The document discusses the patient centered medical home model which aims to address issues with the declining value of primary care. It notes the aging population, rising chronic conditions, and skyrocketing healthcare costs. The medical home model emphasizes comprehensive and coordinated care through accessible primary care providers with long-term patient relationships.
This presentation was presented by Dr. Abdul Nasir Qayyumi - Medical Director for CTTC-Medical Department. This presentation was presented in MoPH to support MoPH's priority of Cancer Screening and Treatment Center to be established in Afghanistan. Presented at 3:00pm,on Sunday, 23rd Dec 2012. www.cttc-af.org
2004 Tmih Out Of Pocket Expenditure In Cambodia 1194wvdamme
This document summarizes a study on out-of-pocket health expenditures and debt in poor households in Cambodia during a dengue epidemic. The study found that:
1) Households that exclusively used private providers paid an average of $103 out-of-pocket, while those that combined private and public providers paid $32, and those that only used public hospitals paid $8.
2) Households financed these costs through savings, selling consumables, selling assets, and borrowing money. After treatment, 63% of households were in debt, with those using private providers more likely to borrow or sell assets.
3) A follow-up found that most households with initial debts were unable to pay
1) The document discusses a practical model for achieving health reform through strategic purchasing by large buyers to leverage the market and reform care delivery.
2) It outlines several truths about the unsustainable increases in health care costs in the US if reforms are not made, as well as the inconsistent quality of care and how costs are not evenly distributed.
3) The document argues that financing reform alone is not enough and that care delivery must also be reformed, as costs are primarily driven by chronic care management and factors like technology, new treatments, and a higher base cost structure in the US compared to other countries.
There has been a growing number of uninsured Americans over the past few decades, reaching over 50 million uninsured currently. Lack of health insurance negatively impacts health outcomes and financial well-being, as the uninsured and underinsured often delay or forego necessary medical care due to high costs. Growing economic inequality in the US has contributed to rising rates of poverty and worsening health outcomes among lower-income individuals and families.
1. The document provides tips to avoid social media fraud, including not clicking links in suspicious emails or messages, not using the same password across multiple accounts, and being wary of requests for money or personal information from strangers.
2. Specific threats discussed include fake notification emails, suspicious posts and messages containing links to phishing sites, and money transfer scams disguised as messages from friends.
3. The document advises maintaining privacy settings, using strong and unique passwords, being skeptical of information posted online, and referring to security resources from organizations like the FBI and US Computer Emergency Readiness Team for additional guidance.
Jeff Lanza, a retired FBI special agent, discusses simple steps to prevent medical identity theft. These include keeping insurance cards secure, carefully reviewing medical statements for unusual charges, requesting annual itemized claim statements from insurers, regularly checking credit reports, obtaining copies of medical records after each visit, and avoiding offers of free medical services. If theft is suspected, Lanza recommends contacting the insurer's antifraud unit, obtaining medical records to check for discrepancies, and filing a police report to investigate and clear credit issues.
This document provides guidelines for organizations to prevent identity theft. It recommends securing physical records with layered access controls and protecting digital media the same as physical records. It also suggests implementing computer security measures like firewalls, encryption, strong passwords that change regularly, and automatic logoffs. Further, it advises establishing policies for handling personal information, training employees, and being cautious over the phone or email to avoid unauthorized access to sensitive data.
This presentation was presented by Dr. Abdul Nasir Qayyumi - Medical Director for CTTC-Medical Department. This presentation was presented in MoPH to support MoPH's priority of Cancer Screening and Treatment Center to be established in Afghanistan. Presented at 3:00pm,on Sunday, 23rd Dec 2012. www.cttc-af.org
2004 Tmih Out Of Pocket Expenditure In Cambodia 1194wvdamme
This document summarizes a study on out-of-pocket health expenditures and debt in poor households in Cambodia during a dengue epidemic. The study found that:
1) Households that exclusively used private providers paid an average of $103 out-of-pocket, while those that combined private and public providers paid $32, and those that only used public hospitals paid $8.
2) Households financed these costs through savings, selling consumables, selling assets, and borrowing money. After treatment, 63% of households were in debt, with those using private providers more likely to borrow or sell assets.
3) A follow-up found that most households with initial debts were unable to pay
1) The document discusses a practical model for achieving health reform through strategic purchasing by large buyers to leverage the market and reform care delivery.
2) It outlines several truths about the unsustainable increases in health care costs in the US if reforms are not made, as well as the inconsistent quality of care and how costs are not evenly distributed.
3) The document argues that financing reform alone is not enough and that care delivery must also be reformed, as costs are primarily driven by chronic care management and factors like technology, new treatments, and a higher base cost structure in the US compared to other countries.
