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Nutrition

Hospital Leadership, Strategy, And Culture In The Age of Health Care Reform

With just eleven months to go before the Value-Based Purchasing component of the Affordable Care Act is scheduled to go into effect, it is an auspicious time to consider how health care providers, and hospitals specifically, plan to successfully navigate the adaptive change to come. The delivery of health care is unique, complex, and currently fragmented. Over the past thirty years, no other industry has experienced such a massive infusion of technological advances while at the same time functioning within a culture that has slowly and methodically evolved over the past century. The evolutionary pace of health care culture is about to be shocked into a mandated reality. One that will inevitably require health care leadership to adopt a new, innovative perspective into the delivery of their services in order to meet the emerging requirements.
First, a bit on the details of the coming changes. The concept of Value-Based Purchasing is that the buyers of health care services (i.e. Medicare, Medicaid, and inevitably following the government’s lead, private insurers) hold the providers of health care services accountable for both cost and quality of care. While this may sound practical, pragmatic, and sensible, it effectively shifts the entire reimbursement landscape from diagnosis/procedure driven compensation to one that includes quality measures in five key areas of patient care. To support and drive this unprecedented change, the Department of Health and Human Services (HHS), is also incentivizing the voluntary formation of Accountable Care Organizations to reward providers that, through coordination, collaboration, and communication, cost-effectively deliver optimum patient outcomes throughout the continuum of the health care delivery system.
The proposed reimbursement system would hold providers accountable for both cost and quality of care from three days prior to hospital admittance to ninety days post hospital discharge. To get an idea of the complexity of variables, in terms of patient handoffs to the next responsible party in the continuum of care, I process mapped a patient entering a hospital for a surgical procedure. It is not atypical for a patient to be tested, diagnosed, nursed, supported, and cared for by as many as thirty individual, functional units both within and outside of the hospital. Units that function and communicate both internally and externally with teams of professionals focused on optimizing care. With each handoff and with each individual in each team or unit, variables of care and communication are introduced to the system.
Historically, quality systems from other industries (i.e. Six Sigma, Total Quality Management) have focused on wringing out the potential for variability within their value creation process. The fewer variables that can affect consistency, the greater the quality of outcomes. While this approach has proven effective in manufacturing industries, health care presents a collection of challenges that go well beyond such controlled environments. Health care also introduces the single most unpredictable variable of them all; each individual patient.
Another critical factor that cannot be ignored is the highly charged emotional landscape in which health care is delivered. The implications of failure go well beyond missing a quarterly sales quota or a monthly shipping target, and clinicians carry this heavy, emotional burden of responsibility with them, day-in and day-out. Add to this the chronic nursing shortage (which has been exacerbated by layoffs during the recession), the anxiety that comes with the ambiguity of unprecedented change, the layering of one new technology over another (which creates more information and the need for more monitoring), and an industry culture that has deep roots in a bygone era and the challenge before us comes into greater focus.
Which brings us to the question; what approach should leadership adopt in order to successfully migrate the delivery system through the inflection point where quality of care and cost containment intersect? How will this collection of independent contractors and institutions coordinate care and meet the new quality metrics proposed by HHS? The fact of the matter is, health care is the most human of our national industries and reforming it to meet the shifting demographic needs and economic constraints of our society may prompt leadership to revisit how they choose to engage and integrate the human element within the system.
In contemplating this approach, a canvasing of the peer-reviewed research into both quality of care and cost containment issues points to a possible solution; the cultivation of emotional intelligence in health care workers. After reviewing more than three dozen published studies, all of which confirmed the positive impact cultivating emotional intelligence has in clinical settings, I believe contemplating this approach warrants further exploration.
Emotional intelligence is a skill as much as an attribute. It is comprised by a set of competencies in Self-Awareness, Self Management, Social Awareness, and Relationship Management, all leading to Self Mastery. Fortunately, these are skills that can be developed and enhanced over the course of one’s …

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Nutrition

Information Required For Seniors To Apply For Medicaid

While there are a lot of people on Medicare for their medical expenses when they get sick, it does not provide for custodial care in a long term care situation. Medicaid does have a program that will provide benefits for people who can’t afford the stay. For people in this situation will need to bring all of the following to the Medicaid office to qualify. The Department of Social Services will need the following items to process an application:

