New WHO guidelines call for more evidence on airborne transmission

The World Health Organization released new guidelines on the transmission of the novel coronavirus. These guidelines acknowledge some reports of airborne transmission of the virus that causes COVID-19. Though it didn’t confirm that the virus spreads through the air.  

WHO acknowledged that some outbreak reports about indoor crowded spaces indicate that there is a possibility of aerosol transmission and some examples can be during choir practice, in fitness classes or in restaurants.  

Though WHO said more research is needed urgently to investigate such instances and assess their significance in the transmission of COVID-19.  

After reviewing the evidence, the WHO said the coronavirus that causes COVID-19 spreads through contact with contaminated surfaces or close contact with infected people spreading virus through respiratory secretion, saliva, or droplets released when a person who is infected sneezes, coughs, sings or speaks.  

The new guidelines state that people should avoid crowding in places, should have good ventilation in buildings, follow social distancing and should wear a mask when physical distancing is not possible.  

Jose Jimenez, a chemist at the University of Colorado said that this is a right move but a small one. It is gradually becoming clear that the pandemic is driven by super-spreading events, and that the best explanation for many events is aerosol transmission.  

Linsey Marr, an aerosol expert said that WHO is using an outdated definition of droplets and aerosols. It is too focused on the size of the droplets and the distance they travel. 

WHO defines aerosols as being under 5 microns since only particles that small could float in the air long enough to be inhaled.  

But Jimenez and Marr mentioned that a much larger range of particle size has been shown to contribute to infection. 

Instead of the size, they believe the differences between droplets and aerosols should be based on how the infection occurs.  

When a person inhales the virus and gets infected, its an aerosol and when the infection occurs by contact, they are droplets.  

But WHO has focused on airborne transmission at long distances and Marr notes that breathing in aerosols is more worrisome when in close contact and when people are in the same room.

Source - http://www.lifecyclehealth.com/whatsnews/2020/7/14/new-who-guidelines-call-for-more-evidence-on-airborne-transmission

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Hospital for Special Surgery opens a new facility in Florida

Hospital for Special Surgery (HSS) opened a new facility in West Palm Beach, Florida. The facility announced its leadership and medical team and the scheduling of almost 1,000 appointments.

David Altchek, MD, founding medical director of HSS Florida and chief emeritus of the HSS Sports Medicine Institute, said in a press release that the new facility will be able to serve as a real center of excellence for patients seeking a wide-range of musculoskeletal health services.

He also mentioned that he is looking forward to working with some of the world’s most highly skilled physicians, surgeons and other specialists at the spectacular HSS Florida campus.

HSS Florida is a 60,000 square-foot facility and the leadership includes orthopedic trauma surgeon Nick Sama, MD, as associate medical director for inpatient services, and sports medicine and shoulder surgeon Ryan Simovitch, MD, as associate medical director for ambulatory services.

HSS Florida’s medical team will help patients with various injuries and pain, including sports injuries and general orthopedic pain.

The facility will also offer sports performance services. HSS Florida will include full-time Florida-based physicians, as well as physicians who will split their time between the New York and Florida HSS facilities.

Louis A. Shapiro, president and CEO of HSS said that HSS is making the highest level of musculoskeletal care more convenient for a community that appreciates and values quality.

This new facility is unique and also unlike any of the other previous expansions as this a brand-new comprehensive center built from the ground up and located outside of the New York City tri-state area.

Source: http://www.lifecyclehealth.com/whatsnews/2020/2/6/hospital-for-special-surgery-opens-a-new-facility-in-florida

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CMS expands telehealth coverage for treatment of opioid abuse disorder

The Centers for Medicare & Medicaid Services will have new reimbursement codes for care providers who utilize telehealth to treat opioid abuse patients. As part of the 2020 Physician Fee Schedule, CMS is adding three CPT codes that will allow providers to bill Medicare for telehealth services included in bundled episodes of care for opioid abuse treatment, including care delivered to the home.

These codes were first proposed in July to apply connected health technology to the ongoing opioid abuse epidemic.

CMS Administrator Seema Verma mentioned in a July press release announcing the proposed codes. She said that proposals were being announced so that the government doesn’t come in the way of patient care, by giving clinicians the support they need to spend valuable time taking care of these patients to ensure their diseases were well-managed and their quality of life is preserved.

Now included in this newly announced final rule in a category titled Communication Technology-Based Services, the codes are:

HCPCS code G2086, covering at least 70 minutes during the first calendar month of office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling;

HCPCS code G2087, covering at least 60 minutes in a subsequent calendar month of office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; and.

HCPCS code G2088, covering each additional 30 minutes beyond the first two hours of office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling (filed alongside the code for a primary procedure).

An analysis of the new codes penned by Nathaniel Lacktman, a partner in the Foley & Lardner law firm and chair of its national Telemedicine & Digital Health Industry Team, and Emily Wein, a healthcare lawyer with the firm, the new codes combine with recent legislation to give new opportunities to deliver care to the patient’s home.

Source - http://www.lifecyclehealth.com/whatsnews/2019/11/13/cms-expands-telehealth-coverage-for-treatment-of-opioid-abuse-disorder

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Suicide deaths and the ‘Opioid Crisis’

Writing in her blog at the National Institute On Drug Abuse, Dr. Nora Volkow and co-author Dr. Joshua Gordon of the National Institute of Mental Health offer an insight that “Suicide Deaths are a major component of Opioid Crisis that must be addressed.”

