Showing posts with label higher. Show all posts
Showing posts with label higher. Show all posts
Do Medicare Beneficiaries Warrant Higher Nurse Patient Care Coordination Ratios
Wednesday, April 30, 2014
In yesterday’s posting on care management nurse-staffing ratios and their associated costs, Peter McMenamin pointed out that a per member per month cost (PMPM) that ranged from $8 to $17 was a reasonable estimation. Whats more, it compared favorably to the monthly management fee in the Comprehensive Primary Care Initiative. This is also important for Accountable Care Organizations that are grappling with the amounts that they’ll need to invest in care coordination to achieve the shared savings. Assuming an ACO becomes accountable for 5,000 beneficiaries, that calculates out to between $480,000 and $1,020,000 per year.
But, asked the Disease Management Care Blog, should there be any differences in care management ratios and costs for Medicare, Medicaid and commercial insurance? If it’s a commercial ACO, should it estimate $500K, while a Medicare ACO should plan lower ratios and invest $1M?
Peter McMenamin’s thoughts:
A parity between Medicare, commercial, and Medicaid is possible but not exactly plausible. Thanks to many co-morbidities, Medicare patients have more different docs, more visits, and more drugs. Unless they are particularly compliant with respect to medications, you’d expect Medicare patients to be more demanding. Unless they return to a physician so frequently that care coordination is incidental or are hospitalized so much that their care is taken care of, they need considerable care management. If Medicare patients take more time for follow-up, etc. that might explain the difference between $20 PMPM and the somewhat lower PMPM estimates from my calculations.
Good point, of course. Yet the DMCB is not so sure that there is a correlation between savings and the intensity of care management beyond a certain threshold for any patient of any age. In addition, while persons with Medicare have greater illness burden, that doesn’t mean the day-to-day management, care plans and shared decision making for conditions like diabetes or heart failure making varies depending on a patient’s age.
Dr. McMenamin and the DMCB will keep their eye out for answers. More to follow.
Women smokers at higher risk of colon cancer taxable
Tuesday, March 18, 2014
Women smokers at higher risk of colon cancer taxable - The link between smoking and lung cancer has long been known. Now researchers also found that smoking may increase the risk of colon cancer, especially in women.
Women who never smoked had a 20 percent higher risk of developing colon cancer compared with women who had never smoked. Meanwhile, the more cigarettes each day exhausted, increase a womans risk of developing colon cancer.
"Women who smoked up to 10 cigarettes a day increase their risk of developing colon cancer," said lead researcher Dr. Inger Gram, a professor from the University of Tromso in Norway, as reported by U.S. News.
The results found by researchers after observing more than 600,000 men and women, aged between 19 0 67 years at the Norwegian Institute of Public Health. Participants were asked to answer questions about their smoking habits, physical activity, and other lifestyle factors.
Been observed for more than 14 years, approximately 4,000 people are known to have colon cancer. Participants were exposed to colon cancer is most smokers, especially women. In women smokers, the risk of colon cancer increased by 19 percent, while only eight percent in men.
The longer a woman smokes, the younger he started smoking, and the more cigarettes that are used every year, the higher a womans risk of developing colon cancer. Even women who had smoked for 40 years has increased the risk by 50 percent.
Even so researchers do not know the obvious reason why cigarettes greater effect on women than men. The only way you can do to protect yourself is to stop smoking as soon as possible. The researcher explained that cigarettes only give poison to the body and can not provide benefits.
Women who never smoked had a 20 percent higher risk of developing colon cancer compared with women who had never smoked. Meanwhile, the more cigarettes each day exhausted, increase a womans risk of developing colon cancer.
"Women who smoked up to 10 cigarettes a day increase their risk of developing colon cancer," said lead researcher Dr. Inger Gram, a professor from the University of Tromso in Norway, as reported by U.S. News.
The results found by researchers after observing more than 600,000 men and women, aged between 19 0 67 years at the Norwegian Institute of Public Health. Participants were asked to answer questions about their smoking habits, physical activity, and other lifestyle factors.
Been observed for more than 14 years, approximately 4,000 people are known to have colon cancer. Participants were exposed to colon cancer is most smokers, especially women. In women smokers, the risk of colon cancer increased by 19 percent, while only eight percent in men.
The longer a woman smokes, the younger he started smoking, and the more cigarettes that are used every year, the higher a womans risk of developing colon cancer. Even women who had smoked for 40 years has increased the risk by 50 percent.
Even so researchers do not know the obvious reason why cigarettes greater effect on women than men. The only way you can do to protect yourself is to stop smoking as soon as possible. The researcher explained that cigarettes only give poison to the body and can not provide benefits.
Diet Soda Linked To Larger Waist Higher Blood Glucose
Wednesday, February 26, 2014
Results of two studies presented at the American Diabetes Associations 71st Scientific Sessions last week described risks of consuming diet soft drinks.The first study found that users of diet soda, on average, experienced a 70% greater increase in waist size compared with non-users. Those with the greatest consumption - two or more diet sodas a day - experienced waist size increases that were 500% greater (5 times greater) than those of non-users:
Diet Soft Drink Consumption Is Associated With Increased Waist Circumference In The San Antonio Longitudinal Study Of Aging
There were 474 participants, aged 65 to 74, who were followed for approximately 9.5 years. To lessen the effect of confounders, results were adjusted for gender, age, beginning waist circumference, diabetes and smoking status, education, ethnicity, leisure-time activity, neighborhood, and length of follow-up.
The authors concluded:
“The promotion of diet sodas as healthy alternatives [to sugar-sweetened drinks] may be ill-advised: they may be free of calories, but not of consequences.”The second study found a link between artificial sweetener consumption and blood glucose in mice:
Aspartame Consumption Is Associated With Elevated Fasting Glucose In Diabetes-Prone Mice
After three months of eating aspartame-spiked chow, mice had higher fasting glucose levels (144 vs. 105 mg/dl) and lower insulin levels than control mice.
As to mechanism, Sharon Fowler, coauthor of both studies, said in an interview with the Daily Mail:
"Artificial sweeteners could have the effect of triggering appetite but unlike regular sugars they don’t deliver something that will squelch the appetite."It was noted that artificial sweeteners may also damage or inhibit brain cells that are involved in feelings of satiety.
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