CMS Posts CY 2019 Notice and Call Letter
The Centers for Medicare and Medicaid Services (CMS) has posted the calendar year (CY) 2019 Advance Notice and Call Letter explaining proposed methodological and payment changes for Medicare Advantage (MA) plans, as well as key policies under Part D. The proposal includes opioid prescribing limits in Medicare Part D and changes to MA utilization of encounter data. It also expands MA supplemental benefits and reducing payments to Employer Group Waiver Plans.
Net Payment Impact
For MA plans, CMS estimates a +1.84 percent net increase on average relative to CY 2018 becau...
Source: Policy and Medicine - March 9, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Why grains make you fat
How is it that a blueberry muffin or onion bagel can trigger weight gain? Why do people who exercise, soccer Moms, and other everyday people who cut their fat and eat more “healthy whole grains” get fatter and fatter? And why weight gain specifically in the abdomen, the deep visceral fat that I call a “wheat belly,” that is inflammatory, worsens insulin resistance and blood sugars, disrupts hormones like testosterone and estrogens, and is associated with greater risk for heart disease, cancer, and Alzheimer’s?
There are several fairly straightforward ways that wheat in all its varied forms–-whole wheat brea...
Source: Wheat Belly Blog - March 3, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle blood sugar gluten grains insulin obesity weight gain Weight Loss Source Type: blogs
There ’s more to the story of the fired patient
She could have been my charming tiny kindergarten teacher, sitting there nonchalantly in her wheelchair with neatly folded arms in her lap. The delicate, airy cloud of silvery blonde hair on her head resembled Queen Elizabeth’s style. I named her Ms. Elizabeth. A few moments ago, though, she looked like a young child who could not comprehend the meaning of her condition. Whenever she was spoken to, her mind seemed to fixate only on one thing: could her pain management intensity be increased? Due to her chronic pain, Ms. Elizabeth begged for more morphine, more pills and more medication.
As a medical scribe, I was tucked ...
Source: Kevin, M.D. - Medical Weblog - February 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Pain Management Source Type: blogs
The Luxury to Choose
By TRAVIS BIAS, MD
The 80 year-old woman lay on her mat, her legs powerless, looking up at the small group that had come to visit her. There were no more treatment options left. The oral liquid morphine we had brought in the small plastic bottle had blunted her pain. But, she would be dead in the coming days. The cervical cancer that was slowly taking her life is a notoriously horrible disease if left undetected and untreated and that is exactly what had happened in this case.
We had traveled hours by van along dirt roads to this village with a team of health workers from Hospice Africa Uganda, the country’s authority o...
Source: The Health Care Blog - February 25, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Gardasil Hospice Africa Uganda vaccines Source Type: blogs
The miscalculated fear of an opioid crisis in Haiti
Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian diaspora in the United States. Although needed painkillers are notably lacking in developing countries, the fear of a similar path has led a high-profile personality to advise against their use in Haiti. Indeed, he...
Source: Kevin, M.D. - Medical Weblog - February 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kenny-moise" rel="tag" > Kenny Moise, MD < /a > Tags: Policy Pain Management Primary Care Source Type: blogs
What ’s love got to do with it: lessons from a dying physician
They came from all corners of the globe to bid him farewell. He looked cachetic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice. He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile.
Some of his visitors were former colleagues; others were friends, previous medical trainees, and mentees. Amidst moments of laughter, crying, and sober reflection, each recounted one anecdote after another of their encounters with Dr. Yeat at som...
Source: Kevin, M.D. - Medical Weblog - February 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/charles-a-odonkor" rel="tag" > Charles A. Odonkor, MD < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs
Proposed Medicare Changes to Limit Opioid Prescribing
by Chad KollasOn February 1, 2018, the Centers for Medicare& Medicaid Services (CMS)published its Advance Notice of Methodological Changes for Calendar Year 2019. Included in these proposed rules were several directives intended to reduce" Opioid Overutilization ” (see p. 202), including formal adoption of the “90 morphine milligram equivalent (MME) threshold cited in the CDC Guideline, which was developed by experts as the level that prescribers should generally avoid reaching with their patients (p. 203). ” CMS proposed “adding additional flags for high-risk beneficiaries who use ‘potentiator’ drugs (such...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 4, 2018 Category: Palliative Care Tags: CMS health policy kollas medicare opioids Source Type: blogs
Proposed Medicare Changes to Limit Opioid Prescribing
by Chad KollasOn February 1, 2018, the Centers for Medicare& Medicaid Services (CMS)published its Advance Notice of Methodological Changes for Calendar Year 2019. Included in these proposed rules were several directives intended to reduce" Opioid Overutilization ” (see p. 202), including formal adoption of the “90 morphine milligram equivalent (MME) threshold cited in the CDC Guideline, which was developed by experts as the level that prescribers should generally avoid reaching with their patients (p. 203). ” CMS proposed “adding additional flags for high-risk beneficiaries who use ‘potentiator’ drugs (such...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 4, 2018 Category: Palliative Care Tags: CMS health policy kollas medicare opioids Source Type: blogs
Psychology Around the Net: February 3, 2018
Well, ol’ Punxsutawney Phil saw his shadow yesterday, so we might be looking at six more weeks of winter — “might,” because he’s usually wrong.