They mention that opioid overdose epidemic is not restricted to people with opioid addiction who accidentally take too much of a pain reliever or unknowingly inject a tainted heroin product.

Hidden in the alarming number of overdose deaths is a significant number of people who decide to take their own life. The authors also mention that due to the current initiatives to reduce opioid prescribing, many patients in pain find it unable to get treatment they need or get stigmatized as “addicts” by the healthcare system. Thus, compounding their difficulties.

There is a rising desperation and despair of people in agony who are denied treatment by misdirected policies of Federal and State drug enforcement agencies and State Medical Boards.

A recent study states that 40% of primary care clinics in Michigan will no longer allow their doctors to prescribe opioids to new patients.

But medical prescribing cannot possibly be the only cause of opioid crisis. It is time we recognize that America’s opioid and suicide crisis are much larger than just prescribing or street drugs. The factors responsible for addiction and suicide are socio-economic. Forty years of wage stagnation compounded by automation of manual labor jobs, structural unemployment and the hollowing-out of rural communities have made millions of people vulnerable to the distractions of street drugs. The crisis is not of medical exposure, but of despair. The labor force has to be redeveloped without which a change will not occur in either overdose or suicide statistics.

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What are the benefits of growing Remote Patient Monitoring Market?

Remote Patient Monitoring (RPM) is a healthcare delivery system that is driven by technology in order to monitor patient’s health, outside the traditional clinical setting. Remote health monitoring systems are affordable and smarter.

Device manufacturers traditionally targeting hospitals and clinics are now presented with new potential revenue channels as they begin offering their services to consumers. These observations have been revealed in the research report from Business Insider Intelligence.

Today, US health systems and hospitals are moving towards improved health care outcomes and reduced costs. One of the tools they use to achieve this aim is Remote Patient Monitoring (RPM) technology. This type of patient care extends the reach of physicians, enables the relationship between patients and caregivers. It also offers providers continuous real time health data.

RPM is a specific technology used to electronically transmit information between patients and physicians. Common patient remote monitoring devices are voice apps that remind diabetes patients to take insulin, while allowing doctors to monitor the disease, digital blood pressure cuffs that lets patients to remotely send physicians their blood pressure and pulse.

Providers using RPM – enabled home healthcare and other telehealth delivery methods are reducing hospital readmission penalties. The University of Pittsburgh Medical Center, reduced the risk of hospital re-admissions by 76% and held patient satisfaction score over 90% by equipping patients with tablets and RMP equipment.

Seniors are driving positive ROI from RPM technology and home-based care largely due to the cohort's high incidence of multiple chronic diseases.

A KLAS Research report surveying 25 healthcare organizations found 38% of healthcare organizations running RPM programs focused on chronic disease reported reduced re-admissions and 17% reported cost reductions.

The future trend in RPM is miniaturization. Device makers are making solutions smaller and less invasive as they partner with new players to expand their market share.

Source - http://www.lifecyclehealth.com/whatsnews/2019/8/30/benefits-of-the-growing-remote-patient-monitoring-market

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How Interactive Patient Engagement Programs Improve Addiction Treatment

Substance addiction is one of the most serious and common challenges that Americans face today. The bad news is that people, particularly young people, are increasingly getting hooked to drugs, alcohol, and tobacco and are starting at a younger age.

According to a report from the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 100 people die every day in the country from drug overdoses and of the 20 million people who have an addiction, the rates of illicit drug use is the highest among those between the ages 18 and 25.

In addition to severely impacting the physical and mental health of the individual battling the addiction, the disease causes major conflicts in families and relationships as well. The challenge is complicated by the fact that the addiction creeps up on individuals and many continue to live in denial. Furthermore, the stigma around the subject means that not many people reach out and ask for help.

However, studies have shown that addiction is a highly treatable disease and 100% recovery is attainable. Modern patient engagement software solutions have shown some success in making the treatment of addiction more effective by making the process more inclusive and empowering. Let’s take a look at some of the benefits of interactive patient engagement in addiction treatment.

Addiction Engagement Software Provide Personalized Treatment

An undeniable fact of addiction treatment is that the course of recovery is different for each individual — what works for one may not work for the other. Depending on the physical and mental health of the individual, and the severity of the addiction, personalized treatment plans are often designed by healthcare professionals and doctors.

The increasing use of remote patient monitoring systems such as telehealth services and mobile apps in addiction treatment means that individuals are able to receive the support and care they require, even if they are unable to meet their physicians in person. For example, most addiction treatment programs involve counseling sessions with psychologists. Patient engagement software systems usually ensure remote availability of counselors in case of emergency and provide a sense of security and comfort to the patient.  

A 2016 Kaiser Permanente Northern California study shows that substance abuse engagement programs, that focus on the overall health progress, use EHRs, and patient portals to allow patients to communicate and engage with their healthcare providers, are much more satisfactory for the patients and such interactive softwares provide them with higher chances of overcoming their addictions. The study showed that patients who are more involved with their treatment and recovery understand the importance of each step of treatment better, and are more likely to adhere to the same and take better care of themselves.