There has been a growing number of uninsured Americans over the past few decades, reaching over 50 million uninsured currently. Lack of health insurance negatively impacts health outcomes and financial well-being, as the uninsured and underinsured often delay or forego necessary medical care due to high costs. Growing economic inequality in the US has contributed to rising rates of poverty and worsening health outcomes among lower-income individuals and families.
1. The document provides tips to avoid social media fraud, including not clicking links in suspicious emails or messages, not using the same password across multiple accounts, and being wary of requests for money or personal information from strangers.
2. Specific threats discussed include fake notification emails, suspicious posts and messages containing links to phishing sites, and money transfer scams disguised as messages from friends.
3. The document advises maintaining privacy settings, using strong and unique passwords, being skeptical of information posted online, and referring to security resources from organizations like the FBI and US Computer Emergency Readiness Team for additional guidance.
Jeff Lanza, a retired FBI special agent, discusses simple steps to prevent medical identity theft. These include keeping insurance cards secure, carefully reviewing medical statements for unusual charges, requesting annual itemized claim statements from insurers, regularly checking credit reports, obtaining copies of medical records after each visit, and avoiding offers of free medical services. If theft is suspected, Lanza recommends contacting the insurer's antifraud unit, obtaining medical records to check for discrepancies, and filing a police report to investigate and clear credit issues.
This document provides guidelines for organizations to prevent identity theft. It recommends securing physical records with layered access controls and protecting digital media the same as physical records. It also suggests implementing computer security measures like firewalls, encryption, strong passwords that change regularly, and automatic logoffs. Further, it advises establishing policies for handling personal information, training employees, and being cautious over the phone or email to avoid unauthorized access to sensitive data.
This document discusses several topics related to improving healthcare quality and financing:
1) Pay-for-performance programs aim to incentivize quality care over quantity by tying provider payments to performance measures rather than just services provided. However, designing effective payment models remains challenging.
2) Medical errors are a major problem, costing billions annually in the US due to injuries, deaths and unnecessary costs. Reducing errors could significantly cut healthcare spending.
3) Patients armed with information about treatment options and costs may choose less aggressive care, reducing overtreatment. However, some argue the system also needs reforms to truly reward high-value care.
4) Adverse events during hospital care remain common globally despite efforts to
This document summarizes key points from a health financing summit:
1. Quality healthcare is essential to the success of any health financing initiative. Pay-for-performance programs aim to improve quality by linking payments to achievement of targets but can have unintended consequences if not designed carefully.
2. International studies show adverse event rates in hospitals have increased significantly over time, costing billions annually. Only a small percentage of errors are reported highlighting the need for improved reporting systems.
3. Proper design of pay-for-performance programs is important to avoid pitfalls like focus on targets over quality, undermining intrinsic motivation, and gaming of the system. Stakeholder input and clear, achievable goals are necessary
Utah's All Payer Claims Database (APCD) provides a vital resource for health reform by allowing analysis of healthcare episodes, costs, quality and utilization across payers. The APCD contains medical and pharmacy claims data on over 2 million commercially insured lives in Utah. Analysis of the APCD data has identified the top diseases by cost and utilization, most common and expensive therapeutic drug classes, and distribution of healthcare spending by patient risk level and chronic conditions. The APCD also facilitates analysis of disease-specific episodes of care, patient burden of illness, and costs by risk group and severity to better understand healthcare resource use.
Single payer health care could provide universal coverage at lower costs than the current US system. Evidence from other countries shows that single payer systems lead to higher access to care, greater utilization of services, better health outcomes, and lower overall costs compared to the US multi-payer system. Administrative costs are much lower under a single payer system due to simplified billing and insurance processes. Taiwan's transition to a national single payer system improved health outcomes, especially for vulnerable groups, while keeping costs low.
This document discusses how improving population health in the United States could help reduce the federal deficit and create jobs. It notes that the primary drivers of increasing federal spending are rising costs for healthcare (Medicare and Medicaid), social security, and low tax revenue due to an aging population and the burden of chronic disease. Improving lifestyle behaviors could help delay the onset and progression of chronic diseases, extending the productive years of Americans' lives and reducing healthcare spending. Strategies discussed include making healthy choices easier through policy changes and supporting organizations that can engage people in effective health promotion programs where they live and work. The document argues that improving population health provides the best strategy for preserving the nation's long-term fiscal solvency.
