The enactment of the Patient Protection and Affordable Care Act (ACA) and the subsequent upholding of the majority of the law by the United States Supreme Court will continue to result in significant changes to the way Americans access health insurance. A key feature of the ACA, and one that may have the biggest impact on state budgets and personnel, is the requirement to have a Health Insurance Exchange (HIX) available and functioning by government-defined deadlines. The Consumer Assistance function of the exchange provides the primary means by which applicants and consumers receive information about the HIX and their options, as well as make health plan enrollment choices.
Presentation from INTEGRATED's Chuck Gooder, senior advisor, and Blake Sternard, the business analyst. The presentation focuses on the ways to identify the major changes of healthcare, with specific attention to the potential challenges posed to enrollees, physicians, hospitals, and healthcare organizations associated with the implementation of Obamacare.
Presentation from INTEGRATED's Chuck Gooder, senior advisor, and Blake Sternard, the business analyst. The presentation focuses on the ways to identify the major changes of healthcare, with specific attention to the potential challenges posed to enrollees, physicians, hospitals, and healthcare organizations associated with the implementation of Obamacare.
Rebroadcast scheduled for 9/14/13 1:00 - 4:00 pm EST http://cpa.tc/34y
70% of Businesses will turn to their CPA for advice on the Patient Protection and Affordable Care Act of 2010. MACPA created this special FREE townhall sponsored by our Exclusive Preferred Provider RJ Princinsky & Associates to help our members learn about what they need to know to advice their clients and employers about this new massive piece of legislation impacting businesses large and small.
Are you being asked by your clients and employers to figure out what they need to know and do, now and later, to stay complaint with all the provisions of PPACA? It is complex and changing but as the trusted advisor, you need to stay ahead of the questions they are asking. It isn't easy but this Special Town Hall, sponsored by MACPA's preferred provider of health care, employee benefit, HR and wellness services, will bring you up to date and answer the questions you have. Right now alll employer business managers and employee benefits managers should be taking steps to be sure they are prepared for the PPACA requirements that take effect later this year in 2014 and beyond. While some requirements vary based on employer size, business entity or type of health plan offered, other requirements apply to all individuals and employer groups regardless of employee size or type of business entity. This special edition Town Hall will provide participants with the information and resources that will help you make informed business decisions and advise clients related to this evolving legislation.
You will learn about Health Exchanges, the individual and employer mandates, DOL requirements, impacts on your benefits plans, penalties and taxes, ratings and premiums and lots more.
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
A look at the trends, populations and products at play.
More questions than answers face a health industry in flux grappling with new meanings of cost, value, compliance and care delivery. Different stakeholder groups offer up different answers as they accelerate to keep pace with medical innovation. Providers, payers and businesses serving healthcare are being asked to incorporate and act on new data, integrate with new platforms and pioneer new offerings to create an increasingly accessible, connected experience. What’s driving the adaptation, and what trends are worth acting on?
Healthcare payers exceeded federally mandated medical loss ratio with esignat...DocuSign
Healthcare payers need strategic plans to reduce wasted administrative resources, prevent profit loss, and keep premiums reasonable. Electronic signatures is one way of solving this problem.
Successfully Implementing a Federally-Facilitated ExchangeCognosante
The Affordable Care Act directs the Secretary of Health and Human Services to establish and operate a Federally-Facilitated Exchange in any state that does not elect to establish a state-based exchange. As the deadline for state submission of a state blueprint and declaration letter approaches, many states are faced with implementing a FFE by the statutorily required enrollment date of October 1, 2013. While a FFE allows states to meet federal timeline mandates, its implementation provides states with limited options and flexibility. Cognosante's latest white paper helps states understand how to successfully implement a Federally-Facilitated Exchange.
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
Managed Care within Health Care covers a variety of information from nursing homes, policies, Medical, Medicare, out of pocket, and partial payment, management, contracts, government, and the Social Security State Fund. Within this working paper I will discuss a few of these mechanisms that are applied and utilized within ‘Managed Care’ today. A system within a system that brings in 25% of the United States debt.