Patient Engagement Software Enable Timely and Reliable Monitoring

The most important aspect of addiction treatment is consistency. Studies have shown that monitoring the progress and acknowledging each step forward is a motivation to control addiction. For example, alcoholics can regularly monitor their blood alcohol levels as a way to stay accountable. Patient engagement portals take this to the next level by providing a comprehensive report of the patient’s health progress in various parameters. Test results, behaviors, attitudes, and progress made in counseling can be monitoring reliably using remote health monitoring systems.

Caregivers and health professionals can monitor the progress made by patients and provide the most effective and relevant treatment needed. This allows for timely detection and intervention whenever the results point toward a red flag. In addition to keeping a tab on relapses, remote health monitoring software systems allow physicians and counselors to treat not just the substance abuse disorder but take into account other medical issues related to age and gender.

Furthermore, a continuous assessment helps in finding the right combination of medicines needed by a patient. Since addiction treatment programs need to be modified with time, keeping a track of the progress becomes imperative to design a treatment that varies according to the patient’s needs and gives the best results.

Interactive Substance Abuse Engagement Software Reduce the Chances of Relapse
Relevant, timely, and critical support and information given to patients when they need it the most is likely to help them maintain their abstinence. However, even with the best possible care and treatment, the chances of relapse for people battling addiction are as high as 40-60%. However, patient engagement programs impact critical preventative care information and also allow patients to comprehensively understand their treatment and recovery. This allows them to understand the significance of each and every step of the journey and helps them make more informed and aware decisions.

Patients involved in opioid addiction engagement programs, as shown by the Kaiser Permanente Northern California study, also seek more medical advice and review medical information more frequently as compared to other patients. Since patients who are battling addiction have complex health needs, keeping them aware of the intricacies of the same helps them adhere to the treatment program more effectively and reduces the chances of a relapse.

Additionally, addiction engagement software solutions allow patients to communicate more effectively with their healthcare providers and seek help whenever they need. By making patients aware of the gravity of the disease and the pitfalls of falling off the wagon, patient engagement programs are able to communicate the urgency and criticality of abstinence.

Conclusion

Conclusion -

Patient management and monitoring programs help make addiction treatment more effective by assuring patients that addiction is treatable inclusive and accessible. Patients who are aware of the impact of their actions and choices will be more likely to make the right call. Furthermore, the availability of medical aid, advice, and information instantly ensures a consistent support system which is not the case in traditional groups or individual counseling sessions.

By allowing the patient to take charge of their recovery journey, substance abuse disorder engagement programs cultivate cooperation and active involvement from the patient, thus, using positive reinforcements to keep patients motivated. Establishing a permanent channel of communication not only helps build trust but also increases the chances of a patient seeking help when they need it the most. Finally, patient engagement programs and strategies are able to dispel myths and preconceived notions regarding addiction and substance abuse by providing accurate and relevant information to patients and their caregivers, which is by far, one of the most important achievements.

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How Shifting to Outpatient Care Can Save Money for Consumers

As of late, we have been seeing a quick ascent in outpatient mind administrations. Outpatient mind has turned out to be very viable because of present-day medicinal skill like insignificantly obtrusive careful capacities, most recent anesthesia strategies, torment administration systems and provider engagement software. This assistance keeps away from potential restorative entanglements and empowers patients to return to homes quickly. Modern patient care software also helps healthcare providers monitor patients after their discharge.

Inpatient vs Outpatient Care 

Inpatient and outpatient mind alludes to the manner in which that a medicinal services benefit is given. Inpatient mind alludes to medicinal administrations that expect you to get conceded into a healing center. Such care, as a rule, includes genuine sicknesses and injury that requires multi-day or a greater amount of remain at the doctor's facility.

Outpatient mind is the restorative administration got when you are not required to remain back at a healing center. This incorporates routine checkups or facility visits and basic surgeries that enable you to leave the doctor's facility around the same time. Such careful administrations, and also recovery medicines and emotional well-being administrations, are accessible as outpatient mind. Outpatient is for the most part more affordable as it uses less of the healing facility's assets.

So how do shoppers spare cash in the event that they move to outpatient mind? We should investigate a wellbeing report discharged by the Blue Cross Blue Shield Association and the Blue Health Intelligence. Their scientists connected progressed examination to the restorative cases database to investigate advertise improvements and the reasonableness with respect to human services measures.

The analysts investigated four systems that can be completed in either inpatient or outpatient settings. Of these, two (spine medical procedure/hysterectomy and lumbar) overwhelmingly recorded a move towards mobile care and the staying two (gallbladder expulsion and angioplasty) kept on staying stable through at various phases of outpatient mind. The non-crisis nature of the picked techniques gave patients the time they expected to search for human services experts, consider the expenses and choose when and where they wanted to experience the therapeutic treatment.

In light of their report, we should consider how quiet care continuum can be guaranteed while enhancing restorative method results and lessening human services costs.

1. Outpatient Care is Cost successful

Therapeutic methods when performed in an outpatient setup, brought about extensive cost reserve funds. For example, when patients wanted to experience angioplasty in an outpatient setting, the sparing in cost was to the degree of $1,062/technique as against system executed as an inpatient.

The Angioplasty methods in inpatient setup demonstrated a lofty ascent. The inpatient cost for Angioplasty strategies enrolled 6.1 percent rise, while outpatient evaluating demonstrated a pitiful 1.4 percent expansion over a period length of five years.

