Showing posts with label do. Show all posts
Showing posts with label do. Show all posts
Disease and Population Health Management Programs Do NOT Exclude Other Conditions
Tuesday, May 13, 2014
![]() |
| Playing whacamole |
"Health care blogging will never lead any serious beer money."
"Disease management coaching focuses exclusively on just one disease."
These are three falsehoods that bubble up in the unlikeliest of places, including cable news outlets, replying to the DMCB spouses asking "and what did you do today?" and webinars, webcasts and other educational meetings about population health and disease management.
While the Disease Management Care Blog finds all three vexing, the most irksome is the canard that the commercial health coaching service providers purposely limit their programs to just one chronic condition, like diabetes, weight loss or readmission prevention.
While that may have been the case in the earliest versions of disease management, that narrow approach was dropped years ago. Thats because patients typically seek advice for a wide range of overlapping concerns and the good nurses hired by the vendors will respond to them. The vendors also understand that their shared risk and performance guarantees depend on claims expense that is driven by the synergies of multiple co-morbidities.
While a purchaser, insurer or accountable provider organization may start out with a focus on a population defined by a single condition - such as diabetes mellitus - that doesnt mean their protocols and care plans wont span the continuum of care and include hypertension, tobacco abuse, depression, housing, chatting about the grandkid and responding to concerns whether this will be finally be NBA superstar LeBron James year.
And the published literature supports the DMCBs contention that modern population health management is multifaceted. Examples include this seven-condition program for dually eligible Medicaid beneficiaries in Georgia, this Midwest employer-sponsored program that enrolled persons with multiple care needs and this physician-focused program that used pay-for-performance to improve measures across multiple conditions. Check out some vendor web sites and youll see erences to "whole person health," the "interrelated aspects of social, emotional, and physical health" and "a holistic view of member health across internal and external care management initiatives."
That being said, the DMCB knows that perception and reality can be two different things. Given the whac-a-mole persistence of the "single disease" myth, the DMCB says the population health management community may benefit clarifying the broadness as well as the depth of their offerings as they continue to build their brand.
Image from Wikipedia
Labels:
and,
conditions,
disease,
do,
exclude,
health,
management,
not,
other,
population,
programs
6 Ways to Wreck Your Blood Sugar Level What not to do if you have type 2 diabetes
Friday, April 25, 2014
Type 2 diabetes is a tough disease. It requires constant vigilance to keep your blood sugar level under control.
It also requires avoiding some common mistakes, many of which are the product of long-held bad habits.
Here are six mistakes that you can learn to avoid.
1. Not Knowing Your Disease
By that he means that you are the one watching your diet, making sure you exercise, and taking your medication on schedule. Understanding how diabetes works will help you make better decisions about how to monitor and manage it. Classes on coping with diabetes are an excellent but underused resource.
“Not enough patients seek them out, and not enough doctors send their patients to them,” Ahmann says.
That’s unfortunate, because not only do they offer essential information; they are often de facto support groups as well, bringing together people who are experiencing the same issues and difficulties and giving them a forum in which to meet and talk with each other.
2. Expecting Too Much Too Soon
One of the biggest hurdles in controlling your blood sugar is sticking to the necessary adjustments you must make to your eating and exercise habits. Many patients become frustrated and give up because they don’t see results right away, says endocrinologist Preethi Srikanthan, MD, assistant clinical professor of medicine at UCLA’s David Geffen School of Medicine.
“Most people expect something dramatic is going to happen right away,” she says. “But it has taken them a decade or two to get to this point, and it will take a while for them to even to get to that initial 5%-10% reduction in weight…These are challenges that must be taken in small steps.”
Expecting too much change right away is a mistake. So is doing too much before you are ready, especially when it comes to exercise, Ahmann says. He advises starting off slowly and easing into the habit.
“If they do more than they can tolerate, they will often quit,” he says. “Or they will do too much and hurt themselves.”
Be sure to talk with your health-care provider before starting a new exercise program, especially if you aren’t already active. He or she can help plan a routine that’s safe and effective, as well as set realistic goals.
3. Going it Alone
There are a lot of resources out there to help you manage your disease. Don’t ignore the fact that one of the most helpful might be right there at home. Spouses, partners, friends, and family members can all make excellent exercise buddies.
“One error that people make when it comes to exercise is that they try to do it on their own without help from other people,” Ahmann says.
There are other advantages to the buddy system. Enlist your spouse or significant other in your efforts to stick your medication schedule and to maintain a healthy diet.
“Eating alone can be a problem,” Ahmann says.