Any paid and unpaid medical bills

Social Security card

Birth certificate or other proof of age

immigration papers of all non-citizens

Car registration or title

Any deeds to property owned with copy of tax listion

Any life insurance policy information

Any health insurance information and payment stubs

Any stocks, bonds, CDs, IRAs, Mutual Funds information

Burial-plot deeds and/or contracts

Any documentation of retirement income

Medicare Card

Savings book – updated

Checking account – most recent statements

oney Market accounts

Social Security benefits, stock dividends, rental income, etc. information

Faarm/business equipment, boats, motors, trailers, motor homes, etc. proof

Tobacco allotment information

Trust fund or promissory note information Safe deposit box information

Proof of disability for those applying on that basis, such as medical reports from physicians

In addition, you should take

Parents names and location of any inherited property (or spouse’s)

Children’s names, ages and addresses

Also take copies of any Power of Attorney(s).

This program can allow people to live their final days in dignity. Sometimes the requirements can be difficult to satisfy, but the end result is a nice place to stay and get the care they need without having to worry about costs. This information will make the first visit to the Medicaid office for that needed program.…

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Healthy Nutrition

Mental Healthcare Reform – Present Successes and Future Challenges

As healthcare reform is becoming a reality, there is much to celebrate within the mental health community. This includes passage of a healthcare reform package that includes parity for mental health and addiction services, expansion of Medicaid to 133% of Federal Poverty Level, inclusion of behavioral health organizations and individuals with mental illnesses in the new Medicaid medical home state option, and authorization and increased funding for grants co-locating mental health treatment and primary care. These and a host of other provisions expand the opportunities for individuals with mental illnesses and addictions to obtain and maintain insurance coverage and access needed services.
But this is not the end of the mental healthcare battle. Simply put, mental health advocates must be ready to play in a new game, in a world where increasing numbers of individuals – by virtue of Medicaid expansion, the emerging Health Insurance Exchanges, and parity regulations – will have access to behavioral health services. We expect to see an additional 15 million individuals – an increase of 43% – eligible for Medicaid alone, with more than 30 million individuals overall who will, in the not too distant future, have insurance coverage.
But this is far more than a matter of numbers – it’s about working smarter. Advocates of mental healthcare anticipate that healthcare reform-driven service delivery redesign and payment reform will unfold at a rapid pace. In order to bend the cost curve, payment reform and service delivery redesign will change how health, mental health, and substance use services are integrated, funded, and managed. Providers must learn to practice healthcare the way healthcare will be done.
As mental healthcare providers and advocates, we must become savvy about positioning ourselves to take advantage of new markets and new opportunities to help control the design and delivery of healthcare services. We must begin to build relationships within and across the entire healthcare sector. As we revisit the concept of “managing care” for individuals and whole populations, we have to be certain that our focus on person-centered, recovery-focused treatment and services is not subsumed by the drive to “bend the curve” in healthcare costs. We must be able to demonstrate our value not only to our customers, but also as key players in these new healthcare consortia.
We must become accountable for efficient and effective services that show results across all health domains. We believe fee-for-service reimbursement will slowly become a thing of the past. So, too, will be the ability to claim that caseloads are full with no-show rates of 50% and more. We risk being left on the sidelines if we don’t move with deliberate speed to ensure continuity and timely access to care; comply with third-party payer requirements; coordinate care with a full range of health providers; and if necessary take on payers that refuse to honor the spirit and letter of the parity regulations.
We must become increasingly customer-focused, from the way we greet individuals who come through our door to the way we market our services. We should expect that with more money available in healthcare – particularly for mental health and addiction treatment – that new and well capitalized players will find behavioral health, traditionally a financially unattractive healthcare sector, far more appealing.
People will be insured and will have an increasing range of options available to them. What differentiates our mental healthcare services? Why should an individual choose to receive treatment and support from us? Are we offering services that will help them meet a full range of healthcare needs? Are our services culturally appropriate for the communities we serve? Can we help them understand and make appropriate use of their insurance coverage? We must retool our organizations with the knowledge that all individuals will now become true “consumers” of healthcare services.
At the same time, we must also be aware that our work is far from over at the state and federal level. Forty eight of 50 states are experiencing severe budget shortfalls. The threat is very real and the mental healthcare advocates are fighting hard to hold on to current funding as legislatures see an opportunity to continue to withdraw needed funds. This is surely a bad idea – even the most generous healthcare benefits will likely not cover the full range of wraparound supports that people with mental illnesses and addictions need to fully recover.
Eleanor Roosevelt once said, “It takes as much energy to wish as it does to plan.” All of our planning, advocacy, and leadership to date have borne fruit, but we must not be content to wish it all works out well. We must fight for our future – and the future of the individuals we are privileged to serve – by acting as key players in the brave new world of healthcare.…