While outpatient use expanded amid the five-year think about period, in general usage did not increment - the outpatient use increments were counterbalanced by noteworthy abatements in inpatient use.

2. Outpatient cost reserve funds on the ascent 

The resultant cost reserve funds as to the four methodology expanded always, however fluctuated altogether amongst inpatient and outpatient offices. The aggregate cost sparing/method in 2014 was significant running from $4,505 if there should arise an occurrence of hysterectomy to $17,530 as respects angioplasty. The rate of yearly cost acceleration was on higher agree as to inpatient techniques and brought about a rising the aggregate cost putting something aside for outpatient strategies. The rate of heightening was impacted by different viewpoints including repayment rules, cost piece with respect to the inpatient and outpatient framework and difference in the patients' wellbeing conditions.

3. Increment in outpatient system 

Amid this examination, Hysterectomies indicated generous move towards outpatient strategies. The extent of those restorative procedures raised from 36 percent to 64 percent, then again the extent of outpatient lumbar/spine medical procedure raised to 82 percent from 61 percent. While, the offer of Angioplasty outpatient developed insignificantly from 43 percent to 50 percent. Then again, laparoscopic gallbladder medical procedure keeps on staying unaffected as this had moved to outpatient by 2010 and recorded 80 percent.

4. Impressive cost investment funds in Hysterectomies 

The outpatient methodology for hysterectomies created valid and raising cost reserve funds. By and large, the distinction between the inpatient per-technique cost and outpatient expanded from $2,781 in 2010 to $4,505 by 2014. The patients set aside, by and large, $483 out-of-stash costs in 2014 by deciding on outpatient techniques. The regular stomach hysterectomy, which is done in inpatient setting, keeps on remaining the most prevalent careful technique and record for almost 50 percent of hysterectomies. In any case, stomach and vaginal hysterectomies needed to clear a path for the progressed laparoscopic and automated helped laparoscopic activities, which are more good to outpatient setting.

5. Fall in out-of-stash costs in Lumbar/Spine Surgery 

Notwithstanding mounting careful costs, outpatient lumbar/spine methods indicated expanded investment funds in the cost, from a normal sparing per strategy of $5,269 in 2010 to $8,475 in 2014. The funds were $320 overall in out-of-take costs by embraced outpatient process. Over the span of this examination, lumbar/spine techniques moved to the outpatient framework by pretty much 20 rate focuses, to 82 percent from 61 percent. This move to outpatient setting came about because of drop in inpatient use by in excess of 50 percent. Subsequently, the use for lumbar/spine stayed unaltered, all in all.

6. Huge investment funds for outpatient Angioplasties 

Outpatient angioplasties likewise gave in surprising expense investment funds regardless of unassuming development of outpatient over the span of the investigation. The distinction in system cost by and large amongst outpatient and inpatient developed from $11,062 in 2010 to $17,530 in 2014. The investment funds in out-of-stash costs on a normal were $1,062 by taking outpatient method in 2014. The proportion of outpatient angioplasty systems developed humbly from 43 percent to 50 percent, amid the examination time frame, however generally use of angioplasties diminished. This was the result of a staff lessening in inpatient systems, and a minor drop in outpatient activities.

7. Gallbladder methodology; outpatient funds increment 

The outpatient gallbladder evacuations additionally recorded expanding cost funds disregarding having an unfaltering proportion of outpatient techniques made in the time of study. The per-method cost distinction amongst inpatient and outpatient expanded by and large from $8,299 in 2010 to $11,262 in 2014. The investment funds by and large were $924 in out-of-stash spending in an outpatient procedure. The greater part of gallbladder medical procedures changed to outpatient setup in view of imaginative of laparoscopic methods and present day negligibly intrusive advances.

Conclusion: 

Because of the advances in medicinal innovation, medications like minor medical procedures and physical recovery can be completed as outpatient mind. The usage of Telehealth programming makes the outpatient techniques significantly more powerful.

Outpatient mind gives numerous advantages to patients. Above all else, they can recoup in the solace of their own home while making the most of their own nourishment as opposed to the healing center sustenance. They can likewise appreciate exercises of their decision that does not negate limitations given by their human services supplier. The patient supplier correspondence is at the core of outpatient systems and contributes incredibly to making the technique exceptionally fruitful. The best care will be driven through simple and advantageous interchanges among suppliers, patients, parental figures, and pros - and a patient provider communication stage can help with this experience.

All the more essentially, outpatient strategies as a rule cost not as much as the practically identical inpatient methods. Remaining in a healing center notwithstanding for only one night of perception isn't shoddy. Indeed, even those having great medical coverage can make huge investment funds, of up to a great many dollars, by choosing outpatient systems.

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Heart Health and You: Tips for Avoiding the #1 Killer

The cardiovascular ailment is the main source of death all around. In 2015, an expected 17.7 million individuals passed on from a heart-related issue - that is 31 percent of the aggregate passings that year. It's not only the United States, either. More than 75 percent of cardiovascular ailment related passings occur in low-and center pay nations. However, the issue is gravely genuine here at home, also. One out of four passings in the United States is a result or something to that effect of coronary illness.

Read more in terms of news: Cardiac Arrest Survival Rate Can Be Increased

Types of Heart Disease:

● Coronary course sickness is a condition in which the muscles of the heart can't get enough blood and oxygen since developments of greasy plaques obstruct the coronary supply routes. This prompts heart assaults, harm to the heart, and can bring about sudden passing.

