MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'disease management'. Sat, 03 Sep 2011 02:12:17 +0100 http://www.medworm.com/index.php?rid=5069475&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-is-the-most-costly-healthcare-expenditure%2F2011.07.27 The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of  healthcare costs in the population. The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases. U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year. This is a result of a combination of factors. Chief among them is the increasing incidence of obesity. Who spends the money? (more…) *This blog post was originally published at Repairing the Healthcare System* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5069475 Wed, 27 Jul 2011 12:00:54 +0100 5069475 http://www.medworm.com/index.php?rid=4419136&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-hot-spotters-is-better-care-for-the-neediest-patients-the-answer-to-lower-healthcare-costs%2F2011.01.31 Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs. If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it: – In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half. &#8... Better Health blogs http://www.medworm.com/rss/comments.php?id=4419136 Mon, 31 Jan 2011 23:00:00 +0100 4419136 http://www.medworm.com/index.php?rid=4337935&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-if-all-patients-were-this-engaged-in-their-health%2F2011.01.12 This video is an excellent testimony of what a truly engaged and knowledgable patient with diabetes looks and sounds like. Kudos to the Mayo Clinic for sharing this wonderful piece about shared decision making. Pay particular attention to the fact that the patient in the video was treated for diabetes by her primary care physician for eight years before being referred to a clearly “patient-centered” endocrinologist. Also note her belief that a patient-centered approach to chronic disease management probably results in shorter, more productive visits in the long run. *This blog post was originally published at Mind The Gap* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4337935 Wed, 12 Jan 2011 20:00:14 +0100 4337935 http://www.medworm.com/index.php?rid=4225414&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fuw7kIPbTkeY%2F Medicare has (finally) recently released a report showing home run results for a disease/care management demonstration project! Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH) Remind Me Again About the CMHCB Medicare Demo… The CMHCB started in 2005. My recollection is that the demo requirements were extremely similar to the Medicare Health Support (MHS) project, with a few exceptions: 1) Applicants had to include direct care providers (delivery systems, physicians) in their program design, 2) patient populations were significantly smaller than MHS.  Please comment on anything I’m missing. I’ve included an addendum at the bottom providing more... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4225414 Fri, 03 Dec 2010 00:35:05 +0100 4225414 http://www.medworm.com/index.php?rid=4164525&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F5-tips-on-how-to-be-a-healthcare-survivalist%2F2010.11.13 There are plenty of “survivalists” out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse. Meanwhile there are things that are much more likely to happen to you — like getting sick — which many of us don’t prepare for at all. So to help you get started, here are five important tips on how you can become a healthcare survivalist: 1.  Take care of your chronic conditions. Whether it’s high blood pressure, diabetes, high cholesterol, depression, asthma or any other kind of ailment, do what it takes to manage your own care. Take your medications and follow your doctors’ instructions. Why? Because if you don’t, your condition can get worse and lead to even more serious problems. As much of a pain as it may (... Better Health blogs http://www.medworm.com/rss/comments.php?id=4164525 Sat, 13 Nov 2010 22:00:47 +0100 4164525 http://www.medworm.com/index.php?rid=4040564&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdiabetes-lessons%2F2010.10.07 As doctors, sometimes the biggest lessons that we learn about disease pathology are those that we learn from the people that have that disease. Diabetes is one such disease. I recently gave a show-and-tell lecture about insulin pumps to the new interns and residents as well as the 3rd-year medical students on their pediatric clerkship with the inpatient endocrine service. We discussed different types of pumps (point A on the picture) and they got to push the buttons and send a bolus or change a basal rate. They also looked at real time CGM (Continuous Glucose Monitors, points C and D on the picture) sensors used to check glucoses levels every five minutes. (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4040564 Thu, 07 Oct 2010 14:00:04 +0100 4040564 http://www.medworm.com/index.php?rid=4022913&cid=t_167103_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fquality-of-life-and-the-importance-of-shay-days%2F2010.10.01 As a medical professional who often treats children with chronic diseases, my patients turn to me not only for treatment advice but often for advice on how to improve their quality of life. I often have difficulty addressing the latter as there is a paucity of research on quality of life outcomes as compared to biomedical outcomes. However, preliminary data from DR Walker et al. (1) have shown that comprehensive disease management improves quality of life and thereby reduces medical costs for some common chronic illnesses. Recently, a patient shared a story with me that was written by an anonymous author which demonstrates the powerful effect of seemingly small efforts on the quality of life of a disabled child. (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4022913 Fri, 01 Oct 2010 15:00:25 +0100 4022913 http://www.medworm.com/index.php?rid=4018247&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FMFllEgfzgTU%2F Care management software is intended to help patients make critical connections across the health care delivery system.  