However, if he’s right, there’s plenty of cozy wintertime activities to get us through the days and nights when it’s too cold or snowy to go out. One of my favorites? Reading! Coincidentally, in this week’s Psychology Around the Net we have a list of 10 new mental health books out in 2018!
We also have the latest on the anti-diarrhea medicine overdoses, a psychologist’s controversial research regarding how we distinguish p...
Source: World of Psychology - February 3, 2018 Category: Psychiatry & Psychology Authors: Alicia Sparks Tags: Addiction Books Habits Industrial and Workplace Medications Phobia Psychology Around the Net Research Substance Abuse anti-diarrhea medicine books about mental illness business coaches Gaydar Imodium Michal Kosinski Opioids Source Type: blogs
The Opioid Crisis – In Your Cupboard
The opioid epidemic of the last 20 years has served to illustrate the powerful addictive properties of anything that binds to opioid receptors of the human brain. Lives are ruined by opioid addiction, more than 100 deaths now occurring every day from overdose as people either take more and more to overcome the partial tolerance or new potent drugs like fentanyl make their way into street versions. Drugs such as oxycodone, hydrocodone, and fentanyl bind to the brain’s opioid receptors provoking a “high” while causing the user to desire more opioids as partial tolerance develops. And make no mistake: Much o...
Source: Wheat Belly Blog - January 30, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle addiction addictive eating disorder opiates opioids undoctored Source Type: blogs
Medtronic ’s Synchromed II Approved to Pump Remodulin Into Veins to Treat Pulmonary Hypertension
The FDA has issued approval for the Implantable System for Remodulin, which is really the Synchromed II drug infusion system from Medtronic, consisting of an implantable pump, controller, and catheter. The system is used to treat pulmonary arterial hypertension by delivering Remodulin (Treprostinil) into the vein at the superior caval-atrial junction.
The pump is implanted under the skin of the abdomen and programmed to deliver the drug at a desired rate. The pump’s drug chamber can be refilled via an injection through the skin whenever the reservoir runs low.
Medtronic has engineered the pump to achieve a high le...
Source: Medgadget - January 30, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Medicine Source Type: blogs
Hospital Groups Plan to Launch a Company to Manufacture Generic Drugs
Manufacturers of generic drugs likeTeva Pharmaceutical have been suffering serious financial reverses (see: Teva warns on profit as drugmaker's problems deepen). Moreover, periodic shortages of generic drugs have been exacerbated by the fact that some of them are manufactured by only one company (see:New Study Highlights Escalated Dangers of Generic Drug Shortages). Here is a quote from this article:In 2011, 251 drug shortages occurred, 73% of which were generic sterile injectables that served as treatments for sepsis, cancer, and other life-threatening illnesses. In February 2011, the FDA announced a severe nati...
Source: Lab Soft News - January 27, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Food and Drug Administration Healthcare Business Healthcare Innovations Hospital Executive Management Pharmaceutical Industry Quality of Care Source Type: blogs
Scientists Just Solved a Major Piece of the Opioid Puzzle | WIRED
When it comes to tackling the opioid crisis, public health workers start with the drugs: fentanyl, morphine, heroin. But biochemists have a different focus: Not the opioids, but opioid receptors —the proteins the drugs latch onto within the body.These receptors embed themselves in the walls of cells throughout the brain and peripheral nervous system. There, they serve as cellular gatekeepers, unlocking not just the painkilling properties for which opioids are prized, but the severe, addictive, and often lethal side effects that, in 2016, contributed to the deaths of more than 50,000 people in the US.But it doesn't ha...
Source: Psychology of Pain - January 22, 2018 Category: Anesthesiology Source Type: blogs
The Quest for Safer Opioid Drugs | The Scientist Magazine
Opioid drugs are well-established double-edged swords. Extremely effective at analgesia, they cause an array of harmful side effects throughout the body, including itching, constipation, and respiratory depression —the slowed breathing that ultimately causes death in overdose cases. What's more, the body's interaction with opioids is dynamic: our receptors for these compounds become desensitized to the drugs' activity over time, requiring ever larger doses to suppress pain and eventually provoking severe dependence and protracted withdrawal.In the past few years, these side effects have plagued growing number...
Source: Psychology of Pain - January 22, 2018 Category: Anesthesiology Source Type: blogs
The Political Economy of Fentanyl
By KAREN SIBERT, MD
Just say No to Fentanyl.
No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice.
I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in an upcoming case. My response always is, “I don’t have emotional relationships with drugs. They are tools in our ...
Source: The Health Care Blog - January 2, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