● Silent Ischemia is a kind of coronary illness in which the bloodstream to the heart muscle is lessened, yet the subject encounters next to no torment or side effects. They may encounter inconvenience while striving physically.

● Myocardial Infarction- - also called a heart assault - happens when bloodstream is blocked and the heart muscle is harmed. The harm can be turned around if the blockage is expelled and the heart, in the long run, gets the blood, oxygen, and supplements it needs to repair itself.

● Congestive heart disappointment is the point at which the heart can't draw enough blood to address the issues of the subject's body. There are different reasons for congestive heart disappointment - it's extremely even more a bunch of side effects, as opposed to a solitary illness. Regularly, heart disappointment happens bit by bit after some time as opposed to all of a sudden, which means millions are living with congestive heart disappointment at this moment. As per information gathered in the National Health and Nutrition Examination Survey, the number of grown-ups living with heart disappointment expanded from 5.7 million out of 2009-2012 to an expected 6.5 million out of 2011-2014. The number is relied upon to increment significantly more in the coming years.

● An arrhythmia happens when the heart's electrical framework does not work ordinarily, causing anomalous rhythms or "arrhythmias."

● Heart abandons happen when impediments called stenosis create in the subject's heart valves, supply routes or veins, halfway or totally obstructing the stream of blood.

● Peripheral corridor ailment creates when greasy plaques or atherosclerosis can likewise influence courses that supply oxygen-rich blood to different territories of the body including the legs and feet. The blockage denies the appendages of oxygen and supplements, delivering side effects including deadness, torment, swelling, and ulcers.

Tips for Preventing Heart Disease 

The amazing insights with respect to the pervasiveness of coronary illness have numerous individuals pondering what they can do to help secure themselves and keep an early demise because of this very normal executioner. While a couple of the sorts - arrhythmia, and heart abandon, for example - are not preventable, most instances of coronary illness are to a great extent preventable with a solid way of life. The main sources of coronary illness incorporate numerous nourishment related issues, for example, weight, elevated cholesterol, type 2 diabetes, and hypertension. The most widely recognized reason is plaque development or atherosclerosis, which is caused by correctable issues including being overweight, unfortunate eating routine, the absence of activity, and smoking. Besides, physical and passionate pressure both put quantifiable and reproducible requests on the heart that can prompt noteworthy cardiovascular issues.

● Eating a solid eating routine lessens your danger of coronary illness. Consolidating "great" fats into your dinners while maintaining a strategic distance from "terrible" fats keeps your corridors free from blockage. Polyunsaturated and Monounsaturated fats found in olive oil, nuts, seeds, avocados, and fish enable the body to grow high thickness lipoprotein (HDL) cholesterol which expels low thickness lipoprotein (LDL) cholesterol from the body. "Awful" fats including soaked and trans fats found in shoddy nourishment make the body grow excessively LDL cholesterol which prompts plaque arrangement in the corridors. An eating regimen loaded with negligibly prepared sustenances pressed with heart-sound polyunsaturated omega-3 unsaturated fats ought to be the objective. Take in more about "great" versus "awful" fats here.

● Physical exercise holds weight under wraps, works the heart muscles, and lessens the pressure that can harm the heart muscles.

● Smoking is a gigantic hazard factor for coronary illness. On the off chance that you smoke, quit. On the off chance that you don't smoke, don't begin and keep away from used smoke however much as could reasonably be expected.

● Excessive liquor utilization harms the heart and raises circulatory strain. Point of confinement liquor admission to two servings for every day at most.

Coronary illness is the main source of death around the globe, yet it is generally preventable. There are different sorts of heart maladies and keeping in mind that some of them are hereditary, various them result from plaque development caused by an undesirable way of life. Eating a solid eating regimen, working out, and abstaining from smoking and in addition liquor can significantly diminish a man's danger of creating coronary illness.

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The BPCI Advanced: The Next Generation of Bundled Payments from CMS

The United States Centers for Medicare & Medicaid Services (CMS) has introduced a new voluntary bundled payment model initiative known as the Bundled Payments for Care Improvement Advanced (BPCI Advanced).

Announced at the beginning of 2018, the BPCI Advanced has come in within just months after several mandatory bundled payment programs were canceled. During their initial phases, bundled payment initiatives had exhibited great promise. But later on, many challenges, ranging from identifying patients, understanding provider claim inputs and defining effective strategies, cropped up. The design of the new BPCI program has renewed the interest in episodic cost management as it counteracts the risks and complex implications connected to the former Medicare program MACRA.

Understanding Bundled Payments

Building up a high quality, but affordable and accessible healthcare system that puts patients first is the foremost goal at CMS. Previously, Medicare used to make separate payments to healthcare providers such as hospitals, post-acute care providers, physicians, etc. for each and every service performed for their patients irrespective of whether it was a single and short illness or a prolonged course of treatment. But they discovered that this payment model resulted in fragmented care, a lack of patient engagement and coordination between providers and healthcare settings. Care providers were being rewarded for the number of services offered rather than the quality of their care.