Today it’s used primarily by 3rd party care managers who are typically either employed directed or indirectly by payers. While not surprising, the state-of-the-art of care management software is that it continues to function as disconnected islands of information. The  2010 Health Information Technology Survey (available at no charge) provides an insightful yet sobering snapshot of care management software. The study was sponsored by TCS Healthcare Technologies, the Case Management Society of America, and the American Board of Quality Assurance and Utilization Review Physicians. The study consists of answers from 670 respondents who chose to fill out to a ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4018247 Thu, 30 Sep 2010 00:37:07 +0100 4018247 http://www.medworm.com/index.php?rid=3965524&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FW7-Cvm8tO98%2F Who has the most comprehensive data about YOUR clinical conditions? For most people, the answer today is “your health plan”, but it’s not at all clear that health plans will continue to have this role in the future. As physicians and hospitals adopt EHRs, it’s foreseeable that clinical data about patients will be far more available and accessible. Will patient data become: A jockeying point for control and business advantage between health plans and care providers, A collaborative opportunity to optimize clinical care and care coordination, or Both? (more…) Article Series - Stages 2 and 3 of HITECH: The Golden Era of Care Coordination or Bureaucrats Practicing Medicine?Overview: Here Come Stages 2 and 3 of HITECH!Megatrend Spotting: Health Plan Role of Having “Best Data... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3965524 Mon, 13 Sep 2010 23:23:38 +0100 3965524 http://www.medworm.com/index.php?rid=3946560&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5rv0xNvyUfk%2F   We’ve spent the past year creating the MU (meaningful use) requirements for Stage 1 of the HITECH act.  As shown by the diagram above, Stage 1 focuses on Data Capture and Sharing. Now it’s time to begin to focus on Stage 2 (Advanced Clinical Processes) and Stage 3 (Improved Outcomes). The current generation of EMRs (electronic medical records) were designed primarily to assist care providers with clinical documentation, billing, and maximizing revenues. They were not designed to enable care coordination and optimize population health.   This essay is the first in a new, ongoing series that will highlight: Design and metrics for Stages 2 and 3 of the HITECH act Companies and care providers developing and using applications targeting Stage 2 and 3 MU objectives This first essay wi... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3946560 Wed, 08 Sep 2010 23:49:07 +0100 3946560 http://www.medworm.com/index.php?rid=3683576&cid=t_167103_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F06%2Falere-.html By Matthew Holt At the AHIP conference in Vegas earlier this month I sat down with the CEO of Alere, Tom Underwood, and long-time friend of The Health Care Blog, Gordon Norman (Alere's SVP of Innovation). I asked Tom about... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3683576 Sun, 20 Jun 2010 23:00:00 +0100 3683576 http://www.medworm.com/index.php?rid=3538242&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FdIwL5RIMh8Y%2F by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA . ….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA). We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle: Realizing the full potential of health IT depends in no small measure on changing the health care system’s overall payment incentives so that providers benefit from improving the quality and efficiency of the services they provide. Only then will they be motivated to take full advantage of the power of electronic health records. Dr. David... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3538242 Tue, 04 May 2010 23:52:12 +0100 3538242 http://www.medworm.com/index.php?rid=3193817&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FcFR4-o2eoB0%2F Check out the latest Health Wonk Review penned by Dr. Jaan Sidorov over at the Disease Management Care blog. I commend Dr. Sidorov for his selection of a new personal photo on his blog — very handsome, and certainly a better presentation than this earlier photo from his youth.   