Rebroadcast scheduled for 9/14/13 1:00 - 4:00 pm EST http://cpa.tc/34y
70% of Businesses will turn to their CPA for advice on the Patient Protection and Affordable Care Act of 2010. MACPA created this special FREE townhall sponsored by our Exclusive Preferred Provider RJ Princinsky & Associates to help our members learn about what they need to know to advice their clients and employers about this new massive piece of legislation impacting businesses large and small.
Are you being asked by your clients and employers to figure out what they need to know and do, now and later, to stay complaint with all the provisions of PPACA? It is complex and changing but as the trusted advisor, you need to stay ahead of the questions they are asking. It isn't easy but this Special Town Hall, sponsored by MACPA's preferred provider of health care, employee benefit, HR and wellness services, will bring you up to date and answer the questions you have. Right now alll employer business managers and employee benefits managers should be taking steps to be sure they are prepared for the PPACA requirements that take effect later this year in 2014 and beyond. While some requirements vary based on employer size, business entity or type of health plan offered, other requirements apply to all individuals and employer groups regardless of employee size or type of business entity. This special edition Town Hall will provide participants with the information and resources that will help you make informed business decisions and advise clients related to this evolving legislation.
You will learn about Health Exchanges, the individual and employer mandates, DOL requirements, impacts on your benefits plans, penalties and taxes, ratings and premiums and lots more.
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
A look at the trends, populations and products at play.
More questions than answers face a health industry in flux grappling with new meanings of cost, value, compliance and care delivery. Different stakeholder groups offer up different answers as they accelerate to keep pace with medical innovation. Providers, payers and businesses serving healthcare are being asked to incorporate and act on new data, integrate with new platforms and pioneer new offerings to create an increasingly accessible, connected experience. What’s driving the adaptation, and what trends are worth acting on?
Healthcare payers exceeded federally mandated medical loss ratio with esignat...DocuSign
Healthcare payers need strategic plans to reduce wasted administrative resources, prevent profit loss, and keep premiums reasonable. Electronic signatures is one way of solving this problem.
Successfully Implementing a Federally-Facilitated ExchangeCognosante
The Affordable Care Act directs the Secretary of Health and Human Services to establish and operate a Federally-Facilitated Exchange in any state that does not elect to establish a state-based exchange. As the deadline for state submission of a state blueprint and declaration letter approaches, many states are faced with implementing a FFE by the statutorily required enrollment date of October 1, 2013. While a FFE allows states to meet federal timeline mandates, its implementation provides states with limited options and flexibility. Cognosante's latest white paper helps states understand how to successfully implement a Federally-Facilitated Exchange.
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
Managed Care within Health Care covers a variety of information from nursing homes, policies, Medical, Medicare, out of pocket, and partial payment, management, contracts, government, and the Social Security State Fund. Within this working paper I will discuss a few of these mechanisms that are applied and utilized within ‘Managed Care’ today. A system within a system that brings in 25% of the United States debt.
hapter 5What Are the Governmental AlternativesThe United StatJeanmarieColbert3
hapter 5
What Are the Governmental Alternatives?
The United States has tried an alphabet soup of health policy options: HSAs, HMOs, IPAs, PPOs, POS plans, ACOs, and so on. Health care analysts often must look beyond specific organizational and financial alternatives and address issues at a higher level and deal with the threads of economic and political thought behind different proposals while considering the overall criteria of access, cost, and quality of care.
Politicians and businesspeople from outside the health care sector advocate many alternatives. To offset their tendency to ignore professional issues, in this chapter we discuss alternatives affecting professional status and roles and institutional responses to them. Table 5-1 presents an array of federal alternatives organized by their primary criteria—access, quality, or cost—and then by the economic philosophies behind them. The items in this array are not intended to be either mutually exclusive or collectively exhaustive; rather, the table provides a framework for looking at both the broad policy picture and specific health care actions taken at various times and places. Later in the chapter, another table (Table 5-3) summarizes policy alternatives added by state and local governments. Many of these alternatives were included as provisions of the Affordable Care Act (ACA). They are still included here, partly because they may be subject to reconsideration in the future.