4. Neglecting Other Problems
In her practice, Srikanthan sees a lot of patients who are dealing with more than just their diabetes. Depression and stress are common among people with the disease, and both can have a negative impact on blood sugar levels.
Constant stress, for example, may produce hormones that hamper the ability of insulin to do its job. “Stress should be considered as a significant contributor to glycemic variation by both patients and physicians,” Srikanthan says.
Ahmann agrees.
“Anything to reduce stress will improve your blood sugar,” he says.
Exercise helps relieve stress and there’s evidence that meditation and massage will have benefits on blood sugar levels, says Ahmann.
People with diabetes are twice as likely to be depressed, and an estimated one of every three people with diabetes have symptoms of depression. The lethargy common to depression can be so discouraging that you might give up your efforts to take care of your diabetes. Not only will that make your diabetes worse, it may also intensify your depression, creating a vicious cycle.
There’s good news, though. According to a new study, treating depression in patients with type 2 diabetes improved their mental and physical health.
“You need to recognize depression and work with it,” Srikanthan says.
5. Misunderstanding and Misusing Medications
Ahmann says that many of his patients share a common misconception when it comes to the drugs used to control their disease.
“They think that medications are more powerful than diet and exercise,” he says.
That’s not necessarily true. In many cases, type 2 diabetes can be controlled by a combination of a healthy diet and regular exercise without the need for medication.
Among patients who do require medications, Ahmann says, one mistake stands out.
“It’s surprising how many people miss doses,” he says.
That’s a quick way to wreck your blood sugar level, so it’s a problem that needs to be recognized and addressed.
“You need to be honest with your [health care] provider that this is an issue,” says Ahmann, who points out that often the solution is for your doctor to change your dosing schedule to one that better suits you. “There are options.”
6. Making Poor Food Choices
When it comes to food and blood sugar, the big mistake is not the single candy bar that you couldn’t resist, Srikanthan says. The bigger picture matters more; unhealthy eating habits, in the long term, will have a worse effect on your blood sugar.
“People think it’s a one-time diversion, but no, it’s a consistent problem that affects your test results,” she says.
The two biggest hurdles, Srikanthan says, are calories and carbohydrates. You have to control both in order to keep your blood sugar level steady.
“Try to be aware of what’s going into your mouth,” she says.
That means keeping a diet diary to keep track of what you are eating and reading nutrition labels so that you can calculate the proper amounts of the foods you choose to eat.
Ask the Internet Do You Use a Slow Cooker
Friday, April 18, 2014
Readers, you have installed Greek yogurt as Queen and Supreme Ruler of Mayofreeland and avocado as Prime Minister. Soft, spreadable cheeses and sour cream are their trusted advisers. Enemies of mayo rejoice!
For this week’s question I took a look deep inside (my kitchen):
Q: My mother gave me a slow cooker many years ago, at my request. I use it to make beans, collards, and oatmeal. Up to now, I’ve been fairly content with my alternating shining success/burning failure within this repertoire, but I’d like to expand. (And avoid setting off the smoke detector when I’m not home.)
Do you have any good vegetarian slow cooker recipes or resources? How about general slow cooker tips for expediting mealtime?
A: CHG readers, it’s all you today! The comments await your sage advice. Thank you!
Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.
readmore
For this week’s question I took a look deep inside (my kitchen):
Q: My mother gave me a slow cooker many years ago, at my request. I use it to make beans, collards, and oatmeal. Up to now, I’ve been fairly content with my alternating shining success/burning failure within this repertoire, but I’d like to expand. (And avoid setting off the smoke detector when I’m not home.)
Do you have any good vegetarian slow cooker recipes or resources? How about general slow cooker tips for expediting mealtime?
A: CHG readers, it’s all you today! The comments await your sage advice. Thank you!
Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.
Seven Reasons Why Small Physician Owned Practices Will Continue to Do Well Despite Accountable Care Organizations ACOs
Sunday, February 23, 2014
Since the Disease Management Care Blog not only wants to be informative but also helpful to its readers, it has developed a seven point generic physician employment inquiry response and recruitment letter. It is available below. The DMCB is confident that those smaller physician-owned private practices that remain independent will find this form letter very helpful in the coming years. The DMCB releases this to the public domain and its colleagues are welcome to copy, paste, distribute, share, alter, modify or adapt all or some of the document as it becomes necessary.