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Whole Food Vitamins

Health Care School Prerequisites

These days there are numerous opportunities for those who want to pursue a career in the field of healthcare industry and other related services. Nowadays, numerous health schools offer proper training and guidance in the different field of specializations under healthcare. Moreover, healthcare services are moving at a fast pace and there are newer trends and information emerging.
Today a whole new dimension has been added to the healthcare sectors as acquiring a Bachelor’s or Master’s Degree in healthcare has become an important prerequisite to become a thorough professional in this field. Now in order to get into the right healthcare schools and build a career, some amount of evaluation and research has to be done. There are thousands of jobs available in this sector and for those with an ambition can make a mark as a medical professional.
There are various jobs in the field of healthcare, starting from entry-level jobs to highly qualified doctors. In fact, the healthcare sector is made up more of support staff than doctors. The options include counseling, nursing, community healthcare, management pharmacy and technical work. Almost every type of work in this field is in high demand.
The prerequisites for studying in a healthcare school differ from school to school and at different levels. Generally, the higher the degree, the greater are the prerequisites for studying in any healthcare school. However, some of the prerequisites for entry into the right healthcare school are:
1. There is a standard system of CAHME accreditation, through which healthcare schools and programs should be measured. The students are assured of accredited programs in these healthcare schools.
2. The healthcare schools should be extensively evaluated. Whatever school you select, it is important that you confirm whether they follow some set standards. Accreditation assures the quality and utility of current trends in the healthcare schools through continuous review and self-evaluation.
3. Some health care schools require experience like a practicing RN in good standing with a license. They have more demand at the entry level.
4. A registration with any of the nationally accredited boards requires work experience in the field of specialization is also an important prerequisite.
5. An associate’s degree in counseling or community healthcare though may only need a high school diploma in addition to the standard employment or the means to pay for the program.
With the proper motivation and dedication, you can find yourself in the right health care schools. There are many options for those who want to pursue healthcare studies further, be it in campus or online. The cause of helping people and the needy will always be in demand, and so the future of the health care sector is quite strong. The compensation and salary packages offered are also significant and fair. Thus, certain prerequisites have to be kept in mind before enrolling into the right healthcare school.…

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Healthy Nutrition

If It Ain’t Broke, Don’t Fix It

January 1 of this year we had to change the electronic transmission protocols for filing electronic medical claims. As a medical billing service, we were proactive throughout 2011 getting the protocols in place. As the January 1 deadline approached it became apparent that not everyone was quite so proactive.
We are now well into over a month of transmitting claims and the process seems to becoming more fraught with disaster. The new protocols are referred to as 5010 and the old ones were 4010A. The 4010s worked great and all the bugs were out of it but again the statisticians simply want more data, most likely data that could be held over physicians heads as a tool to coerce them into doing things not necessarily in the best interest of the physician and most assuredly not in the best interest of American medicine.
Today as I was reviewing the transmission reports it struck me as to the absurdity of some of the rejections. From a claim standpoint, we still refer to a lot of the data as if we are looking at what was once called a paper form a HCFA1500 and now called CMS1500. Basically the same piece of paper with two major exceptions, each provider had a spot for two numbers, his NPI and his legacy number and one column in section 24 disappeared and the rendering physician NPI and/or legacy number no longer was in 24K but was now in 24J, but I have digressed. The absurdity is in box 32.
The bottom three boxes on a CMS1500 are 31,32, and 33. Box 31 is the physician of record taking responsibility for the claim. Box 32 is the name and location of where the service was performed and box 33 is the entity and address of where payment is to be made. Here is the absurdity. For Medicare, if the service is performed anywhere but the provider’s office, the data must be filled in. But if it is in the providers office the box must be left blank or the claim will be rejected. Now wouldn’t it be simple to just ignore that info if it is unnecessary? But apparently they are too incalcitrant into a format that they can’t! And to compound the issue, United Health Care will reject the claim if the service is performed in the office and box 32 is not populated. Besides, why have the box if you don’t want it populated.
The rules should be uniform but apparently they are not. One will reject the claim if it is populated while another rejects it if it is not populated. From the standpoint of attempting to keep them all happy it can be a nightmare.
So seriously folks, if the 4010A worked why change it just to gather more statistical information that will only serve to drive up the cost of health care.
If it ain’t broke don’t fix it.…