Table 5-1 Illustrative Federal Government Health Policy Options
Access to Care
• Administered systems
• Universal coverage
• Expand or reduce eligibility or benefits
• Mandate coverage and services
• Captive providers
• Control insurance industry practices
• Mandate employer-based insurance coverage
• Consumer-driven competition
• Implement insurance exchanges
• Encourage basic plans with very low premiums for low-income workers and “young invincibles”
• Mandate individual coverage
• Allow states flexibility to reallocate federal funds for vouchers
• Oligopolistic competition
• Expand or contract coverages in entitlement and categorical programs
• Allow states to reallocate federal uncompensated care funds
• Eliminate ERISA constraints on the states
• Expand the capacity of the system
Quality of Care
• Administered system
• Mandate participation in quality improvement efforts in federal plans and programs
• Add more pay-for-performance incentives
• Select providers and programs on the basis of quality excellence
• Consumer-driven competition
• Encourage or mandate transparency of quality reporting in federal plans and programs
• Oversee licensure and credentialing of foreign-trained providers
• Oligopolistic competition
• Work reporting of quality care and adverse events into purchasing specifications for federal programs and disseminate to the public
• Encourage wider use of health information technology
Cost of Care
• Administered system
• Use full bargaining power in negotiation of ...
Many consumer and health care advocacy initiatives are convergin.docxdrennanmicah
Many consumer and health care advocacy initiatives are converging toward a mandate to provide public access to many types of information about managed care organization (MCO) performance, costs, and quality. In fact, employers in the many parts of the country who are the major purchasers of health insurance are now requiring MCOs to make “health plan performance data” available to subscribers to facilitate their choice of plans.
Discuss and provide the rationale for your opinion on providing data in areas such as patient outcomes, compliance with national standards for preventive and chronic care, and comparative costs to the public.
What obligation, if any, does an employer, and/or MCO have to educate subscribers in how to interpret performance data? At whose expense should such education be provided?
What are the possible benefits or disadvantages to making such performance data available to the public?
.
Our exclusive study reveals 20 key findings that will help health plans set the course for their digital member experience strategies in 2016 and beyond.
Medicaid: What You Need to Know (CSH and Foothold)Ronan Martin
In our first session, Foothold Technology Director of Client Services, Paul Rossi and Senior Advisor, David Bucciferro, along with Sue Augustus from CSH, will bring us back to basics of all things Medicaid. They will cover topics ranging in commonly used terms, coverage and eligibility and the differences between Medicaid and Medicare. This webinar series is designed for beginners and experts alike. Beginners will walk away with a strong foundation and experts will have the opportunity to contribute to the conversation.
State innovation and medicare expansion waivers employer considerationsDebera Salam, CPP
How will the state response to the Affordable Care Act affect employers? In this special report, we explain how state innovation and Medicare expansion waivers will impact businesses now and in the future.
"eHealth Literacy, Getting Started" was presented at the Center for Health Literacy Conference 2011: Plain Talk in Complex Times by Shannah Koss, MPP, President, Koss on Care LLC (Principal, MAXIMUS eHealth Literacy Collaborative).
Description: Learn how to design and develop a consumer-oriented strategy and foundation for outreach, education, and engagement in the early stages of your state or community's health IT and reform programs. Find out about funding options. Share challenges and solutions for integrating eHealth literacy tools and resources into the emerging health IT infrastructure.
