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Centered Pregnancy

centered pregnancy

Anna Cherry, CNM

Centering Pregnancy

On this week’s show, Womens Telehealth’s Tanya Mack sat down with Certified Nurse Midwife, Anna Cherry, of Providence Women’s Health Care of Roswell, to learn about how the centering pregnancy prenatal care program their practice has been participating in is improving outcomes for the patients they serve.

Centering Healthcare Institute explains how centering pregnancy works:  Centering group prenatal care follows the recommended schedule of 10 prenatal visits, but each visit is 90 minutes to two hours long – giving women 10x more time with their provider. Moms engage in their care by taking their own weight and blood pressure and recording their own health data with private time with their provider for belly check.

 

Final MACRA Rules

MAG

Elizabeth Woodcock

Final MACRA Rules

On October 14, CMS issued the final MACRA rule. This new Medicare reimbursement system is
known as the Quality Payment Program (QPP). It offers two reimbursement options for physicians, including the Advanced Alternative Payment Model (APM) and the Merit-based Incentive Payment System (MIPS). CMS says 2017 will be a “transition year and iterative learning and development period.” 2018 will be the “second transition year.”

CMS will provide more information for 2020 and beyond beginning next year.   Key points: 1) If a physician doesn’t bill at least $30,000 in Medicare Part B allowable charges or they see less than 100 Medicare patients per year, they are exempt from QPP. This includes more than 30% of all physicians who are billing for Medicare Part B services (more than 380,000) 2) CMS will collect data on costs – but only behind the scenes. This MIPS pillar will not count for the 2017 performance year; its “weight” was transferred to the Quality category 3) Only four activities need to be reported by physicians – and none if they are already recognized as a medical home 4) CMS is committed to increasing the number of physicians who are in APMs – and it estimates that 70,000 to 120,000 physicians (5% to 8% of all physicians billing under the Medicare Part B) will qualify as an APM participant in 2017 5) The number of EHR “meaningful use” (now known as “Advancing Care Information”) requirements dropped from 11 to five – but it is still necessary for physicians to report on most of them to achieve a score of 100%.

The QPP begins in 2017 – with MIPS reporting required by March 31, 2018. This initial performance year establishes a provider’s Medicare payments in 2019 – with an adjustment of 4% up or down. If a physician fails to submit any 2017 data (i.e., qualify for the program), they will receive a negative 4% payment adjustment. If a physician transmits a “test” – e.g., one quality measure, one improvement activity, or the required ACI measures – they will avoid the penalty; a partial year of reporting will result in a neutral or small positive adjustment. The full year provides for a “moderate” positive payment adjustment.

Qualifying participants who achieve a final score of 70 or higher will be eligible for the exceptional performance adjustment – which will be funded from a pool of $500 million.  MIPS allows reporting by an individual or group. Qualifying professionals are defined as physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists.  The cost category is eliminated for the first performance year (2017) – so Medicare reimbursement is tied to the remaining three: Quality, Clinical Improvement Activities, and ACI, which account for 60%, 15% and 25%, respectively, of the composite score that will determine your Medicare adjustment in 2019.

Participating in an APM offers an automatic 5% incentive payment for all Medicare patients. Less
than 100 organizations qualify for an APM today – and many physicians in those organizations
won’t reach the CMS threshold of receiving 25% of Part B payments or seeing 20% of its
Medicare patients through the APM. More importantly, the application period to join an APM in
2017 has passed. CMS expects about 25% of eligible clinicians to be part of the second path of
APMs in 2018.

Elizabeth Woodcock

Elizabeth Woodcock is one of the leading third party payer and medical practice management
consultants in Georgia. She is a professional speaker, trainer and author. Woodcock has focused
on medical practice operations for more than 20 years. She has delivered presentations at regional and national conferences to more than 200,000 physicians and managers.

In addition to her popular email newsletters, she has authored 15 best-selling practice management books and published dozens of articles in national health care management journals. Woodcock is a fellow in the American College of Medical Practice Executives and a certified professional coder. In
addition to a degree from Duke University, she has an MBA in health care management from The
Wharton School of Business of the University of Pennsylvania.

Turning Point Breast Rehabilitation

breast cancer

Jill Binkley

Turning Point Breast Rehabilitation

TurningPoint Breast Cancer Rehabilitation improves quality of life for women with breast
cancer by providing, promoting and advocating specialized and evidence-based rehabilitation.
TurningPoint is a non-profit 501(c)3 healthcare organization. Services offered include physical
therapy, massage therapy, exercise classes, educational seminars, counseling, and nutritional counseling.