REPOSITIONING LIVESTOCK ON THE GLOBAL DEVELOPMENT AGENDA copppldsecretariat
LIVESTOCK AND THE PUBLIC GOOD NEXUS
Jimmy W. Smith
World Bank
IADG Annual Meeting
IFAD, Rome, Italy
May 4-5, 2010
[Originally posted on http://www.cop-ppld.net/cop_knowledge_base]
The Canada Health Infoway Plan document outlines Canada Health Infoway's mission to foster and accelerate the development of electronic health records across Canada. It discusses the need for EHR in Canada due to rising healthcare costs and an aging population. Infoway aims to have 50% of Canadians with an electronic health record by 2010. The document summarizes Infoway's programs, investments, and progress in implementing EHRs, as well as the expected benefits to stakeholders such as improved care quality, access, and productivity for patients and healthcare providers.
Presentation from the Livestock Inter-Agency Donor Group (IADG) Meeting 2010.
4-5 May 2010 Italy, Rome IFAD Headquarters
The event involved approximately 45 representatives from the international partner agencies to discuss critical needs for livestock development and research issues for the coming decade.
[ Originally posted on http://www.cop-ppld.net/cop_knowledge_base ]
Finland has a universal healthcare system funded through general taxation. It has 124 hospitals across 12 regions. The population is aging and projected to increase modestly to 6.2 million by 2060. Healthcare expenditures were €15.4 billion in 2008, with primary care and inpatient medical care representing the largest costs. The system is decentralized with municipalities and hospital districts providing most services.
This document discusses variation in healthcare and chronic disease management. It covers what variation is, why it matters, and how it should be analyzed. It notes there are warranted and unwarranted sources of variation. The document recommends addressing unwarranted variation by managing knowledge and expertise, tailoring evidence to individuals, and communicating options from the patient's perspective.
Trends in Telehealth: A Focus on Patient Safety (Handouts)VSee
2017 Telehealth Failures & Secrets to Success by VSee
Speaker: Ingrid Vasiliu-Feltes, MD MBA (VP, Quality and Safety, MEDNAX)
Presentation slides handouts
More info at: vsee.com/conference
This document discusses health care challenges and opportunities in West Virginia. It notes that costs continue to escalate as the population ages and chronic diseases increase. To address this, the health system needs to shift focus to prevention, wellness, care coordination and integrated physical and behavioral health. This will require payment models that reward healthy outcomes. West Virginia faces additional challenges with expanding Medicaid coverage and high rates of conditions like asthma in foster children. Efforts are underway in WV to improve data, care coordination programs, prescription drug management, health IT and establish a health insurance exchange. Overall, primary care physicians must play a leading role to guide the system through this time of both challenges and opportunities.
This editorial discusses the concept of "iatrogenic poverty", where illness itself can lead to poverty in developing countries through two pathways. First, the death or disability of an income earner reduces future income generation. Second, the costs of seeking treatment, including opportunity costs and direct costs, can force households to deplete their savings, sell assets, or fall into debt, potentially tipping them into poverty. The convergence of demand for modern treatments, supply of new medical technologies, and lack of regulation in transitional economies exacerbates this problem. Solutions proposed include social health insurance, reforms to improve healthcare provision and costs, and targeted social assistance to directly transfer resources to the poor.
Prepared by Helene Andre and Luka Grujic for French Tech Hub
The aging population is expected to sky rocket in the next decade and the United States has to rethink how it will deliver care for its elderly.
With recent advancements in technology, Aging in Place has emerged as strong solution to address this pressing need.
In this presentation, French Tech Hub explores the dynamics of the U.S. aging population and gives an overview of the solutions that are being developed for Aging in Place.
This document summarizes health data from Mumbai over several years. It shows increases in cases of diseases like malaria, diarrhea and hypertension between 2008-2009 and 2011-2012. A household survey found that over 75% of citizens use private healthcare, and over 30% of households spend more than 11% of annual income on medical costs. Only 20% of citizens have medical insurance. In 2011-2012, there were estimated cases of 274,957 for diabetes, 392,378 for malaria, and 63,227 for tuberculosis. The report identifies issues like a lack of public health surveillance and a focus on tertiary rather than primary healthcare.
,The definitive study and set of data on how investments and family planning and RH are cost-effective and beneficial to women and families. Cost-benefit analyses are outlined, as are health benefits using global and Philippine data.
This document summarizes Senator Barack Obama's health policy plan, which focuses on achieving universal health care coverage, health care reform, and strengthening public health. It outlines some of the key problems in the current US healthcare system from the perspectives of providers, purchasers, and consumers. Obama's plan would invest in health information technology and reform reimbursement to align with quality. The plan is estimated to cost $50-65 billion annually but could save $120-200 billion through reduced administrative costs, improved disease management, and health IT savings. If implemented, it could lower family insurance costs by $2,500 and cover 10 million more people.
