U.S. Obesity Rate Shows Signs of Leveling Off

CDC study finds very young children seem to be slimming down, but more older women are obese

WebMD News from HealthDay

By Mary Brophy Marcus

HealthDay Reporter

TUESDAY, Feb. 25, 2014 (HealthDay News) -- Obesity still looms large in the United States but the scale's relentless climb may have leveled off, according to the latest results of a U.S. Centers for Disease Control and Prevention study.

One-third of adults and 17 percent of children and teens are obese, said CDC researchers who focused on more than 9,000 adults and children in 2011-2012 and compared them to five previous obesity analyses dating back to 2003-04.

"We found overall that there was no change in youth or adults," said study author and epidemiologist Cynthia Ogden.

But within specific age groups, weight shifts were apparent. More older women are obese, but very young children seem to be slimming down.

One specialist in childhood obesity was pleased with the overall findings.

"I tend to be an optimist. The fact that we are seeing a leveling off is actually a good thing," said Dr. Sara Lappe, a pediatrician at Cleveland Clinic Children's who specializes in childhood obesity.

Obesity in adults is defined as a body mass index (BMI) of 30 or above. BMI is a calculation of body fat based on height and weight. A 5-foot 9-inch adult who weighs 203 pounds has a BMI of 30 and is considered obese, for example.

Obesity in kids is defined as a child who has a BMI at or above the 95th percentile for children of the same age and sex.

Ogden said the results for preschool-age children are a bright spot in the findings.

"We found among preschoolers, 2- to 5-year-olds, there was a significant decrease in obesity," Ogden said. Prevalence of obesity in children that age dipped from 14 percent in 2003-2004 to about 8 percent in 2011-2012, she noted.

Cleveland Clinic's Lappe said: "I think this piece of the study is actually good. There are a lot of early intervention programs in Head Start and preschools, and education directly to parents that may be starting to pay off."

"Hopefully," Lappe added, "as they [the children] get older, we'll see the numbers come down."

The authors of the study, published in the Feb. 26 issue of the Journal of the American Medical Association, report that many preventive health programs and efforts have been launched by the government in recent years to combat the obesity epidemic in the United States.

These include new food labeling measures by the U.S. Department of Agriculture, as well as state and community programs sponsored by the CDC, and First Lady Michelle Obama's Let's Move program.

Even so, the overall numbers haven't inched down. In fact, obesity prevalence ticked up in women 60 and older, from less than 32 percent in 2003-2004 to more than 38 percent in 2011-2012.

source : U.S. Obesity Rate Shows Signs of Leveling Off

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Retail Clinics for Kids: No Sub for Pediatricians

By Rita Rubin
WebMD Health News

Reviewed by Hansa D. Bhargava, MD

Feb. 25, 2014 -- Like many busy parents, Ellen Hoffman likes the convenience of the MinuteClinic, a handful of which can be found in CVS pharmacies within a few miles of her home in Bethesda, MD.

Her two daughters, 14 and 12, often get ear infections or colds that are going around. “I used to take them [to MinuteClinic] all the time because my pediatrician’s office was a pain in the neck,” Hoffman says. “I could never get in there.”

Eventually, though, her local MinuteClinics became so popular that their wait times were as long as those at the pediatrician’s office. Still, Hoffman says, she takes her girls to MinuteClinics in Florida when they come down with something while visiting their grandparents.

“It’s better than not having that resource, but it doesn’t replace having your own doctor,” Hoffman says.

That’s the message the American Academy of Pediatrics (AAP) is trying to get through to parents in a new update of its 2006 policy statement about retail-based clinics in pharmacies, supermarkets, and “big box” stores.  The group continues to oppose the retail clinics, calling them “an inappropriate source of primary care for pediatric patients.”

Compared to 2006, “there’s a lot more of them, and our patients are using them,” says Geoffrey Simon, MD, a pediatrician in Wilmington, DE. He chairs the AAP’s Committee on Practice and Ambulatory Medicine, which issued the updated statement. 

While most retail clinic patients are adults, polls cited in the policy statement found that 15% of children were likely to be taken to one.

Advice for Parents

Consider these tips if you take your child to a retail clinic:

• They're designed only to handle common illnesses such as pinkeye, strep throat, and ear infections, as well as minor injuries. They're not meant to replace primary care doctors.
• Tell the health-care provider at the clinic if your child is allergic to any medications.
• Bring contact information for your child’s doctor so the clinic can forward information about the visit.

According to CVS, MinuteClinic is the largest and fastest-growing retail clinic provider in the country, with more than 800 locations inside CVS pharmacies in 28 states and the District of Columbia. They're staffed by nurse practitioners and physician assistants -- they are not doctors but are licensed to practice medicine. 

Walgreens runs about 400 Healthcare Clinics staffed by nurse practitioners in 20 states and the District of Columbia. And nearly 100 Walmart stores in 20 states offer clinics that are owned and run by independent companies.

source : Retail Clinics for Kids: No Sub for Pediatricians

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New ACA Insurance Causes Headaches In Some Doctors' Offices

By Jenny Gold

Mon, Feb 24 2014

Sheila Lawless is the office manager at a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly – scheduling patients, collecting payments, keeping the lights on. Recently she added another duty--incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges. 

Open enrollment doesn’t end until March 31, but people who have already bought Obamacare plans are beginning to use them. “We had a spattering in January—maybe once a week. But I think we’re averaging two to three a day now,” says Lawless. 

That doesn’t sound like many new customers, but it’s presented a major challenge: verifying that these patients have insurance. Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company. “We’ve been on hold for an hour, an hour and 20, an hour and 45, been disconnected, have to call back again and repeat the process,” she explains. Those sorts of hold times add up fast. 

In the past, offices have been able to make sure patients are insured quickly, by using an online verification system. But for exchange patients, practices also have to call the insurer to make sure the patient has paid his premium. If he hasn’t, the insurance company can refuse to pay the doctor for the visit, or come back later and recoup a payment it made. 

That’s because of a provision of the law that gives exchange patients who neglect to pay their premium a “grace period” of up to 90 days. During the first 30 days, insurers have to pay any claims incurred by the patient. But for the next 60 days, nothing is guaranteed. If the patient visits the doctor, the insurer can “pend” the claim – that is, wait to pay the doctor until the patient pays his premium. At the end of the 90-day grace period, if the patient has not paid the premium, the insurer can cancel the coverage and refuse to pay the pended claims, or recoup the payments it’s already made.  And that puts the doctor’s office at risk. 

So Lawless is checking first with the insurer to make sure that everything is in order before proceeding with the visit. If the premium has not been paid, Lawless gives the patient the option of rescheduling the appointment or paying in cash and then applying to his insurer for the payment. 

“Most small practices run lean and mean – you’ve got one or two people to do this process plus do their other job duties that day as well, which is tend to the patients in front of them,” says Lawless. To manage the new workload, she’s had other staffers, including nurses, step in to answer the phone. And that means longer hours, more overtime, and higher overhead expenses. And then there’s the plain old annoyance factor. 

source : New ACA Insurance Causes Headaches In Some Doctors' Offices

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