Bundled payments for care improvement which align incentives for providers were more effective and efficient as it encourages them to work closely together across all settings and specialties. All the payments of multiple services that beneficiaries receive during an episode of care are linked together. Healthcare providers involved in this payment arrangement are held accountable both performance-wise and financially for episodes of care. This leads to better patient engagement, coordination and more value-based care solutions at a lower cost to Medicare. Those receiving the bundled payments may either end up with gains or losses depending on how successfully they handled their resources and costs during each episode of care.

Medicare promoted BPCI bundled payment programs as they have proven to decrease the providers' total expense on 90-day episodes. This BPCI Medicare payment model provides a lump sum bonus if aggregate fee-for-service (FFS) costs are less than an episodic benchmark. There are also penalties if the FFS costs are higher than the benchmark. This design of the BPCI program is aimed to motivate providers in decreasing their total episodic expenditures. This also includes the addition of internal costs of items such as implants.

Under the retrospective approach adopted by the BPCI Advanced, the total FFS payment for a Clinical Episode is retrospectively reconciled against a preset target price. The Benchmark Price is set by taking into consideration the historical Medicare FFS spending, the Episode Initiator's efficiency relative to its peers over time and the adjustments for patient characteristics and regional spending trends. A discount, known as the CMS Discount, is applied to the Benchmark Price to calculate the Target Price. Some of the major advantages of BPCI Advanced over the former BPCI program are the introduction of prospective pricing and the risk adjustment at both the provider and beneficiary level. The annual re-basing of Target Prices are also expected to generate more accurate pricing.

CMS Announcements on BPCI Advanced

The BPCI Advanced is classified as an Advanced Alternative Payment Model (APM) under the Quality Payment Program. The first group of participants is set to be active from October 1, 2018, and the model period performance will be for three months, until December 31, 2023.

All applications were processed via the BPCI Advanced Application Portal. Applications submitted outside of the Application Portal were not be accepted. Incomplete applications were also rejected. As per the plan, Target Prices are to be calculated and distributed to the applicants before the first performance period of each year. The target prices for this year are expected to be distributed in May 2018 and the applicants have time up to August 2018 to sign their participation agreements.

Before signing the BPCI Advanced Agreement, participants have the option to review a summary of beneficiary claims data and line-level beneficiary claims. This is expected to be distributed by the end of May 2018. Participants who wish to view this information have to fill a Data Request and Attestation (DRA) form during their application process. They have to provide the time period for the requested data and also the legal basis for disclosure under the Health Insurance Portability and Accountability Act (HIPAA). This helps to get a valuable insight into a provider's care delivery processes and costs. If any applicant feels the current BPCI Medicare program is not a good fit for them, then a written request can be given to withdraw the application. For those who are unable to apply this time. a second application opportunity is expected from CMS in January 2020.

Clinical Episodes in BPCI Advanced Model

CMS has announced that the Bundled Payments for Care Improvement Advanced model will test a new iteration of bundled payments for 32 Clinical Episode which includes 29 inpatient Clinical Episodes and 3 outpatient Clinical Episodes. Participants of the BPCI Advanced will be held accountable for one or more Clinical Episodes from the launch of the program in October 2018 and are not allowed to add or drop such Clinical Episodes until January 1, 2020.

INPATIENT CLINICAL EPISODES

1. Disorders of the liver excluding malignancy, cirrhosis, alcoholic hepatitis
2. Acute myocardial infarction
3. Back & neck except spinal fusion
4. Cardiac arrhythmia
5. Cardiac defibrillator
6. Cardiac valve
7. Cellulitis
8. Cervical spinal fusion
9. COPD, bronchitis, asthma
10. Combined anterior-posterior spinal fusion
11. Congestive heart failure
12. Coronary artery bypass graft
13. Double joint replacement of the lower extremity
14. Fractures of the femur and hip or pelvis
15. Gastrointestinal obstruction
16. Hip & femur procedures except major joint
17. Lower extremity/humerus procedure except hip, foot, femur
18. Major bowel procedure
19. Major joint replacement of the lower extremity
20. Major joint replacement of the upper extremity
21. Pacemaker
22. Percutaneous coronary intervention
23. Renal failure
24. Sepsis
25. Simple pneumonia and respiratory infections
26. Spinal fusion (non-cervical)
27. Stroke
28. Urinary tract infection

OUTPATIENT CLINICAL EPISODES

1. Percutaneous Coronary Intervention (PCI)
2. Cardiac Defibrillator
3. Back & Neck except Spinal Fusion

The Conveners for BPCI Advanced program

From hospitals and physicians to post-acute providers, multiple independent parties are engaged in delivering patient care across an episode. An organization that brings together these various care-providing parties is called a convener. The convener distributes the above-mentioned bonus or pays the penalty incurred with higher than benchmark FFS costs. The BPCI Advanced program applications were due on March 12. Starting on Oct. 1, 2018, the participants are subject to immediate downside risk.

Any organization can play the role of convener, but they must have an adequate administrative capacity, the financial capacity to take on the risks and the ability to gain the trust of the various bundle participants. Hospitals, large physician groups, third-party consultancies, or specialty associations like the Academy of Academic Medical Colleges can serve conveners who rally local providers into agreements.

Since there is significant financial risk associated with the BPCI Advanced model, several conveners of the former BPCI dropped out when downside risk was phased in. But the organizations that had started to manage the previous bundled payment models successfully, are likely to succeed under downside risk as they will be more prepared for it. Organizations like consulting groups and product suppliers who do not have the ability to directly initiate episodic spending may find the risk levels in the BPCI Advanced program too high for them. Since post-acute facilities are also unable to initiate episodes under the new BPCI Advanced model, they may not be interested in serving as conveners either.