The document discusses Accountable Care Organizations (ACOs) under Medicare. It summarizes a Medicare demonstration project that showed cost savings, which informed the development of ACOs in the Affordable Care Act. It then outlines requirements for ACOs, including structure, governance, quality measures, and a proposed rule from CMS regarding operations and reimbursement through Medicare shared savings programs.
The document provides information about Accountable Care Organizations (ACOs) and the Medicare Shared Savings Program proposed by CMS. It explains that ACOs allow groups of healthcare providers to coordinate care for Medicare patients, with the goals of improving quality of care and reducing costs. Providers can form or join ACOs to participate in the program. ACOs will be evaluated on quality measures and their ability to lower healthcare spending compared to spending benchmarks. ACOs that meet quality standards and reduce costs below their benchmark can earn a share of the savings, with larger rewards available to ACOs that take on two-sided risk models involving potential loss sharing as well.
This document discusses several topics related to improving healthcare quality and financing:
1) Pay-for-performance programs aim to incentivize quality care over quantity by tying provider payments to performance measures rather than just services provided. However, designing effective payment models remains challenging.
2) Medical errors are a major problem, costing billions annually in the US due to injuries, deaths and unnecessary costs. Reducing errors could significantly cut healthcare spending.
3) Patients armed with information about treatment options and costs may choose less aggressive care, reducing overtreatment. However, some argue the system also needs reforms to truly reward high-value care.
4) Adverse events during hospital care remain common globally despite efforts to
This document summarizes key points from a health financing summit:
1. Quality healthcare is essential to the success of any health financing initiative. Pay-for-performance programs aim to improve quality by linking payments to achievement of targets but can have unintended consequences if not designed carefully.
2. International studies show adverse event rates in hospitals have increased significantly over time, costing billions annually. Only a small percentage of errors are reported highlighting the need for improved reporting systems.
3. Proper design of pay-for-performance programs is important to avoid pitfalls like focus on targets over quality, undermining intrinsic motivation, and gaming of the system. Stakeholder input and clear, achievable goals are necessary
Utah's All Payer Claims Database (APCD) provides a vital resource for health reform by allowing analysis of healthcare episodes, costs, quality and utilization across payers. The APCD contains medical and pharmacy claims data on over 2 million commercially insured lives in Utah. Analysis of the APCD data has identified the top diseases by cost and utilization, most common and expensive therapeutic drug classes, and distribution of healthcare spending by patient risk level and chronic conditions. The APCD also facilitates analysis of disease-specific episodes of care, patient burden of illness, and costs by risk group and severity to better understand healthcare resource use.
Single payer health care could provide universal coverage at lower costs than the current US system. Evidence from other countries shows that single payer systems lead to higher access to care, greater utilization of services, better health outcomes, and lower overall costs compared to the US multi-payer system. Administrative costs are much lower under a single payer system due to simplified billing and insurance processes. Taiwan's transition to a national single payer system improved health outcomes, especially for vulnerable groups, while keeping costs low.
This document discusses how improving population health in the United States could help reduce the federal deficit and create jobs. It notes that the primary drivers of increasing federal spending are rising costs for healthcare (Medicare and Medicaid), social security, and low tax revenue due to an aging population and the burden of chronic disease. Improving lifestyle behaviors could help delay the onset and progression of chronic diseases, extending the productive years of Americans' lives and reducing healthcare spending. Strategies discussed include making healthy choices easier through policy changes and supporting organizations that can engage people in effective health promotion programs where they live and work. The document argues that improving population health provides the best strategy for preserving the nation's long-term fiscal solvency.
REPOSITIONING LIVESTOCK ON THE GLOBAL DEVELOPMENT AGENDA copppldsecretariat
LIVESTOCK AND THE PUBLIC GOOD NEXUS
Jimmy W. Smith
World Bank
IADG Annual Meeting
IFAD, Rome, Italy
May 4-5, 2010
[Originally posted on http://www.cop-ppld.net/cop_knowledge_base]
The Canada Health Infoway Plan document outlines Canada Health Infoway's mission to foster and accelerate the development of electronic health records across Canada. It discusses the need for EHR in Canada due to rising healthcare costs and an aging population. Infoway aims to have 50% of Canadians with an electronic health record by 2010. The document summarizes Infoway's programs, investments, and progress in implementing EHRs, as well as the expected benefits to stakeholders such as improved care quality, access, and productivity for patients and healthcare providers.
Presentation from the Livestock Inter-Agency Donor Group (IADG) Meeting 2010.