Infectious Disease

Infectious Disease Specialists of Atlanta

Infectious Disease

Medicine is becoming increasingly fragmented and complex. The infectious diseases specialty has become especially pivotal in our health care system when it comes to clarifying diagnoses, preserving our antibiotic armamentarium with cautious use of this limited resource, and protecting patients from complications that are associated with these complex treatments.

Unfortunately, the number of young physicians who are going into the infectious diseases specialty is declining. Two years ago, more than 40 percent of infectious diseases training programs (slots?) went
unfilled (i.e., a program seeking three new trainees might only get two and some smaller programs might not get any)  – while last year more than 60 percent of infectious disease training programs were short of fellowship trainees.

It is essential to convince more young physicians to go into the infectious disease specialty if we hope to
ensure that patients have access to the care they need.

After Dr. Dretler graduated from Tufts University Medical School in Boston in 1978, he trained in internal medicine at St. Elizabeth’s Hospital of Tufts University. He completed his infectious disease training at Emory University in Atlanta in 1981. He then started his Infectious Disease Specialists of Atlanta practice at DeKalb Medical where his group is now based.

He has served as president of the Infectious Disease Society of Georgia, as the president of the DeKalb Medical Society, and as both the chief of medicine and the chief of staff at DeKalb Medical. Dr. Dretler also served as the medical chairman of the DeKalb Medical Foundation. He has been heavily involved in medical research and has been a principal investigator for 25 years on more than 100 NIH studies, including clinical research in AIDS, Hepatitis C, Pseudomembranous colitis, and influenza. Dr. Dretler has published more than 25 articles and posters.

Telestroke Care

telemedicine

Tanya Mack, Julie Stover, Dr. Matt Gwynn

Telestroke Care

In 2015, the CDC list acute stroke as the 5 th leading cause of death in the US. Those who survive can often face serious long term disability. Yet, there is a mismatch between the patients present with a stroke and the accessibility of expert neurology care. The Census Bureau has estimated that 20% of stroke patients live in rural areas with no access to neurology care in their community.

The first 60 minutes after the onset of a stroke is critical to prevent death and improve the patient’s prognosis. Yet if neurology care is not available, patients are often diverted to the closest large regional center which may be 30-90 min.  away.

New telemedicine technologies are being used to surmount these around the clock access issues
by improving distribution of neurology experts. Today’s segment features, AcuteCare Telemed experts,
one of the nation’s leaders in providing telestroke programs to hospitals.

Medical Association of Georgia Medical Reserve Corps

Medical Association of Georgia

Dr. John Harvey

Medical Reserve Corps

President George W. Bush created the USA Freedom Corps to foster a culture of citizenship and responsibility. The Citizen Corps is the component of USA Freedom Corps, which creates local opportunities for individuals to volunteer to help their communities prepare for and respond to emergencies.

The Medical Reserve Corps (MRC) is the component of the Citizen Corps that brings together local health professionals, community volunteers to provide support services, and others with relevant skills. The MRC is a national network of volunteers – organized locally to improve the health and safety of their communities.

It comprises 993 community-based units and more than 200,000 volunteers located throughout the U.S. Georgia has 18 approved MRC. MRC volunteers include medical and public health professionals, as well as other community members without health care backgrounds. The MRC prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as
other emergencies affecting public health, such as disease outbreaks.

MRC frequently support community health activities that promote healthy habits.  MAG Medical Reserve Corps With the approval of the U.S. Department of Health and Human Services, the Medical Association of Georgia (MAG) and the Georgia Department of Public Health (DPH) developed the nation’s first medical society-sponsored statewide volunteer MRC. The MAG MRC is training physicians to respond to declared emergencies in Georgia.

The MAG MRC coordinates the deployment of physicians during such emergencies. MAG MRC units are capable of setting up mobile hospital systems. And under extreme circumstances (e.g., a shortage of health care providers in a given area), MAG MRC units can perform some of the functions that would otherwise be performed by the full-time emergency medical response personnel in the state.

Physicians and other volunteers must register on the “Georgia Responds: State Emergency Registry of Volunteers in Georgia” (SERVGA) – www.servga.gov – before they can serve as a MAG MRC volunteer.

Rural Medicine

womens telehealth

Tanya Mack, Chris Denson

Rural Medicine

Many states exhibit disparities in rural health vs. healthcare and Georgia is no exception. Georgia has
108/159 counties (68%) defined as “rural.” Most would agree that health should not be determined by
one’s residence or zip code, yet many healthcare challenges are unique to rural settings such as:
community infrastructure, poverty, education, and transportation.

Geographically, Georgia has many “Medical Deserts” where access is severely compromised. There are 54 rural hospitals in GA and many are financially vulnerable. GA’s rural health communities may be losing the capacity to deliver the right care at the right time at the right place.