Lifecycle Health has designed a healthcare care coordination and patient management software platform where all individuals involved in patient’s episode of care, including the patient and all the care providers, are able to coordinate and collaborate throughout the treatment episode. Though it may seem like Greek to most, our team of experts at Lifecycle Health understand what CMS is looking for. The Lifecycle Health cloud platform organizes multi-provider care teams around patient episodes and manages patients along the care continuum that save providers time and costs. From the quality of care to costs and patient satisfaction, the Lifecycle Health platform allows its members to get real-time visibility into a patient’s episode of the various providers involved. Allow us to guide your organization to efficiently master the all-new bundled payment program, the BPCI Advanced.

If a convener, physician group, ACO, or hospital wants to become effective at managing risks for episodes for bundled payments or BPCI Advanced, -- they should look at utilizing the Lifecycle Health platform.  Lifecycle Health can provide them the platform to improve their internal care coordination, or they can also the partner and utilize the Lifecycle Care Coordination service that is a turn-key solution utilizing the platform and plugs right into existing processes for patient care except the Lifecycle Health Patient Navigation and Coordination service to follow patients post-acute.

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Here are the 3 Tips You Need to Fight Obesity by Focusing on Wellness Activities

If you struggle with your weight, you know that it is a seemingly impossible battle. Fad diets, conflicting information from experts, busy schedules, and waning motivation are just a few of the hurdles standing in your path to losing weight. Now that the focus is shifting from dieting to living a healthy lifestyle centered on wellness-focused activities, you may find it easier to win the battle against obesity once and for all.

1.    Make Working Out Fun

If you lead a sedentary lifestyle, it is difficult to break your habits and exercise regularly. If you avoid working out because you don’t want to join a gym, you are not alone. Fortunately, you can start moving more and begin looking forward to working out if you find a workout routine that is enjoyable.

One way to begin is to go walking with a friend. You’ll feel less like you’re working out and more like you’re getting time to catch up when you turn your walk into an hour of talking and laughing. It’s also better to work out with someone who will help you stay accountable. This accountability partner should be someone you trust and enjoy spending time with; choose someone who will not judge you while keeping you on track.

Another way to find an enjoyable workout routine is to try out various YouTube exercise videos. With a quick search, you can find free workout routines for beginners. You also can search by the type of exercise you think you’d like to do, from yoga to indoor walking. If you want to skip the search, check out this list of best YouTube workout videos from Thrillist.

You also can schedule times to do online workouts with your accountability partner – consider video chatting during the workout to motivate one another. The best part about using online workout videos – other than saving tons of money on a gym membership – is that you can try out as many as you’d like until you find the one that you enjoy the most.

2. Get Plenty of Rest

It seems counterintuitive to think of resting when you’re trying to lead a healthy lifestyle, but getting plenty of sleep is a key component of wellness. Sleep and rest help you learn, process memories, restore your energy, and repair muscles. Strive to get seven to eight hours of sleep per night and take steps to improve the quality of your sleep.

Wind down before bedtime instead of exercising right before bed. Also, put away your electronics about an hour before you hit the sheets. Dim bedroom lights and declutter so that you can relax and drift off to sleep more quickly.

3. Eat a Balanced Diet

The only diet you should think about when fighting obesity is a balanced one. Take a new approach to eating by taking the word “diet” out of your vocabulary. Choose whole foods and grains, water, and lean proteins. Watch your portion sizes and avoid rewarding yourself for working out with food.

Have healthy snacks like almonds, carrot sticks, and celery on hand and fill up by drinking enough water each day. Share healthy recipes with your accountability partner and plan meals together on the weekend so you are set for the week ahead and don’t find yourself at a drive-thru on a busy night.

If you have tried everything to fight obesity but aren’t successful, talk to your doctor about bariatric surgery. This option especially is recommended for people with a body mass index (BMI) greater than 40, but people with a lower BMI coupled with health concerns also are eligible. For more information on bariatric surgery click here.

Keep in mind that bariatric surgery reduces the size of your stomach and physically limits the amount of food you can consume. Patients often see rapid, significant weight loss, but you will need a brief hospital stay and have the potential for long-term vitamin deficiencies if you don’t maintain a proper diet.

You can fight obesity if you focus on wellness activities. Find an enjoyable workout routine, get plenty of rest, and eat a balanced diet. If you continue to struggle, talk to a doctor about bariatric surgery.

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3 Reasons Why Value-Based Care Options of Patient Engagement Improve Treatment Quality for Patients

When it comes to value-based care options, experiments are still ongoing with better and highly-evolved choices expected to come to the forefront in the days to come.  However, it does not in indicate that the present options in any way lack the treatment quality for patients.

Rather there has been a massive rise in the number of people looking for the flexible and economical ways of treatment that a value-based healthcare system offers -- and the demand has multiplied in all the three domains of healthcare including physical, mental and social. 

The constant pursuit of mankind to create a healthier society has been stunted by the emergence of chronic diseases in aging populations.  It is where a value-based healthcare concept seems to be highly effective and in line with the real objective of health care: increasing value. The health outcomes measure value which certainly matters to the patients who analyze it relative to the cost of achieving these outcomes.