4-5 May 2010 Italy, Rome IFAD Headquarters
The event involved approximately 45 representatives from the international partner agencies to discuss critical needs for livestock development and research issues for the coming decade.
[ Originally posted on http://www.cop-ppld.net/cop_knowledge_base ]
Finland has a universal healthcare system funded through general taxation. It has 124 hospitals across 12 regions. The population is aging and projected to increase modestly to 6.2 million by 2060. Healthcare expenditures were €15.4 billion in 2008, with primary care and inpatient medical care representing the largest costs. The system is decentralized with municipalities and hospital districts providing most services.
This document discusses variation in healthcare and chronic disease management. It covers what variation is, why it matters, and how it should be analyzed. It notes there are warranted and unwarranted sources of variation. The document recommends addressing unwarranted variation by managing knowledge and expertise, tailoring evidence to individuals, and communicating options from the patient's perspective.
Trends in Telehealth: A Focus on Patient Safety (Handouts)VSee
2017 Telehealth Failures & Secrets to Success by VSee
Speaker: Ingrid Vasiliu-Feltes, MD MBA (VP, Quality and Safety, MEDNAX)
Presentation slides handouts
More info at: vsee.com/conference
This document discusses health care challenges and opportunities in West Virginia. It notes that costs continue to escalate as the population ages and chronic diseases increase. To address this, the health system needs to shift focus to prevention, wellness, care coordination and integrated physical and behavioral health. This will require payment models that reward healthy outcomes. West Virginia faces additional challenges with expanding Medicaid coverage and high rates of conditions like asthma in foster children. Efforts are underway in WV to improve data, care coordination programs, prescription drug management, health IT and establish a health insurance exchange. Overall, primary care physicians must play a leading role to guide the system through this time of both challenges and opportunities.
This editorial discusses the concept of "iatrogenic poverty", where illness itself can lead to poverty in developing countries through two pathways. First, the death or disability of an income earner reduces future income generation. Second, the costs of seeking treatment, including opportunity costs and direct costs, can force households to deplete their savings, sell assets, or fall into debt, potentially tipping them into poverty. The convergence of demand for modern treatments, supply of new medical technologies, and lack of regulation in transitional economies exacerbates this problem. Solutions proposed include social health insurance, reforms to improve healthcare provision and costs, and targeted social assistance to directly transfer resources to the poor.
Prepared by Helene Andre and Luka Grujic for French Tech Hub
The aging population is expected to sky rocket in the next decade and the United States has to rethink how it will deliver care for its elderly.
With recent advancements in technology, Aging in Place has emerged as strong solution to address this pressing need.
In this presentation, French Tech Hub explores the dynamics of the U.S. aging population and gives an overview of the solutions that are being developed for Aging in Place.
This document summarizes health data from Mumbai over several years. It shows increases in cases of diseases like malaria, diarrhea and hypertension between 2008-2009 and 2011-2012. A household survey found that over 75% of citizens use private healthcare, and over 30% of households spend more than 11% of annual income on medical costs. Only 20% of citizens have medical insurance. In 2011-2012, there were estimated cases of 274,957 for diabetes, 392,378 for malaria, and 63,227 for tuberculosis. The report identifies issues like a lack of public health surveillance and a focus on tertiary rather than primary healthcare.
,The definitive study and set of data on how investments and family planning and RH are cost-effective and beneficial to women and families. Cost-benefit analyses are outlined, as are health benefits using global and Philippine data.
This document summarizes Senator Barack Obama's health policy plan, which focuses on achieving universal health care coverage, health care reform, and strengthening public health. It outlines some of the key problems in the current US healthcare system from the perspectives of providers, purchasers, and consumers. Obama's plan would invest in health information technology and reform reimbursement to align with quality. The plan is estimated to cost $50-65 billion annually but could save $120-200 billion through reduced administrative costs, improved disease management, and health IT savings. If implemented, it could lower family insurance costs by $2,500 and cover 10 million more people.
The document discusses Accountable Care Organizations (ACOs) under Medicare. It summarizes a Medicare demonstration project that showed cost savings, which informed the development of ACOs in the Affordable Care Act. It then outlines requirements for ACOs, including structure, governance, quality measures, and a proposed rule from CMS regarding operations and reimbursement through Medicare shared savings programs.
The document provides information about Accountable Care Organizations (ACOs) and the Medicare Shared Savings Program proposed by CMS. It explains that ACOs allow groups of healthcare providers to coordinate care for Medicare patients, with the goals of improving quality of care and reducing costs. Providers can form or join ACOs to participate in the program. ACOs will be evaluated on quality measures and their ability to lower healthcare spending compared to spending benchmarks. ACOs that meet quality standards and reduce costs below their benchmark can earn a share of the savings, with larger rewards available to ACOs that take on two-sided risk models involving potential loss sharing as well.
