritual, emotional, mental and social aspects of their lives and whether their needs are being met. [...]