Tags: disease management (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3193817 Thu, 21 Jan 2010 16:43:55 +0100 3193817 http://www.medworm.com/index.php?rid=3193663&cid=t_167103_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F21%2Fbritish-journal-of-hospital-medicine-2009-vol-70-no-12%2F British Journal of Hospital Medicine 2009 (Vol. 70 No. 12) contents page Title: Pulmonary complications in liver disease Skinny: Pulmonary complications of liver disease are poorly understood and often identified late. Article focuses on the two major pulmonary complications – hepatopulmonary syndrome and portopulmonary hypertension, which differ in their clinical features and management. Includes diagnostic criteria and staging tables. (Print subscription held at Fade Library) Posted in Diagnosis, Diseases and Disorders, Journals Tagged: Diagnostics, Disease Management, Hepatopulmonary Syndrome, Liver Diseases, Portopulmonary Hypertension (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3193663 Thu, 21 Jan 2010 12:22:56 +0100 3193663 http://www.medworm.com/index.php?rid=3084731&cid=t_167103_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fnursing-times-2009-vol-105-no-48%2F Fade Fave: Depression in adults with long term conditions 1: how to identify and assess symptoms. Fade Skinny: The first in a two part unit depression in adults with long term conditions. NICE has provided guidance on carrying out assessments to identify and manage mental health problems. The article discussed prevalence  and causes of depression in this group, how to identify and assess the condition  and the initial management options. For a copy of  this article please contact Fade Library. Posted in Current Awareness, Journals Tagged: Assessment, Depression, Disease Management, Long Term Conditions, Mental Health, NICE, Patient Management, Prevalence (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3084731 Mon, 14 Dec 2009 09:10:40 +0100 3084731 http://www.medworm.com/index.php?rid=2931085&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5FVQDknxCBw%2F I just received an email from CMS announcing the latest official word on the Medicare Medical Home Demonstration (MMHD): 10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of House Bill 3200 contains a provision to repeal this demonstration and replace it with an independent practitioner-based medical home pilot described further in the bill. In addition, the House bill includes a second medical home pilot to evaluate community-based medical home models... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2931085 Tue, 27 Oct 2009 15:59:21 +0100 2931085 http://www.medworm.com/index.php?rid=2796539&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fp5se2G_011g%2F Updated 6:10 pm, September 14, 2009 One bad deal can ruin your day. Today, LifeMasters filed for Chapter 11 bankruptcy protection.  According to its press release: “The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for Medicare and Medicaid Services (CMS), ” said George D. Pillari, President of LifeMasters. Mr. Pillari, named President of LifeMasters today, is a Managing Director of Alvarez & Marsal Healthcare Industry Group, LLC and had been working with the company and its board as a restructuring advisor prior to the filing. During the last four years, LifeMasters participated in three CMS Demonstration Projects aimed at testing ce... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2796539 Mon, 14 Sep 2009 23:43:51 +0100 2796539 http://www.medworm.com/index.php?rid=2796365&cid=t_167103_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fcommentology-improving-cost-containment.html Stephen J. Motew writes: Surgical specialists practice under a slightly more regimented reimbursement model predominantly due to the global period payment for surgical procedures. The total care of the surgical patient for any procedure, including pre-op evaluation, the procedure itself,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2796365 Mon, 14 Sep 2009 23:00:00 +0100 2796365 http://www.medworm.com/index.php?rid=2670910&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FWgmP776-3Xk%2F by Al Lewis, Disease Management Purchasing Consortium International, Inc. Medical homes probably do save money in very controlled settings, where the entire team is literally or at least figuratively under one roof, such as Kaiser.  However, the belief that one can overlay a traditional medical home model across an entire state and save money in the process turns out to be total fiction. The poster child for that fiction, North Carolina’s Community Care program, turns out to cost state taxpayers probably $400 million a year, rather than save them $300 million, as the state’s self-serving and blatantly incorrect analysis claimed.    A more extensive analysis is available for review, and any state is welcome to the backup data as well. Here’s a press release with more detai... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2670910 Tue, 04 Aug 2009 23:40:03 +0100 2670910 http://www.medworm.com/index.php?rid=2580290&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FkBeDK-VyyFs%2F Download a copy here .  Excerpts from the Executive Summary: Effective Interventions Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired: Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 – 6 weeks after discharge Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in the management of their chronic conditions Coordinated care interventions that identify patients with chronic conditions at high risk of hospitalization in the coming year, conduct initial assessments and care... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580290 Tue, 24 Mar 2009 13:00:58 +0100 2580290 http://www.medworm.com/index.php?rid=2288961&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FkBeDK-VyyFs%2F Download a copy here .  Excerpts from the Executive Summary: Effective Interventions Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired: Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 - 6 weeks after discharge Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in the management of their chronic conditions Coordinated care interventions that identify patients with chronic conditions at high risk of hospitalization in the coming year, conduct initial assessments and care plann... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2288961 Tue, 24 Mar 2009 13:00:58 +0100 2288961 http://www.medworm.com/index.php?rid=2087159&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F505753400%2F by Thomas Wilson, PhD, DrPH and Vince Kuraitis What’s the right metaphor for Medicare Health Support (MHS), CMS major experiment with disease management for Medicare beneficiaries?  We prefer to look it as a bridge failure that presents an opportunity to improve future engineering and design. We’ve now had the time to read, reread, and reread again the very recent report from Research Triangle Inc (RTI) — Evaluation of Phase I of the Medicare Health Support Pilot Program Under Traditional Fee-for-Service Medicare: 18-Month Interim Analysis .  Here’s a listing of our 8 key takeaway points: There’s Sufficient Evidence to Conclude "MHS Didn’t Work As Expected" Some Quality Measures in MHS Improved, Yet Outcomes Didn’t. Why? MHS Suffered Execution Ni... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2087159 Thu, 08 Jan 2009 03:55:22 +0100 2087159 http://www.medworm.com/index.php?rid=2580306&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FfYm9rsBbxNY%2F by Thomas Wilson, PhD, DrPH and Vince Kuraitis What’s the right metaphor for Medicare Health Support (MHS), CMS’ major experiment with disease management for Medicare beneficiaries?  We prefer to look it as a bridge failure that presents an opportunity to improve future engineering and design. We’ve now had the time to read, reread, and reread again the very recent report from Research Triangle Institute (RTI) — Evaluation of Phase I of the Medicare Health Support Pilot Program Under Traditional Fee-for-Service Medicare: 18-Month Interim Analysis .  Here’s a listing of our 8 key takeaway points: There’s Sufficient Evidence to Conclude "MHS Didn’t Work As Expected" Some Quality Measures in MHS Improved, Yet Outcomes Didn’t. Why? MHS Suffered ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580306 Wed, 07 Jan 2009 23:57:20 +0100 2580306 http://www.medworm.com/index.php?rid=2511422&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FfYm9rsBbxNY%2F by Thomas Wilson, PhD, DrPH and Vince Kuraitis What’s the right metaphor for Medicare Health Support (MHS), CMS’ major experiment with disease management for Medicare beneficiaries?  We prefer to look it as a bridge failure that presents an opportunity to improve future engineering and design. We’ve now had the time to read, reread, and reread again the very recent report from Research Triangle Institute (RTI) — Evaluation of Phase I of the Medicare Health Support Pilot Program Under Traditional Fee-for-Service Medicare: 18-Month Interim Analysis .  Here’s a listing of our 8 key takeaway points: There’s Sufficient Evidence to Conclude "MHS Didn’t Work As Expected" Some Quality Measures in MHS Improved, Yet Outcomes Didn’t. Why? MHS Suffered ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2511422 Wed, 07 Jan 2009 23:57:20 +0100 2511422 http://www.medworm.com/index.php?rid=2078833&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F502690086%2F by Vince Kuraitis and Thomas Wilson, PhD, DrPH CMS has just released the 2nd Report to Congress evaluating the Medicare Health Support (MHS) program. MHS is Medicare’s most visible and significant demo focusing on chronic disease management. We’ve been poring over the report and will provide more detailed analysis and implications later this week. This 2nd Report to Congress covers 18 months of data on this 3 year project. It provides far more details and substantiation than RTI’s first report, which only covered 6 months data. However, there’s nothing in here to change our January 2008 conclusion:  The rumors of MHS’s death have NOT been greatly exaggerated. Here are the five key findings: (more…) Article Series - CMS Bumps Off Medicare Health SupportCMS: “Rumors... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2078833 Sun, 04 Jan 2009 19:57:29 +0100 2078833 http://www.medworm.com/index.php?rid=2580308&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FD_ni2w0R1t8%2F by Vince Kuraitis and Thomas Wilson, PhD, DrPH CMS has just released the 2nd Report to Congress evaluating the Medicare Health Support (MHS) program. MHS is Medicare’s most visible and significant demo focusing on chronic disease management. We’ve been poring over the report and will provide more detailed analysis and implications later this week. This 2nd Report to Congress covers 18 months of data on this 3 year project. It provides far more details and substantiation than RTI’s first report, which only covered 6 months data. However, there’s nothing in here to change our January 2008 conclusion:  The rumors of MHS’s death have NOT been greatly exaggerated. Here are the five key findings: (more…) Article Series - CMS Bumps Off Medicare Health SupportCMS: “Rumors... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580308 Sun, 04 Jan 2009 18:07:23 +0100 2580308 http://www.medworm.com/index.php?rid=2511424&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FD_ni2w0R1t8%2F by Vince Kuraitis and Thomas Wilson, PhD, DrPH CMS has just released the 2nd Report to Congress evaluating the Medicare Health Support (MHS) program. MHS is Medicare’s most visible and significant demo focusing on chronic disease management. We’ve been poring over the report and will provide more detailed analysis and implications later this week. This 2nd Report to Congress covers 18 months of data on this 3 year project. It provides far more details and substantiation than RTI’s first report, which only covered 6 months data. However, there’s nothing in here to change our January 2008 conclusion:  The rumors of MHS’s death have NOT been greatly exaggerated. Here are the five key findings: (more…) Article Series - CMS Bumps Off Medicare Health SupportCMS: “Rumors... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2511424 Sun, 04 Jan 2009 18:07:23 +0100 2511424 http://www.medworm.com/index.php?rid=2074807&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F500424670%2F by Vince Kuraitis and David C. Kibbe MD, MBA Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare .  The book is co-authored by Dr. Jerome Grossman and Dr. Jason Hwang. We have mixed reactions. The book is mistitled. It should have been titled "The Innovator’s Diagnosis". The book does a fantastic job at diagnosis (Dx) of problems in the U.S. health care system. It presents many new, innovative analytical frameworks and lenses through which to view the U.S. health system. However, it’s weak on prescription (Rx): many of the proposed solutions are speculative, ungrounded, and/or defy political reality. We understand that th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2074807 Thu, 01 Jan 2009 20:40:30 +0100 2074807 http://www.medworm.com/index.php?rid=2580309&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FPXRe6iyPEIQ%2F by Vince Kuraitis and David C. Kibbe MD, MBA Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare .  The book is co-authored by Dr. Jerome Grossman and Dr. Jason Hwang. We have mixed reactions. The book is mistitled. It should have been titled "The Innovator’s Diagnosis". The book does a fantastic job at diagnosis (Dx) of problems in the U.S. health care system. It presents many new, innovative analytical frameworks and lenses through which to view the U.S. health system. However, it’s weak on prescription (Rx): many of the proposed solutions are speculative, ungrounded, and/or defy political reality. We understand that th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580309 Thu, 01 Jan 2009 20:14:18 +0100 2580309 http://www.medworm.com/index.php?rid=2511425&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FPXRe6iyPEIQ%2F by Vince Kuraitis and David C. Kibbe MD, MBA Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare .  The book is co-authored by Dr. Jerome Grossman and Dr. Jason Hwang. We have mixed reactions. The book is mistitled. It should have been titled "The Innovator’s Diagnosis". The book does a fantastic job at diagnosis (Dx) of problems in the U.S. health care system. It presents many new, innovative analytical frameworks and lenses through which to view the U.S. health system. However, it’s weak on prescription (Rx): many of the proposed solutions are speculative, ungrounded, and/or defy political reality. We understand that th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2511425 Thu, 01 Jan 2009 20:14:18 +0100 2511425 http://www.medworm.com/index.php?rid=2512550&cid=t_167103_134_f&fid=36985&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fsugarstats%2F%7E3%2FqbTVjbKQH38%2F Hey everyone, As many have already noticed we pushed out some new revisions a few weeks ago as we’ve made a few big as well as small upgrades to SugarStats. While there are various user interface and design changes, the majority of it went on under the hood. What we’ve launched is a solid foundation for [...] (Source: SugarStats.com - Simple, Online Blood Sugar Tracking for Diabetes Management) SugarStats.com - Simple, Online Blood Sugar Tracking for Diabetes Management blogs http://www.medworm.com/rss/comments.php?id=2512550 Thu, 11 Dec 2008 01:02:05 +0100 2512550 http://www.medworm.com/index.php?rid=2005496&cid=t_167103_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F12%2Fmobile-phones-for-hivaids-treatment.html In honor of World AIDS Day, I'm linking to a post on the MobileActive.org blog about treating HIV/AIDS patients via mobile phones. The post discusses two programs to engage patients with "virtual call centers," text messages and, eventually, home testing services, particularly in South Africa, which has the world's highest population of HIV-positive residents. (Thanks to Dr. Enoch Choi for alerting me to this post.)I've covered mobile health in the developing world several times on this blog and elsewhere, notably from one week of the the Making the eHealth Connection conferences in Italy last summer, and subsequent follow-up coverage. See "The Davos of health IT?" and "Desmond Tutu Presents e-Health Call to Action."Those who attend the 25th annual TEPR conference in February should expect... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2005496 Tue, 02 Dec 2008 00:12:00 +0100 2005496 http://www.medworm.com/index.php?rid=1815619&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F400405909%2F “Why can’t we all just get along?”  Rodney King The Megatrend: Collaborative Care Management Networks (CCMNs) It’s been quite a while since I spotted a new Disease Management Megatrend, but here’s one that’s long overdue: Collaborative Care Management Networks will be necessary to achieve optimal care coordination. The trend in a nutshell:  payers (and others) are recognizing that optimal care coordination will require collaboration among health care stakeholders. This CANNOT be achieved with yesterday’s proprietary IT and business models. CCMNs will share many — perhaps all — of the following elements: (...)Read the rest of Megatrend Spotting: Collaborative Care Management Networks (528 words) © | Permalink | No comment | Want more on these topic... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1815619 Tue, 23 Sep 2008 03:35:31 +0100 1815619 http://www.medworm.com/index.php?rid=1709545&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F365401906%2F CMS announced today that all 10 participating groups in the Physician Group Practice (PGP) demonstration achieved quality targets, and that the groups are sharing $16.7 million in incentive payments. The program rewards providers for improved outcomes delivered to Medicare patients with congestive heart failure, coronary artery disease, and diabetes. This goes a long way in explaining Medicare’s seeming lack of enthusiasm for past or future disease management demos with DM companies and/or health plans. Congratulations doctors! Related Posts (# comments) May 18, 2008 — The Medical Home: Pull the RUC Out (9) May 13, 2008 — The Medical Home: Confusion Over Care Management Fees (0) February 14, 2008 — Medicare Health Support: “Do not go gentle into that good night&#... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1709545 Fri, 15 Aug 2008 05:07:23 +0100 1709545 http://www.medworm.com/index.php?rid=1494305&cid=t_167103_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F06%2F04%2Feconomic-costs-of-serious-mental-illness%2F Individually, we don’t much care about global or societal costs of our care. When we hear about the budget deficit or anything to do with healthcare costs in the billions, we tend to tune out. Why? Well, most of us simply can’t wrap our heads around such numbers. We deal in the $10s and $20s of everyday life, the $100 cable bill, and the $1,500 mortgage. Few of us know what tens of thousands of dollars looks like at a time, much less millions. Much less billions or trillians. When get to those numbers, it just becomes meaningless. So my eyes tend to gloss over when people ramble on about “disease management” and savings of “billions of dollars” if only we could convince employers to better recognize that mental illness has a significant impact on thei... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1494305 Thu, 05 Jun 2008 00:25:12 +0100 1494305 http://www.medworm.com/index.php?rid=1451936&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F293236048%2F This third and final post in the series addresses questions about the future of the Patient Centered Medical Home (PCHM): What’s problematic about using the RUC methodology with the PCMH? What’s the optimal level for a PCMH care management fee? Should primary care leaders pull the RUC out? How?  What’s Problematic About Using the RUC Methodology with the PCMH? There are at least two reasons for not having the RUC methodology seen anywhere in the same county country as the PCMH. First, the RUC methodology doesn’t account for technology and services needed for optimal care management. Second, the RUC methodology is conceptually flawed. 1) The RUC methodology doesn’t account for technology and services needed for optimal care management. Here’s what the RUC recommended meth... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1451936 Mon, 19 May 2008 04:49:20 +0100 1451936 http://www.medworm.com/index.php?rid=1446363&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F291286227%2F Today’s post (#2 in a series) tackles several questions: What is the American Medical Association/Specialty Society RVS Update Committee (RUC)? What is the RUC’s role in the Medicare Medical Home Demonstration project? How are people reacting to RUC recommendations for PCMH reimbursement levels? What is the American Medical Association/Specialty Society RVS Update Committee (RUC)? The AMA formed the RUC to act as an expert panel in making recommendations to CMS on the relative values of Current Procedural Terminology (CPT) codes using the Resource Based Relative Value Scale (RBRVS). The RUC is composed of 29 members, only 5 of whom are primary care physicians. The RUC  has come under severe criticism as being an enemy of primary care. For example… (more…) Shar... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1446363 Fri, 16 May 2008 00:14:28 +0100 1446363 http://www.medworm.com/index.php?rid=1439973&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F289763443%2F This report has stirred cries of confusion and outrage. I’ll elaborate on these cries in the second posting of this series, but if you can’t wait, read here, here, here, here, here, here, here, and here. Welcome to a series of three blog postings discussing the PCMH, care management fees, and the RUC report.  