Conversely, due to these rural healthcare challenges, Georgia has also become an incubator for new policies, programs and collaborative partnerships designed to help decrease healthcare disparities.

Special Guest:

Chris Denson, MPH, Director of Advisory Services, HomeTown Health

End of Life

End of Life

Dr. Richard W Cohen

End of Life

End-of- life is a significant issue for patients, families and health care teams. The Institute of Medicine and the book ‘Being Mortal’ have increased the awareness of the public and the health care profession. The key to the issue is the ability of a patient to express their wishes for how they chose to live out their life and the ability of the health care team to honor those wishes.

Those wishes are documented in an ‘Advance Directive’ and, when appropriate, in a ‘Physician Orders for Life Sustaining Treatment’ (POLST). The POLST is a medical order that aims to enable seriously
ill patients to designate the treatments they desire and to ensure that those preferences are honored by medical professionals.

The Georgia POLST Collaborative is a part of the National POLST Paradigm. The Georgia POLST
Collaborative aims to educate patients, families and health care professionals throughout the state about end-of- life planning, advance directives, and the Georgia POLST.

Dr. Richard Cohen recently retired as the medical director of the WellStar Health System’s Ethics Department. He founded Wellstar’s Health System Ethics and Advance Care Planning and End-of- Life programs. Dr. Cohen is the chairman of the Board of Georgia Health Decisions, the chairman of the Georgia POLST Collaborative, and a member of the Executive Committee of the National POLST Paradigm Taskforce.

He practiced total joint restoration in Atlanta for 40 years. Dr. Cohen received he medical degree from the Jefferson University Medical School in Pennsylvania.

 

Health Literacy

health literacy

Dr. Ruth Parker

Health Literacy

Health literacy is focused on what physicians and other health care providers can do to provide their patients with information that is both understandable and useful. Patients often struggle understanding what they need to know and do – and health care professionals often deliver messages that are too complicated for patients to understand.
An Institute of Medicine (IOM) report estimated that nearly half the adult population lacks the literacy skills to understand and use health information. One study found that just 12 percent of U.S. adults have the health literacy skills they need to manage the demands of our complex health care system. In addition, their ability to absorb and use health information can be compromised by stress or illness. Limited health literacy is associated with poor health status, higher use of services, and worse clinical outcomes.

Preventable complications result in more stress on the patient and their family members – as well as increased costs. “Patient centeredness” is a salient theme within the medical profession, but it can be a difficult practice to put into place on a daily basis. Health literacy encourages physicians and other health care providers to practice good listening and communications skills to ensure that their
patients receive information and advice they need in a way that is both understandable and useful.

Ruth Parker, M.D., is a professor of Medicine, Pediatrics and Public Health Department at the Emory University School of Medicine in Atlanta. She attended medical school at the University of North Carolina at Chapel Hill. Dr. Parker completed residencies in internal medicine and pediatrics at the University of Rochester, and she was a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania. Dr. Parker has focused on health literacy for more than 20 years.

She is a co-author of the ‘Test of Functional Health Literacy in Adults’ (TOFHLA) and the definition of health literacy that is used by Healthy People 2010, the IOM, the NIH, and in the Affordable Care Act. Dr. Parker has served in leadership roles as a health literacy advocate for professional societies, including the AMA and the ACP Foundation.

She has consulted with a number of state and federal agencies, professional organizations, and industry regarding their health literacy efforts. Dr. Parker was a member of the IOM Health Literacy Committee and the Health Literacy Roundtable. She has received a number of national awards for her work.

Special Guest:

Dr. Ruth Parker, MD, Professor of Medicine, Pediatrics and Public Health
Department, Emory University School of Medicine  facebook_logo_small3  twitter_logo_small-e1403698475314  linkedin_small1  youtube logo  google-plus-logo-red-265px  instagram

 

Autism Spectrum Disorder

autism

Caitlin Delfs

Womens Telehealth Logo

Autism Spectrum Disorder

The CDC estimates that the prevalence of Autism Spectrum Disorders (ASD) in the US is approximately
1:68 children. ASD affects more males (1:42 ) than females (1:189). ASD is a class of neurodevelopmental conditions including: interaction difficulties, communication and language impairments, and repetitive behaviors.

The average of at ASD diagnosis is around 4 years of age, but can be diagnosed much earlier.  Recent studies suggest that there is a gap between the number of children diagnosed with ASD and those
receiving services to treat ASD. Yet- we know early intervention helps children with ASD progress. Our
segment today focuses on the latest in ASD intervention and how technology has impacted the field. Top national expert, Dr. Caitlin Delfs, from the Marcus Autism Center joins us to provide the latest in ASD information and research findings.

More info soon!