Magazine article Drug Topics

IOM Report on Nutrition Offers New Opportunities

Magazine article Drug Topics

IOM Report on Nutrition Offers New Opportunities

Article excerpt

A recent Institute of Medicine (IOM) 300-page report recommending expansion of Medicare coverage of nutrition services for the elderly may suggest new opportunities for pharmacists. Originally requested in the Balanced Budget Act of 1997, the study was one of three produced by IOM, a division of The National Academy of Sciences. "The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population" examines whether there is evidence for extending coverage under Medicare and estimates the cost. The report can be accessed on the Internet at

"I think it is an excellent report, and the recommendations are important,' said Philip J. Schneider, clinical professor and director, Latiolais Leadership Program, College of Pharmacy, Ohio State University, and president-elect of the American Society for Parenteral & Enteral Nutrition (ASPEN). "As we get more into preventive maintenance and promotion of health in an effort to control health-care costs, it is essential that we look at the role of nutrition."

The report addressed several key issues: evidence that nutrition services benefit individuals in terms of morbidity, mortality, or quality of life; whether registered dietitians and other health-care professionals are qualified to provide such services; and the related costs. The report made four recommendations. They include:

Nutrition therapy, on referral from a physician, is to be a reimbursable benefit for Medicare beneficiaries. Registered dietitians are currently the health-care professionals considered eligible for reimbursement as providers of nutrition therapy, but other health-care professionals could in the future submit evidence for evaluation by the Health Care Financing Administration (HCFA) as reimbursable providers.

Reimbursement for enteral and parenteral services in the acute care setting would be continued at the present level.

HCFA is to reevaluate existing reimbursement systems for nutrition services in all areas of care, including home care.

"I was pleased to see these issues supported in various health-care environments, and that they recognize the importance of interdisciplinary groups of physicians, nurses, pharmacists, and dietitians in improving the quality of nutrition care for patients," said Jay M. Mirtallo, specialty practice R.Ph. in nutrition and surgery, Ohio State University Medical Center. …

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