1. The document provides tips to avoid social media fraud, including not clicking links in suspicious emails or messages, not using the same password across multiple accounts, and being wary of requests for money or personal information from strangers.
2. Specific threats discussed include fake notification emails, suspicious posts and messages containing links to phishing sites, and money transfer scams disguised as messages from friends.
3. The document advises maintaining privacy settings, using strong and unique passwords, being skeptical of information posted online, and referring to security resources from organizations like the FBI and US Computer Emergency Readiness Team for additional guidance.
1. The document provides tips to avoid social media fraud, including not clicking links in suspicious emails or messages, not using the same password across multiple accounts, and being wary of requests for money or personal information from strangers.
2. Specific threats discussed include fake notification emails, suspicious posts and messages containing links to phishing sites, and money transfer scams disguised as messages from friends.
3. The document advises maintaining privacy settings, using strong and unique passwords, being skeptical of information posted online, and referring to security resources from organizations like the FBI and US CERT for more guidance.
This document provides tips on protecting personal information and preventing identity theft. It outlines simple safeguards like shredding documents, being vigilant against scams, using security software, and regularly checking credit reports. Contact information is given for credit bureaus, do-not-call registries, and reporting identity theft. Key terms like fraud alerts and credit freezes are defined to help protect against new accounts opened in someone else's name.
Presentation by Sheila Richmeier, MS, RN, FACMPE, President & Founder of Remedy Healthcare Consulting
"Think Clinical: Running a More Efficient Practice through Optimal Clinical Operations"
Presentation given at Lawrence Medical Managers meeting June 8th 2011
The document discusses preparations for the transition from ICD-9 to ICD-10 coding which must be completed by January 1, 2012. It outlines vendor discussions that should take place, lists resources for ICD-10 information, and describes the impacts on providers including increased documentation needs, coding errors, payment delays, and effects on administrative staff from training requirements and system upgrades. Benefits of ICD-10 like greater specificity and reduced errors are also noted.
This document contains a vendor's 5010 readiness checklist, asking questions about upgrading software to support 5010 transactions including 277, 277CA, and 999 error reports; whether licensing allows for updates; the status of level 1 and 2 testing; supporting both 4010A1 and 5010 formats concurrently; any additional costs, hardware requirements, or charges for new transactions; and training for new data elements and ICD-10 codes.
This document is a checklist for clearinghouses and payers regarding their readiness for the transition to HIPAA version 5010. It includes questions about whether systems will be upgraded to support 5010, when upgrades and testing will be completed, whether fees will change, and how clearinghouses and payers will communicate with providers during the transition process.
1. A large practice must organize to implement ICD-10-CM by assigning point people to oversee the project and formulate an implementation plan addressing coding, systems, and testing.
2. An impact analysis will identify all areas affected, such as clinical documentation, IT systems, contracts, and policies.
3. A communication plan, budget, and timeline will be developed to coordinate vendor system updates, staff training, testing, and the transition to ICD-10-CM coding on October 1, 2013.
The document provides an overview of ICD-10 and the transition from ICD-9 to ICD-10. It discusses the key organizations involved in ICD coding including CMS, WHO, AAPC and AHIMA. It outlines the timeline for transitioning to the 5010 transaction standards by 2012 as a prerequisite for the ICD-10 implementation deadline of October 1, 2013. The document details the improvements in specificity and functionality provided by ICD-10 codes as well as the impact of the transition on providers, payers and other stakeholders.
The document provides an overview of emergency management in Kansas, including the key phases and roles of emergency management at the local, state, and federal levels. It discusses common hazards in Kansas, the mission of the Kansas Division of Emergency Management to coordinate response and resources, and how the Emergency Operations Center functions to support response efforts. It also outlines individual and community preparedness actions residents can take.
The document discusses the vision of the Kansas Department of Health and Environment to promote healthier residents living in safe environments. It notes that chronic illnesses and diseases account for most health care costs in the US. Risk factors for chronic diseases include behaviors like tobacco use, poor nutrition, and physical inactivity. The document presents data on obesity trends in the US from 1985 to 2008, which have significantly increased over that time period.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Lawrence mm june 2011
1. 6/8/2011
Patient Centered Medical Home
What Does it Mean?
Lawrence Medical Managers meeting
June 2011
Sheila Richmeier, MS, RN, FACMPE
Declining value of primary care
Primary care is in trouble. . . .