The health care reform law calls for the creation of state-based insurance Exchanges. This Legislative Brief provides an overview of state progress toward creating the Exchanges and the role of entities typically involved with the insurance placement process (such as brokers and agents) under the Exchanges. It also discusses the emergence of private health insurance Exchanges.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Consumer-Centric Healthcare: 2015--The Tipping Point Has Arrived (Report by William Blair)
Consumers—in tandem with disruptive healthcare technology and healthcare services providers—are the key to solving many of US healthcare's woes, particularly the unsustainably high cost of care.
Public exchanges, private exchanges, and high-deductible health plans are growing quickly. Disruptive forces of competition will create a lower-cost system that promotes the growth of highly efficient, low-cost, and high-quality providers and technologies.
The continued movement of financial and quality risk back to providers (and increasingly to consumers themselves) is encouraging providers and consumers to seek preventive medicine, cost efficiency, clinical efficacy, and overall value in healthcare. In turn, this could drive significant change regarding the primary point of care delivery (rapidly moving outside the hospital), the overall cost of healthcare and investment decisions made by healthcare providers.
Consumer-centric healthcare providers will experience strong top- and bottom-line growth over the coming years. Investors in both the public and private-equity markets will achieve superior long-term returns by identifying and investing in these companies.
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
This slideshow presents best practices, lessons learned, and policy recommendations around covering Georgia's uninsured. It is based on a review of the open enrollment period for the Health Insurance Marketplace that ran from fall 2014 to winter 2015 and includes findings from interviews with enrollment assisters and other community partners.
Similar to Consumer Assistance and Health Insurance Exchanges: Analysis of Options Available to States (20)
SmartStream, as an EMR extender, searches for whether the patient has completed a behavioral health assessment
whenever he schedules an appointment or his insurance is verified. If no current assessment exists, SmartStream
will send a notification to the patient to complete a behavioral health assessment, M3, or ‘Monitor My Mood’. The notification will include an automated hyper-link to M3 and is sent using secure email or secure mobile messaging. The objective is for the patient to complete the behavioral health assessment BEFORE their scheduled office visit.
National statistics show that as of 2010, “85% adults and 75% teens own cell phones”. Plus “Ethnic minority groups
are more likely to own a mobile phone and use mobile phones to access health information”. With this knowledge and leveraging the ubiquitous use of cell phones, SmartStream provides a way for students with asthma to enter their peak flow meter readings into mobile devices.
SmartStream™ is an intelligent health information delivery system capable of data stream mining of real-time data feeds so the most current information is used. With SmartStream™ Collaborate, our rapid deployment offering, we can deploy a solution tailored to your specific needs in as few as 90 days.
eSante™ MITA provides support for Medicaid Management Information Systems (MMIS) architecture projects and Medicaid Information Technology Architecture (MITA) State Self Assessments (SS-A).
Cognosante: MITA 3.0 SS-A Methodology DemonstrationCognosante
Cognosante looks forward to meeting your MITA 3.0 SS-A needs using our unmatched MITA knowledge, experience, and flexible methodology. Cognosante will ensure your MITA SS-A is a valuable, long-term asset that supports your enterprise.
Cognosante’s ICD-10 Policy Transformation and Remediation solution helps our customers make the ICD-10 transition smoothly by reducing potential risks and preventing oversights.
Improve EPSDT Service Quality Through Meaningful Use of ITCognosante
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. A legal standard of coverage and access for low-income children. EPSDT has remained a central component of Medicaid, because of the operational and financial capacity it gives states to create appropriate pediatric health care systems (its ability to finance early, preventive, and on going healthcare for children at medical and social risk remains unparalleled in public or private health insurance). This paper provides an ntroduction to EPSDT, an overview of current EPSDT service and quality monitoring, and how EPSDT can be better supported through Meaningful Use of health IT.