Dear [insert name of physician here]:
Thank you for your recent [select: tweet, email, Facebook posting or VM] inquiry about leaving your current salaried position and joining our practice. Thanks to widespread patient dissatisfaction with the institutions that were spawned by "health orm," our small business has experienced tremendous growth. We are constantly on the lookout for new talent that complements our projected demand. Maybe you can join our team!
As you are undoubtedly aware, many of our colleagues nationwide have been lured into full time employed positions involving large complicated corporate practice arrangements, many of which were set up to be ACOs. Savings havent materialized and many of these organizations have responded by demanding more patient "throughput" from their employed physicians and imposing cutbacks in vital support services.
In contrast to those organizations, our practice offers you:
1) a completely transparent compensation arrangement that equitably divides our net revenue income among the owner-physicians. No more having to deal with an unwieldy administration that allocates salary amounts based on some opaque budget of anticipated revenues and upside savings minus overhead and capital allocations that you have no say in.
2) a team-based environment that not only relies on your expertise but knows whos boss. Unlike those other complicated practice settings with layers of middle management, our office personnel report directly to you, period.
3) a patient population that is not only grateful for our high "same day" service standards and efficient and compassionate practice style, but who also recognize that unnecessarily calling at the end of the business day or repeatedly while were on night call is reason to be assisted in finding another physician. We have caully cultivated a very loyal following of patients who genuinely partner with us.
4) a highly trained and motivated administrative support and care management staff that not only uses state-of-the-art approaches to deal with private managed care commercial insurers, but uses a "3A" approach of Anticipating, Automating and Appealing any service that requires prior authorization from you. Youll only get involved in these matters when its necessary.
5) a stable practice environment. Speaking of managed care insurers, they comprise the bulk of our business. While they are far from perfect, Medicare and Medicaid they are not. They dont threaten us with arbitrary fee schedule cuts, audits, and payment delays. We firmly believe patients and taxpayers should get what they pay for. Its not our fault if they havent paid for our level of clinical and consumer excellence.
6) an EHR system is not only low cost and user-friendly, its modular and cloud-based. Our vendor has agreed to performance guarantees, there are no one-sided "hold-harmless" clauses and its seamlessly compatible with any hand held device of your choice any time and any where.
7) a unique market niche that sits in that "sweet spot" between a local employer community that likes us, insurers that respect us, specialist physicians work with us and a multispecialty ACO close by that welcomes our errals.
Once again, thank you for contacting us. Please send your CV to [insert P.O Box address here] where we will store it in strictest confidence along with dozens of your colleaques CVs. We promise you that when we get to it in the coming months, we will contact you.
Best regards,
Why Do Health Insurance Rates Go Up
Wednesday, June 5, 2013
Why Do Health Insurance Rates Go Up?
If you listen to your own personal insurance rates, youre possible to note that over a amount of your time theyre quite possible to travel up. the general public area unit attentive to the actual fact that insurance premiums tend to extend over time, and these jumps in price will gift quite an money strain for someone UN agency is on a decent budget. so as to be able to best anticipate once your rates can go up within the future, its an honest plan to pay a while learning concerning however insurance rates area unit calculated and why they often head skyward.
Although many folks notice their insurance rates intensifying, few folks ever remark on their insurance rates happening. Premiums terribly seldom fall, and also the reason for this reality is that the same reason for many will increase in insurance rates. like all alternative field of the fashionable business world, the health care business is deeply laid low with inflation. because the price of living rises, the price of medical aid rises with it. this suggests that insurance firms area unit forced to boost their rates to avoid losing cash. Inflation is wide thought of by economists to be the first reason why insurance rates increase.
The other reason why {you area unit|youre} possibly to search out yourself paying a lot of for insurance coverage is that you just are cost accounting your insurer cash. The a lot of insurance claims you create, the more cash the corporate must pay on you. This causes you to, to some extent, a money liability, therefore if you create claims usually your company can raise your rates. thanks to this reality, identical {people UN agency|people that|folks that|those that|those who} want insurance the foremost area unit those who usually find yourself straining to form their monthly payments when a increase in their insurance rates.
To protect themselves, insurance firms typically provide higher rates to totally different folks looking on however usually those customers area unit possible to form claims. this is often why folks with chronic conditions like respiratory disease, vision issues, or polygenic disease area unit possible to possess higher rates than folks while not similar afflictions. its conjointly the explanation why those that smoke and area unit so possible to possess smoking-related health issues have higher insurance premiums than most non-smokers, UN agency area unit statistically less possible to form insurance claims. If you have got recently visited a hospital or have had a doctor write you a brand new prescription, prepare to check your insurance rates increase consequently.
Subscribe to:
Comments (Atom)