I can’t claim to smooth the uproar, but I hope to frame the issues so that they can be understood and discussed constructively. The series will address numerous questions. This first post: What is the PCMH care management fee? Why is the PCMH care management fee important? Why are people confused? The second post: What is the American Medical Association/Specialty Society RVS Update Committee (RUC) ? What is the RUC’s role in the Medicare Medical Home Demonstration... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1439973 Tue, 13 May 2008 23:00:48 +0100 1439973 http://www.medworm.com/index.php?rid=1386929&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F274415208%2F     Google Wants to Index Your DNA, Too Business Week; April 18, 2008 A few years ago I remember reading a vivid description of how much information is contained in one person’s genetic code:  a stack of phone books high enough to reach the top of the Washington Monument.      Share This Related posts (and # of comments) Ruminations on the 2007 Healthcare Unbound Conference (1) Healthcare Informatics Webinar: Google, Microsoft, & Dossia Create the Personal Health Information Network (0) Birth Announcement: the Personal Health Information Network (PHIN) (3) Yet Another Dark Cloud in the Stormy Skies of Medicare DM (0) The Medical Home: Advancing, But Still Many Questions (1) (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1386929 Mon, 21 Apr 2008 03:15:41 +0100 1386929 http://www.medworm.com/index.php?rid=1354172&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F265732889%2F While not providing anything close to the “final answer”, The New York Times does a good job summarizing the onoging Medicare Health Support (MHS) fracas.  To borrow from one of my colleagues, it’s more “enlightened ambiguity” about the ultimate fate of the MHS beached whale.  Medicare Finds How Hard It Is to Save Money, The New York Times; April 7, 2008 For One Company, Role in Medicare Experiment Has Hurt Stock, The New York Times; April 7, 2008 Share This Article Series - CMS Bumps Off Medicare Health SupportCMS: “Rumors of Medicare Health Support’s Death Have Not Been Greatly Exaggerated”$389 M of Healthways’ Market Value Vaporizes After CMS Announcement. What Happened?Insufficient Evidence to End Medicare Health SupportGuest Pos... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1354172 Mon, 07 Apr 2008 15:35:55 +0100 1354172 http://www.medworm.com/index.php?rid=1315425&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F254518888%2F  Vince Kuraitis and Thomas Wilson, PhD, DrPH “If you aren’t confused you don’t know what’s going on.” Jack Welch, former CEO, General Electric           Thanks to the continuing opacity of the Centers for Medicare and Medicaid Serices (CMS), we remain confused about the future of Medicare Health Support (MHS). It’s been over a month since we last commented on MHS. What’s MHS?  It’s JUST the Federal Government’s most significant and visible effort to deal with one of the American health system’s biggest challenges — managing care for patients with chronic diseases. In late January CMS announced that it planned to end MHS Phase I and did not plan to proceed with MHS Phase II.  Evidence presented to justify that decision was sketchy at best and opaque at... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1315425 Wed, 19 Mar 2008 21:15:56 +0100 1315425 http://www.medworm.com/index.php?rid=1298804&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F250451981%2F About three weeks ago Cain Brothers Investment Bankers released a report that foreshadowed the collapse of HMO stock prices that has occurred over the past few days.  The report was entitled: FAREWELL TO A TIME OF PLENTY? Health Plan Strategies for Growth in a More Challenging Market.  Here are a few highlights from the report: (more…) Share This Related posts (and # of comments) Resources (1) e-Newsletter archives (0) Disease Management and the Medicare Health Support (MHS) Project: “Houston, we have a problem.” (4) The Medical Home: Advancing, But Still Many Questions (1) Medicare Health Support: “Do not go gentle into that good night” (0) (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1298804 Wed, 12 Mar 2008 23:03:04 +0100 1298804 http://www.medworm.com/index.php?rid=1287785&cid=t_167103_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F03%2F08%2Fdisease-management-information-toolkit-dmit%2F DMIT (All the information and files on this page form the DMIT toolkit) is a voluntary good practice tool that the NHS may wish to use to strengthen their approach to Disease Management, by presenting data at Primary Care Trust (PCT) level on conditions contributing to high numbers of emergency bed days.  It models the effects of possible interventions which may be commissioned at a local level. It aims to support decision-makers, commissioners and deliverers of care for people with LTCs. DMIT will help users to analyse and consider the likely impact of possible commissioning options before they are taken. This information can then be used to inform commissioning decisions at local level by planning appropriate interventions, matching care to need. (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=1287785 Sat, 08 Mar 2008 07:45:16 +0100 1287785 http://www.medworm.com/index.php?rid=1252795&cid=t_167103_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F02%2Fpodcast-himss-ceo-steve-lieber.html ORLANDO, Fla.