MMIS Solutions: A New Approach to Forming MMIS Project TeamsCognosante
It’s not just about filling the boxes on your organization chart – it’s about forming a project team that ensures the success of your MMIS project. Among the most important phases of the MMIS Design, Development and Implementation (DDI) project is the planning phase, and within the planning phase, there is no more important step than establishing a strong MMIS DDI project team. The project team represents the most important contributing factor to the success or failure of the MMIS DDI project. While the approach to forming an MMIS DDI project team may seem similar to other state information technology (IT) projects, it is far from the norm. The size, complexity and risk associated with MMIS DDI projects require a greater level of detailed planning and creativity when forming the project team .
How Should Medicaids Respond to the ICD-10 Postponement?Cognosante
“HHS Secretary Kathleen Sebelius Announces Delay of ICD-10 until October 1, 2014” was the title of a CMS press release dated April 9, 2012. The news came in response to political pressures to postpone the original October 2013 deadline and ongoing industry concerns related to the bumpy transition to the new 5010 versions of electronic transactions. This paper outlines three key actions states can take to ensure the continuity of their ICD-10 transition efforts in the 'extra year.'
A Roadmap for States Using the Federally Facilitated Exchange Cognosante
The passage of the Patient Protection and Affordable Care Act (ACA) resulted in significant changes to the ways Americans will access and purchase health insurance. A key feature of the ACA, and one that may have the biggest impact on state budgets and personnel, is the requirement for states to have a health insurance exchange (HIX) up and functioning by January 1, 2014.
This paper outlines the steps which states must take should they elect the Federally Facilitated Exchange (FFE) model and includes a high-level roadmap for implementing the FFE at the state level. Cognosante summarizes the recommended actions for states to adopt the FFE model and highlights key areas and actions required to achieve successful implementation.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Consumer Assistance and Health Insurance Exchanges: Analysis of Options Available to States
1.
2. Consumer Assistance and Health Insurance Exchanges
Analysis of Options Available to States
October 2012
Contents
INTRODUCTION ............................................................................................................................................ 1
HIX CONSUMER ASSISTANCE ..................................................................................................................... 2
CONSUMER ASSISTANCE/CALL CENTER OPTIONS ................................................................................... 3
1. FFE AND SPE MODELS: USE FFE CONSUMER ASSISTANCE ....................................................................... 3
2. SBE AND SPE MODELS: ADD EXCHANGE CALLS TO EXISTING STATE CALL CENTER ................................... 3
3. SBE AND SPE MODELS: USE VENDOR WITH CALL CENTER AND FFE EXPERIENCE TO HANDLE HIX CALLS3
QUESTIONS TO CONSIDER ........................................................................................................................... 4
ABOUT COGNOSANTE .................................................................................................................................. 4
Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this white paper.
ii
3. Consumer Assistance and Health Insurance Exchanges
Analysis of Options Available to States
October 2012
INTRODUCTION
The enactment of the Patient Protection and Affordable Care Act (ACA) and the subsequent upholding of
the majority of the law by the United States Supreme Court will continue to result in significant changes
to the way Americans access health insurance. A key feature of the ACA, and one that may have the
biggest impact on state budgets and personnel, is the requirement to have a Health Insurance Exchange
(HIX) available and functioning by government-defined deadlines.
There are six functions of the HIX that are mandated by ACA:
Eligibility/Enrollment. Establishing a seamless process for determining eligibility for qualified
health plans (QHPs) and all insurance affordability programs; handling eligibility appeals; and
processing redeterminations of eligibility. Enrolling consumers into QHPs and connecting Medicaid
and Children’s Health Insurance Program (CHIP) eligible consumers with the appropriate state
agency to effectuate enrollment (or at the state option, directly effectuating the enrollment into
Medicaid/CHIP plans); transmitting enrollment information to plans; and transmitting to the federal
government information necessary to initiate advanced premium tax credits (APTCs) and cost-sharing
reductions (CSRs).
Plan Management. Determining plan standards beyond federal minimums; certification, selection
and oversight of plans; collection, review and analysis of plan rates, benefits and quality information;
issuer outreach, training and oversight and the exchange of issuer and plan data with the state
department of insurance and with the Centers for Medicare and Medicaid Services (CMS).