Understanding The Genesis Of Value-Based Care

A value-based care is a type of reimbursement that decides the payments for care delivery based on the quality of care provided by the care provider. It rewards providers for both effective patient engagement, care effectiveness, and efficiency. In the past few years, this type of reimbursement has evolved as one of the most efficient alternatives and potential replacement for the regular fee-for-service type of reimbursements in which the patients/payer pay the provider retrospectively for the services they deliver on annual fee schedules or bill charges.

The traditional fee-for-service reimbursement model promotes quantity of services. However, lately, the federal medical programs have developed multiple reimbursement programs rewarding healthcare providers for the quality of care they provide to the patients. The primary aim of such value-based care programs is to fulfill three objectives:

1. To provide better care to individual patients
2. Improving the strategies for population health management
3. Reducing the overall healthcare costs

Better Patient Engagement And Contribution Of Value-Based Care

According to a study that was published in BMJ Quality & Safety in 2017 the chances of re-hospitalization were reduced by 39% with better patient-provider communication and a higher score of patient satisfaction. Those patients who perceived that their healthcare providers were truly giving them due attention and were listening to them keenly reported 32% less readmission.

The study also showed that better patient engagement improved the overall wellness including patient-goal setting. A value-based care system ensures that the patient and provider engagement is focused and the caretaker gives all the attention to the patient. The value-based payment structures make the maintenance of a consistently high level of health of the patients possible and it can be further enhanced with better communication and patient education.

Also visit: http://www.lifecyclehealth.com/blog/2017/3/8/4-provider-patient-communication-considerations

3 Reasons How Value-Based Care Can Improve Treatment Quality Of Patients

1. CUTS DOWN MISDIAGNOSIS CHANCES

With the cost pressures in the healthcare sector increasing steadily, established remuneration models related to healthcare services are now undergoing transition around the world. Now fees for performance and value-based systems are most eagerly preferred over the increased fees for service. Even the major players in the medical fraternity including Medicare and Medicaid in the United States, the National Healthcare Institute in the Netherlands, the National Health Service in the UK and many other leading university hospitals in Europe have taken a step in this direction.

Correct and timely diagnosis is the path to a successful and positive patient outcome. When a patient visits a doctor for the first time, the initial few minutes are dedicated to determining the subsequent steps that directly influence the cost and of course the treatment. The diagnosis itself is a complex challenge it has a high potential for human error as well as errors that arise from the whole system itself.

Misdiagnosis is a serious issue that can lead to unnecessary treatment of non-existing conditions or improper treatment or even proper yet delayed treatment. All these issues not only impact the patient but also the provider. More often, the diagnostic errors are caused as a result of staff shortages, temporary overwork or even time pressure. The occurrence of diagnostic errors can be restricted with the help of a modern software-based workforce management system that contributes in optimizing the organization of in-house resources.

When robust hospital information systems and innovative user-friendly diagnostic tools are used it cuts down errors leading to faster and accurate diagnosis.    

2. GREATER TRANSPARENCY LEADS TO IMPROVED OUTCOMES

It is an established fact that quality of diagnosis, treatment decisions based on this diagnosis and the monitoring of the treatment can have a significant impact on the patient outcomes. However, it is very much important that the results are transparent if improved outcomes are expected. According to economist Michel Porter, the providers do not have an option but to improve value if they want to survive the challenges of lower payment rates and potential loss of market share.

Although the hospital managers are well aware of this situation, they are not aware of the suitable measurement methods. With the patient engagement software, a healthcare provider is solely dedicated to one patient and all his attention is focused on the patient. The discussion is more on a one-to-one basis with the patient entirely depending on the provider for his suggestions. The credibility of the healthcare provider is at stake and he is certainly handling more responsibility of taking care of the patient across the care continuum while serving a hospital environment and after the patient starts their recovery outside the hospital stay.

The approach is more practical and effective as no payment adjustments are expected. The transparency in communication ensures that patient is well aware of the condition and is prepared to face the health challenges, and is more accountable for their own responsibilities for a good recovery. This ultimately leads to a positive outcome for the healthcare providers as well as the patient is well aware of their recovery needs and responsibilities.

3. BETTER CONTINUITY CARE POST-DISCHARGE

Today’s healthcare organizations are highly sophisticated albeit fragmented, a collection of service providers. Until a decade ago, a patient’s case ended with a transfer to a specialist or another provider or discharge. However, follow-up was not considered an important step in the success of a treatment. The rising costs have made the payers more aware of the methods to optimize the use of available healthcare resources.

It is quite possible to improve patient outcomes as well as reduce the costs by embracing the overall patient journey and following patients using the latest value-based care health software. Even the law supports and favors healthcare organizations in the U.S. that foster communication, coordination, and follow-up with the specialists, rehabilitation centers, and general practitioners whom the patients visit after discharge.

The patients can easily communicate with their respective specialists and healthcare providers using the same platform without patients having to leave their homes, and healthcare providers keep a tab on a patient's health condition without incurring extra costs for the services offered by the hospitals.

With the leverage Lifecycle Health technology platform and patient navigation services, you can easily transform a healthcare provider's operations and patient care services into a streamlined, affordable, and effective patient experience. 

Reference: http://www.lifecyclehealth.com/blog/2018/2/9/3-reasons-why-value-based-care-options-improve-quality

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