• Overwhelming amount of work
• Poor compensation
• Pipeline is drying up
• Aging and sicker population
• Health care costs skyrocketing
• Quality and coordination lag
• Physician frustration
2010 TransforMED
1
2. 6/8/2011
Aging and sicker population
•52% of the American population has a chronic medical
condition
•Number of older people is projected to rise from 31.6 to 65
million from 1990 to 2030
•Lifestyles are having an impact on health like never before
•2/3 of elderly are overweight or obese
•Obesity rates have doubled
• since mid-80s alone
AHRQ Chronic Care
Rising costs
• 52% of US population has a chronic disease
• Individuals with chronic illness account for 80% of health care
spending
▫ 75% of every dollar
▫ 83% of every Medicaid dollar
▫ 99% of every Medicare dollar
• Life style is having an impact on health
▫ 2/3 of elderly are overweight or obese
▫ Obesity rates have doubled since mid-80s
▫ Obesity is responsible for 1/3 of the growth of health care
spending
Hitting the “Bulls-eye” in Health Reform
• Increasing Prevalence of Chronic Conditions and
Increasing Costs
Prevalence of Chronic Conditions Cost of Specific Chronic Conditions
Chronic Condition Prevalence Annual Cost
180 49%
Cardiovascular Disease 80 million $475.3 billion (includes both
170 48% direct and indirect costs)
160 157 Diabetes 23.6 million $116 billion of direct healthcare
47% costs
149
150 $58 billion in indirect costs/ lost
141 46%
productivity
140 133
45%
125 Asthma ~20 million $18.3 billion, including direct
130 healthcare costs (10.1 billion)
118 44% and indirect costs/ lost
120 productivity (8.2 billion)
43%
110 Depression 20.9 million ~$100 billion of direct healthcare
100 42% costs (across all mental
illnesses)
90 41% ~$79 billion in indirect costs/ lost
productivity (across all mental
80 40% illnesses)
1995 2000 2005 2010 2015 2020
2010 TransforMED
2
3. 6/8/2011
Frustration
Value of primary care
• Easily accessible first contact with the
health care system
• Comprehensive care for all health related
situations regardless of age or sex
• Coordination and integration of care across
settings
• Personal relationships over time through
partnerships in the context of family and
community
9
Easily accessible
• Time • Availability
▫ Office hours ▫ Language barriers
▫ Same day access ▫ Transportation
• Location problems
• Delivery
▫ In person
▫ On phone
▫ Interactive websites
3
4. 6/8/2011
Timely access Percent reporting that it is very difficult/difficult:
30
73% of Americans report
having difficulty in
obtaining timely access
41
to their doctor
60
73
0 25 50 75 100
Source: Commonwealth Fund Survey of Public Views of the U.S. Health Care System, 2008.
11
11
After hours care without ER visit
Percent reported very/somewhat difficult getting care on nights,
weekends, or holidays without going to ER*
100
75 65 68
59 63 63
57
50 45 43
38 38
33
25
0
AUS CAN FR GER NETH NZ NOR SWE SWIZ UK US
* Base: Needed care and answered question.
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
2010 TransforMED
12
Emergency Room Use in Past Two Years
Percent Any ER use Used ER for condition treatable
by regular doctor, if available
75
50 44
35 37
33
27 29
26 26 25
25 22 22
16 15
10 10 8 12
7 9 7
5 5
0
TH
NZ
N
R
R
H
NZ
N
R
FR
R
S
UK
E
FR
S
IZ
UK
US
E
IZ
US
SW
GE
T
SW
AU
CA
GE
NO
AU
CA
NO
SW
SW
NE
NE
Source: 2010 Commonwealth Fund International Health Policy Survey in Eleven Countries.
2010 TransforMED
4
5. 6/8/2011
Growth of Retail Clinics, Year End 2005–2007
Number of retail clinics
900
1000 800 30 states
23 states Dec. 07
800
Dec. 06
600
400
200 60
18 states
Dec. 05
0
2005 2006 2007
Source: Interview with Mary Kate Scott, principal of Scott & Company, July 2008.
%
80 Retail clinic choices
64 62
60 53
48
40 34
20
0
Clinic hours Location Did not have Cost was Did not have
were more was more to make an lower than a usual
convenient convenient appointment another source of care
than another than another for a source of care
source of care source of care retail clinic
Notes: Categories are not mutually exclusive; respondents were able to select multiple categories.
Source: Center for Studying Health System Change 2007 Health Tracking Household Survey, April 2007–January 2008.