Consumer Assistance. Providing assistance, education and outreach to consumers; Navigator
management; call center operations; website management; and general support of the Exchange’s
eligibility and enrollment functionality.
Financial Management. Developing a sustainable business model; collecting user fees; handling
transfer payments related to tax credits and CSRs; assuring financial integrity; and applying risk
adjustment, reinsurance and risk corridor programs.
Oversight. Ensuring accurate an accounting of all activities, receipts, and expenditures, including
required reporting to HHS, participating in audits and cooperating with HHS investigations as needed.
Quality. Evaluate quality improvement strategies and oversee implementation of enrollee satisfaction
surveys, assessment and ratings of health care quality and outcomes, information disclosures, and
data reporting.
Due to the amount of time required to design and implement most of these functions, almost all states
must decide how they intend to meet HIX requirements. There are three options for how states can choose
to meet the ACA exchange requirements
State-Based Exchange (SBE). State implements and operates all areas of the HIX.
Federally Facilitated Exchange (FFE). Federally implemented and operated exchange available for
use by those states that will not or choose to not have an SBE functional by the deadline:
HHS provides, hosts and operates all system components and business functions included in the
FFE scope, including SHOP, Plan Management, and Consumer Assistance
State is responsible for implementing some functionality that is not included in the FFE scope
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4. Consumer Assistance and Health Insurance Exchanges
Analysis of Options Available to States
October 2012
State Partnership Exchange (SPE): State elects to implement and operate some functions of the
exchange, and rely on the Federal Exchange for the remainder:
HHS provides, hosts and operates most system components and business functions included in the
FFE scope
State is responsible for implementing the functions not included in FFE scope
State can choose to operate plan management, consumer assistance or both functions
HIX CONSUMER ASSISTANCE
The Consumer Assistance function of the exchange provides the primary means by which applicants and
consumers receive information about the HIX and their options, as well as make health plan enrollment
choices.
Generally speaking, the consumer assistance requirement of ACA can be interpreted to include:
Operating a consumer support call center
Providing consumers with help through a range of modalities including telephone with interactive
voice recognition (IVR) support, email, online chat, text messaging, social media, walk-ins, mail and
other mechanisms
Establishing and operating a notification management system that allows electronic and paper
notifications to consumers through multiple channels
Allowing consumers to provide feedback to the HIX through multiple mechanisms
For states choosing to participate in the FFE, there may still be an option to implement and operate a
state-specific Consumer Assistance Center, with policies and activities directed towards the goals and
priorities of the state. Many consumers are anticipated to use the consumer assistance function, and it is
imperative that the requirements for each state be defined to accommodate stakeholders. They include:
Individuals shopping for plans
Individuals requesting general or eligibility information
Employers
Employees
Brokers
Navigators
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5. Consumer Assistance and Health Insurance Exchanges
Analysis of Options Available to States
October 2012
CONSUMER ASSISTANCE/CALL CENTER OPTIONS
There are many ways a state can choose to handle the consumer assistance requirement of ACA, all
providing varying levels of control to the states. With the exception of marketing/outreach and navigator
functions, all of the consumer assistance requirements are included in the FFE. States that choose the FFE
option are by default opting to have HHS run and operate those requirements on their behalf. States that
select the SBE or SPE models can choose to insource almost all functions and have them managed by a
state-run call center, or outsource some or all functions to a vendor specializing in this area. States
selecting the SPE model can either use the FFE to provide consumer support services, or can set up their
own state-based consumer support center just like states choosing the SBE model.
Below is a brief review of the options available to states under each of the three HIX models:
1. FFE and SPE Models: Use FFE Consumer Assistance
The FFE does include a consumer assistance function, which is included in the “offering” for any state
selecting the FFE model. Additionally any state selecting the SPE model can choose to have its exchange-
related calls handled by the federal call center. The FFE will include a toll-free hotline staffed by HHS or
an HHS-selected and managed vendor. The state Medicaid and CHIP agencies will need to collaborate
closely with the FFE to establish protocols to help consumers resolve issues that affect both programs,
and to ensure smooth handoffs among entities.