—Here’s a podcast that’s been a year in the making. Actually, it was a year plus an hour and a half. Last year in New Orleans, I had a lively, hour-long conversation with HIMSS President and CEO Steve Lieber that was supposed to be for a podcast, but the recording didn’t work.On Saturday, I showed up at the appointed hour for another sit-down with Lieber, and realized I’d forgotten my recorder back at my hotel, so we rescheduled for about 90 minutes later. Well, the third time was a charm, and the result is this podcast, a lively, half-hour-long conversation with Steve Lieber, just ahead of the opening of the annual HIMSS conference.Podcast details: Interview with Steve Lieber at HIMSS ’08. MP3, mono, 64kbps, 13.8 MB. Running time 30:10.0:30 Expected attendance of ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1252795 Sun, 24 Feb 2008 19:15:00 +0100 1252795 http://www.medworm.com/index.php?rid=1192910&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F227052043%2F Thomas Wilson, PhD, DrPH and Vince Kuraitis Last Tuesday during the cocktail hour, CMS issued documents portending the end of the Medicare Health Support (MHS) project.    We initially used the word “bizarre” to describe the announcement from CMS’ staff.  After further thought, “reckless” and/or “insubordinate” strike closer to home. First, let’s have the head-honcho at CMS instruct us on how things should be done. In September 2007 Kerry Weems, the new CMS Administrator, declared that “cocktail hour press releases” from his agency must stop, and that a new era of “transparency” and “accountability” must begin.   So here’s the list of decision criteria we draw from Mr. Weems statement: 1) No cockt... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1192910 Fri, 01 Feb 2008 06:36:26 +0100 1192910 http://www.medworm.com/index.php?rid=1187224&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F225680618%2F Vince Kuraitis and Thomas Wilson, PhD, DrPH Today’s POO (persistent obfuscatory orations) Award goes to the Centers for Medicare Services (CMS) for their posting of two bizarre documents updating progress on the Medicare Health Support (MHS) program.  The documents “appeared” (no press release, no announcement, a reference to “today” but no date) on the web page for the MHS demonstration project. While a casual reader would probably review these documents and scratch their head, we interpret them as a death knell for the Medicare Health Support chronic disease management (DM) project and that there will be no MHS Phase II. As we wrote in our previous essay — Disease Management and the Medicare Health Support (MHS) Project: “Houston, we have a problem” —  we caution... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1187224 Wed, 30 Jan 2008 04:25:56 +0100 1187224 http://www.medworm.com/index.php?rid=1154073&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F217342986%2F My colleague and friend Dr. Jaan Sidorov has recently started a blog — Disease Management Care Blog.  Check it out and add it to your RSS feed.  Jaan is eminently qualified to write on the topic — he spent 25 years at Geisinger Health System in Pennsylvania as a practicing physician and as an executive, and he just ended a term on the board of DMAA—the Care Continuum Alliance (formerly Disease Management Association of America). Jaan’s sense of humor and articulateness shine through in his latest posting “Are Integrated Delivery Systems really all that?” He presents a Top 10 list of “why IDS’ could always remain the health care solution of the future”. Jaan, it’s worth splitting a hair here. Let’s clarify who we’re talking about when saying “an integra... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1154073 Wed, 16 Jan 2008 00:55:49 +0100 1154073 http://www.medworm.com/index.php?rid=1096264&cid=t_167103_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F200451112%2F Over at The Health Care Blog, Brian Klepper has written an excellent article entitled “Bad Medicine: How The AMA Undermined Primary Care in America.” His essay could just as easily been entitled “How the AMA Undermined Chronic Disease Care in America” — it’s very informative reading. Share This (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1096264 Fri, 14 Dec 2007 19:56:08 +0100 1096264 http://www.medworm.com/index.php?rid=1085670&cid=t_167103_134_f&fid=35152&url=http%3A%2F%2Fsstrumello.blogspot.com%2F2007%2F12%2Fmore-discrediting-of-disease-management.html There is growing evidence that so-called "disease management" programs do not prove their worth, at least in terms of saving money. According to a study issued by the RAND Corporation, such programs appear to improve the quality of health care, but there is little evidence that such efforts actually save money. The RAND study is not the first to raise this question. A 2004 report from Congressional Budget Office raised its own concerns, saying that there was "insufficient evidence" that disease management programs can reduce overall health spending, or generate savings for federal health programs such as Medicare. Diabetes is perhaps the condition most often targeted by such disease management programs because it is relatively easy to do a glycosated hemoglobin (better known as the hemoglo... Scott's Web Log blogs http://www.medworm.com/rss/comments.php?id=1085670 Tue, 11 Dec 2007 14:00:00 +0100 1085670