Traditional Model New Model
• Unnecessary barriers to access • Same or next day access by
by patient patients
• Monday through Friday • After hours and weekend care
9–5 • Alternate means of
• In person visit only communication
• Primary care physician could ▫ Interactive website
not see you ▫ Phone triage and follow-up
• Same physician or team sees you
every time
• Alternate visit types
▫ Group visits
▫ e-visits
5
6. 6/8/2011
16
Comprehensive
• Whole person care • Quality versus
• Population quantity
management
▫ Preventive
▫ Chronic disease
management
• Non-differentiated
care
• Often birth to death
• Evidence based
Traditional Model New Model
• Event – based medicine • Continuous healthcare
• Experience based
• Quality improvement
▫ Docs with the most
experience are the best ▫ Patient experience survey
docs ▫ Provider satisfaction survey
▫ Employee satisfaction survey
▫ Clinical outcome
measurement
▫ Financial outcome
measurement
▫ Study and planning of results
• Evidence based
▫ Evidence based guidelines
▫ Clinical outcomes reported
Traditional Model New Model
• Reactive management of • Pro-active population
patients’ preventive and management for chronic and
chronic care preventive care
▫ Patient makes appointment ▫ Anticipate needs of patients
when needed prior to visit
▫ Acute chronic is managed in ▫ Pre-visit planning
hospital setting ▫ Management of high acuity
▫ High acuity patients are patients more intensely
known as “frequent flyers” ▫ Overall better management
of chronics
6
7. 6/8/2011
19
Coordination of care
• Emphasis on • Tracking & follow-up
communication ▫ Referral tracking
▫ With patient /family ▫ Test tracking
▫ Across settings • Medical neighborhood
• Facilitate transitions
▫ Information
▫ Accountability
• Community resources
▫ Home health
▫ Nursing homes
▫ Health departments
2010 TransforMED
Medicare re-hospitalization rates
JAMA
7
8. 6/8/2011
Traditional Model New Model
• Proactive transitions of care
• Reactive coordination of care
between hospitals and primary
• Referral specialists taking care
over care
▫ Patients are pro-actively
• Patient goes to specialists as called after hospitalization
needed
• Agreement on roles &
responsibilities between
specialists and primary care
• Referral and test tracking
• PCP coordinates all care
outside office
23
Relationship
• Personal physician • Continuity
▫ Increased efficiency
• Team assigned to care
▫ Better quality
• Long term
• Communication
▫ For patient
engagement
▫ For patient education
8
9. 6/8/2011
Traditional Model New Model
• Physician is the main • Multidisciplinary team is
source for care the source of care
▫ Each member
participates in the care
▫ Each member has a
role
▫ All members
understand each
others’ roles
Traditional Model New Model
• Patient engagement
• Communication as
▫ Giving test result
needed with patients – numbers
sharing only need to ▫ Giving patients
know information information resources
• Directive communication ▫ Knowledge by patient
about internal and
external team members
• Collaboration
▫ Patients receive care
plan at each visit
▫ Patient is part of care
team helping to make
decisions about care
Goals in running a medical home --
• Good quality outcomes
• Good financial outcomes
• Good satisfaction outcomes
2010 TransforMED
9
10. 6/8/2011
Satisfaction outcomes
• Happy docs
• Happy staff
• Happy patients
Medical home concepts - Access, patient centered care,
team based care
2010 TransforMED
Financial outcomes
Internal Health care system
• Salaries • Hospitalization
• Revenues • Re-hospitalizations
• Profit margin • Use of generic drugs
• Bonuses • Complications in
• Cost of unit of service surgery
• ER utilization
Medical home concepts - Care coordination, access,
sound practice management, health information
technology
Quality outcomes
Chronic disease Population
management management
• Disease specific • Preventive medicine
▫ Diabetes ▫ Cancer screening
▫ Hypertension ▫ Immunizations
▫ Coronary heart • High risk behaviors
disease ▫ Obesity
• High users of the system ▫ Smoking
▫ Child safety
Medical home concepts - Care management,
health information technology, care coordination
10
11. 6/8/2011
32
What comes first?
Where is medical home?
• PCMH demonstrations rollout in every state except
Alaska.
• Medicare Advanced Primary Care demonstration.
• Federal departments and agencies establish PCMH as
the foundation for national transformations:
▫ Department of Defense
▫ Department of Veterans’ Affairs
▫ HRSA
2010 TransforMED
11
12. 6/8/2011
2010 TransforMED
Get started. . . .
"In order to succeed, your desire for success
should be greater than your fear of failure.“ --
Bill Cosby
"The problem in my life and other people's lives is
not the absence of knowing what to do, but the
absence of doing it.” -- Peter Drucker
2010 TransforMED
Questions
Sheila Richmeier, MS, RN, FACMPE
sheila@remedyhc.com
Remedy Healthcare Consulting
www.RemedyHealthcareConsulting.com
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