2. SBE and SPE Models: Add Exchange Calls to Existing State Call Center
Many states already operate call centers focused on health care, whether for Medicaid or another
program. These call centers may have the technical capability required to handle HIX-related calls, but
the subject matter and level of systems expertise will be vastly different. Most state Medicaid call centers
use state-specific legacy systems and the callers are mostly Medicaid participants who generally have
some familiarity with the program. HIX calls, on the other hand, will require knowledge of a new
federally-managed system and the skills to work with callers who may have never interacted with any
type of public health program in the past.
3. SBE and SPE Models: Use Vendor with Call Center and FFE Experience to Handle
HIX Calls
Many states currently work with vendors to provide consumer support activities, including Medicaid
hotlines and enrollment brokers. These vendors have the technical capability and policy experience
necessary to handle these types of calls and many may also be able to handle basic exchange
informational calls. However, understanding how the FFE works in relation to other state systems and
programs, and being able to assist new consumers with navigating the new health care program, is a
specialty that requires understanding of state and federal programs and experience working with state
departments of health as well as CMS and CCIIO. At first glance, establishing a new call center to handle
exchange calls may seem less cost-effective than either using the FFE call center or adding exchange calls
to an existing state-run call center. However, having an experienced partner who can facilitate this
process will result in long-term benefits such as reduced time and effort spent by state staff trying to
implement a consumer assistance function.
States that are interested in outsourcing the consumer assistance function still have time to make final
decisions and procure a vendor. For most vendors, it will take 3 – 5 months to establish a HIX-focused
call center, depending on the exact scope of calls and operational requirements. To be ready by October 1,
2013, states should have a vendor selected and working on implementation no later than April 30, 2013 to
ensure sufficient time for implementation, testing, and go-live readiness reviews.
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6. Consumer Assistance and Health Insurance Exchanges
Analysis of Options Available to States
October 2012
QUESTIONS TO CONSIDER
States that have not yet made final determinations regarding their HIX or Consumer Assistance function
of their HIX, should ask themselves these key questions:
States that have not yet selected a model:
How much state control do we want over the consumer assistance operation in our state?
States that want more control and do not want to have the HHS call center handling their calls should
select the SBE or SPE models in order to manage the Consumer Assistance function themselves.
States that have selected the SPE or SBE models:
Do we have the state resources to handle the additional call volume and scope?
Are there ways to combine existing health-related call centers into one operation to reduce costs and
increase efficiencies?
Are there vendors who are better positioned to manage and operate our Consumer Assistance
function?
These options all include a varying degree of risk, state control, cost effectiveness, and efficiency that
must be examined by each state to determine their preferences.
Having a solid, customer-service-focused, efficient Consumer Assistance function is key to ensuring that
all HIX consumers are educated and making the best choices for themselves and their families. During the
beginning stages of the HIX program, consumers will have more questions and concerns, and how those
are handled will set the stage for the future of the program. It is in the best interest of every state to
carefully review the requirements and determine how to best meet them based on their state’s needs and
preferences; making the best choice for the state now will save time and resources, reduce costs and risks,
and improve operational inefficiencies in the future.
ABOUT COGNOSANTE
Cognosante has consulted with many states, such as Utah and District of Columbia, on the
implementation of their HIX programs; we understand the challenges states are facing implementing this
part of the ACA regulation and we are actively working with our clients to find the best possible solutions
to these challenges. Our expertise combines knowledge of ACA, exchanges, and the FFE; understanding
of how health care reform can impact other state programs such as Medicaid and CHIP; and the ability
and capacity to implement and operate both large- and small-scale contact centers. Cognosante currently
supports CMS in developing the FFE, which gives us a unique understanding of the FFE systems and
how they integrate with other state systems
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