Showing posts with label deliver. Show all posts
Showing posts with label deliver. Show all posts
More on the Definition of Care Management and how well do IPAs and PHOs deliver on it
Friday, December 20, 2013
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| Care management in action? |
As discussed and quoted by the Disease Management Care Blog, heres one useful definition courtesy of the New England Journal:
"A set of activities designed to assist patients and their support systems in managing medical conditions and related psychosocial problems more effectively, with the aims of improving patients’ functional health status, enhancing the coordination of care, eliminating the duplication of services, and reducing the need for expensive medical services."
Now another one has emerged, thanks to this article by Lawrence Casalino and colleagues that appeared in the August issue of Health Affairs. The authors were interested in comparing the use of "care management processes" in small to medium sized physician-own practices that were either in or outside of an Independent Practice Association ("IPA") or Physician Hospital Organization ("PHO").
For this article, Casalino et al developed a "care management index" that reconciled five care management "processes" (1. use of a registry, 2. access to nurse care managers, 3. reliance on guideline-based reminders at the point of care, 4. sending care/health maintenance reminders to patients and 5. reporting outcomes)against the four chronic conditions asthma, heart failure, diabetes and depression. Having all 5 processes available for all four chronic conditions resulted in a top score of 4 x 5 or 20. The score therefore ranged from a high of 20 down to zero.
So, as ACO wannabes, hospital administrators, health system entrepreneurs, policymakers and regulators assess their care management landscape, they now, thanks to Health Affairs, have this handy zero to twenty scale.
To perform the study, a sample of physician-owned practices were asked to participate in a telephone survey in which the lead physician or administrator was asked about the 5 processes for each of the four conditions.
The results resembled the DMCB spouses scoring of her husbands clean-up-after-himself processes. There were some points, but theres plenty of room for improvement against the measured baseline.
Small to medium-sized practices with "significant" participation in an IPA or a PHO had a average care management process score of "10.4" vs. a score of "3.8" in the unaffiliated practices. When the care management processes were provided by the IPA or PHO to the practices, the average score was 5.4.
The value proposition for IPAs and PHOs includes care management, but they have a ways to go.
Lifestyle Changes That Deliver Weight Loss Results
(Article first published as Lifestyle Changes Can Aid in Weight Loss on Technorati.)
There are a number of lifestyle modifications that can help people lose weight to improve health and live a longer and healthier life. Permanent weight loss involves much more than simply reducing calories and exercising more. While these are necessary elements in the weight loss battle, there are many other compounding factors which must be addressed before starting a weight reduction program. Stress, mindset and support play an important role in determining the success of your best weight loss efforts.
Obesity continues to be one of the most pressing health issues which threaten the longevity of millions of people, and the numbers continue to grow unabated each year. While many overweight and obese people understand they are carrying too much weight, the majority doesn’t realize the extent of their weight problem and can benefit from a structured program which centers on lifestyle changes.
Next you will need to develop a charting system which you faithfully maintain each day. It’s important to keep track of every food and drink item you eat as well as daily exercise, and include a section for your emotional state or other comments which help or hinder your progress. The best strategy is to plan and complete your food diary for each day a week ahead of time. Enter each food and drink item along with the amount eaten into your log at the beginning of the week and shop accordingly. You have now removed the thought and emotional aspects of eating. This is part of the reason commercial diet plans such as Jenny Craig are so successful.
Lifestyle Changes Shown Effective for Obesity
he Obesity Society and published in The Journal of the American Medical Association reveals that obese individuals who were provided prepackaged meal replacements and placed on a 5 day per week exercise schedule were able to achieve successful and permanent weight reduction. The participants were monitored with regular telephone calls, support and encouragement, and after 12 months lost a total of 27 pounds. This study highlights the importance of structure and positive mindset in addition to calorie reduction and physical activity when beginning a weight loss program.
The Beginning: Making a Weight Loss Plan
While not everyone who needs to lose weight will be able to participate in a structured study to accomplish their goal, it is possible to develop a plan which will help you achieve the same results. The most important first step is to make sure you have a positive mindset. Don’t begin a weight loss journey if you aren’t fully committed to the idea. Permanent weight loss is one of the most difficult tasks many people will ever undertake and the only way you’ll succeed is to be mentally prepared.
Next Step: Planning for Results
Diet Basics: Eating to Boost Fat Loss
The type of foods you eat are just as important as the number of calories in your diet. Foods that are highly processed break down into glucose quickly and encourage the buildup of fat around the abdomen. Additionally, refined carbohydrates offer your body very little in the way of nutrition which means you remain hungry and more apt to eat as you are subconsciously driven to find essential vitamins and minerals required by your body. To lose weight, eliminate all wheat, bread, pasta and sugary treats and drinks. Substitute with fresh vegetables, nutritious nuts, seeds, lean protein sources, healthy monounsaturated fats and drink green tea.
For many individuals, weight loss is a significant challenge. Less than 1 in 20 people are able to achieve and maintain their goal because they don’t properly plan and prepare to lose excess fat. Once you have developed the correct mindset and charted your daily meal plan, natural weight loss will be within your reach.
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