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Nutrition

The Benefits of Good Penis Health

There can never be a great sexual pleasure without proper penis health. True, men’s reproductive health can determine the mood of any sexual activity they may be engaging into. However, a lot of men these days do not give serious attention to this, thinking that life can still go on without undergoing such penis health care.
Given this fact, many men are now struggling to get back the pleasure they once enjoyed or experience the pleasure deprived to them. Little of them know that it only requires proper consultation and care for their reproductive health to get out of this kind of situation.
Benefits In Health
If only men can know how much they can get out of maintaining a good reproductive health, every one of them will surely start getting one. In fact, the most important benefit they can get from it is lessening the risk of getting prostate problems. As the world knows, prostate problems can take the life of a man. Therefore, they very well need not to get this problem to avoid risking their lives.
Another thing that men can get out of good penis health is making them more emotionally stabled. Since a good reproductive health can open up great opportunities for sexual satisfaction and pleasure, the emotional sense of men is boosted to the positive side. Their self-esteem and confidence will always be on top of the picture.
Benefits In Sexual Life
More than the good effects of this to the overall health of men, it can also spice up the sexual life of most men. This is true especially those who have a problem in terms of their organ’s size, semen production, and ejaculation as well.
Given the proper ways to care for the reproductive health, there are greater chances that men can develop a permanent penis enlargement, good seminal fluid production and also controlled ejaculation. With all these, most men will always find pleasure in their sexual life, especially that they can easily satisfy the needs of women already.
Also, another important thing is that good penis health can decrease the risk of men being impotent. Meaning, men don’t need to worry anymore about getting into a situation when he cannot anymore make sexual activities and children as well.
In the end, it is definitely of great importance to give proper attention and care to the penis health. The benefits that can be acquired from it are so important that if it is not given the right attention, it can cost a life.…

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Whole Food Vitamins

Branding Vs Direct Response – Which is Best For My Practice?

I’m asked frequently how important Branding is to a healthcare practice. My answer is “it’s critical”. Every potential patient (and referring physician) is asking themselves a critical question that your marketing message has to answer “Why you?”. Branding helps you differentiate your practice from your competition and provides the answer(s) to the question “Why You?”.
I’m also asked what type of marketing is more important, building your brand or getting new patients to come to your office quickly and cost-effectively. This type of marketing is called “direct response” marketing. I believe that both are important factors in the success of your marketing campaign.
Branding is a form of marketing where a consumer (your prospective patient) sees or hears your message through any medium (web site, email, TV, print ad, radio, direct mail, etc.) and hopefully remembers who you are, what you do, and why they should consider you if/when they need or want your services. Most of the time, the action isn’t immediate (i.e. “direct response”).
The marketer has to hope that once the consumer sees/hears the message they remember it. Advertising studies show that the average consumer needs to see a message 5-7 times before it becomes familiar to them. You must hope that the consumer has enough name recognition from your previous marketing that when they do need/want your services, they think of you first and don’t get distracted by your competitors’ marketing messages. This can happen often if the prospect goes to the Yellow Pages or Google and then sees your competition.
In “Direct response marketing”, there is generally a strong message with a compelling offer or “call-to-action”. You’re giving your prospective patient a reason to contact you NOW. You’re directing the consumer where to go next (i.e. “Click here now” or “Call today”) and you’re giving them a reason to do so now. A big benefit to “direct response” is that it’s easier to measure results. You can look at metrics like response rates, open rates, click through rates, and conversion rates. You can directly calculate your ROI (return on investment), which helps you offset any advertising costs from the profits you generate.
Although branding is not as accurate to measure and your efforts can take time, you have to develop your brand to help overall conversions in your direct response marketing. Ideally, your marketing message should answer both these questions: “Why You?” and “Why Now?”. This is why Branding and Direct Response are both extremely important.
If you need help developing a more compelling message to build your brand or you need a better direct response rate to improve your ROI, contact me to assistance. Proven Strategies for a Strong, Profitable Practice!…