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%PM, %04 %664 %2018 %14:%Sep

Fall Outreach Updates, September 2018

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With students back in school, fall is a great time to circle back practice outreach efforts to remind patients of upcoming chronic condition follow ups, recommended vaccines and health screenings.

The Physician Alliance and the Practice Resource Team (PRT) are working with physician practices in September to help close gaps in care in:

Family Practice:

  • Preventative screenings
    • Breast Cancer
    • Cervical Cancer
    • Colorectal

Internal Medicine:

  • Congestive Heart Failure
  • Coronary Artery Disease (CAD)
  • Hypertension (HTN)
  • Chronic Kidney Disease (CHF)

Pediatrics:

  • Adolescent Well-Care Visits
  • Combo 2

Thank you to all the committed practice staff, practice resource team members and TPA staff that are that are working toward closing gaps in care. The Physician Alliance created numerous education materials that include posters along with patient action plans. These action forms can be handed out directly to patients. The poster guidelines help prevent and aid in detection of disease along with informative tips.

Utilizing these materials within the practices are a great way to engage and educate patient populations.  Click here to access available materials.  The marketing materials are available to The Physician Alliance physician practice members.

The American Heart Association created “Get with the Guidelines- Heart Failure” quality improvement program.  Click here to download their Heart Failure fact sheet. 

This blog is for informational purposes only and should not be considered medical advice.

Sources: American Heart Association, Centers for Disease Control

To read additional blog articles, please visit our Blog archives page.

 

%PM, %06 %661 %2018 %14:%Aug

Quality Measures Reminder Updates, August 2018

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August is a great month to reach out to patients to schedule recommended screenings.  Identifying and closing gaps in care can improve physician practice quality measures, revenue and patient care. Focusing on closing gaps early helps avoid large, last-minute, time-consuming outreach efforts at the end of the year.

Targeted quality measures

(focus areas for TPA private practices)

Internal Medicine focus:  Preventive screenings

Family Medicine focus:

  • Well child 0-11 years (Combo 10 and Combo 2 immunization schedule)
    • Combo 10HEDIS measure childhood immunization status 1
      • Assesses children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three H influenza type B (HiB); three hepatitis B (HepB), one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their 2nd birthday.1
    • Combo 2: Immunizations for Adolescents2
      • Assesses adolescents 13 years of age who had one dose of meningococcal vaccine, one Tdap vaccine and the complete human papillomavirus vaccine series by their 13th birthday.2 

Pediatrics focus:

  • Well child visit 3-6 year

 

To view the CDC 2018 chart for recommended immunization schedule for children and adolescents (18 years and younger) click here.

By coordinating and implementing an outreach plan around the recommended childhood immunizations along with patient preventive health screenings, physician practices can begin to close gaps and schedule appointments.

To order preventive screening posters along with valuable patient education materials through The Physician Alliance website, click here now.

 

This blog is for informational purposes only and should not be considered medical advice.

Sources:  Centers for Disease Control (CDC), U.S. Preventative Services Task Force (USPSTF), National Committee for Quality Assurance (NCQA)1,2

To read additional blog articles, please visit our Blog archives page. 

 

%PM, %02 %578 %2018 %12:%Jul

Help Prevent Diabetes, July 2018

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Did you know that according to the American Diabetes Association, “the total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity?”  And that 1 in 3 adults have prediabetes in the USA? 

Prediabetes is when an individual’s blood glucose (sugar) level is elevated more than normal, yet not high enough for it to be diagnosed as type 2 diabetes.  This precursor can lead to diabetes.  The population of adults aged 65 years and older with prediabetes is now over 23 million. To view the National Diabetes Statistics report click now.

July is a great month to focus on educating patients on how they can begin making strides to implement necessary lifestyle changes in order to prevent the onset of diabetes.  Physicians can initiate dialogue with their prediabetes patients on recommended lifestyle changes such as:

  • Getting physically active (150 minutes per week recommended)
  • Managing body weight
  • Quit smoking
  • Incorporating healthier foods/meals into daily regimen

The Physician Alliance and the practice resource team are partnering with physician practices to bring awareness to prediabetic and diabetic patients on how to implement positive changes and address barriers that may impact actions.

Diabetes depends on individual self-care.  With this in mind, The Physician Alliance created self-management forms along with action plans to help diabetic patients monitor their daily activities and commit to following recommended steps.

Physicians and their practice staffs can download these forms to hand out to patients by clicking here

Getting a head start educating patients to implement healthier activities to be proactive in preventing diabetes can help lead to less healthcare dollars spent on this disease in the long run. Download the Staggering Costs of diabetes PDF.

This blog is for informational purposes only and should not be considered medical advice.

Sources: American Diabetes Association, Centers for Disease Control

To read additional blog articles, please visit our Blog archives page.

%PM, %11 %720 %2018 %16:%Jun

Scheduling WELLNESS visits, June 2018

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The WELLNESS visit is a “no hands” on visit. This visit is not the same as a traditional physical exam which is a hands-on exam.  A patient wellness visit is a visit to identify high risk behaviors, provide advice on lifestyle and preventative screenings, and to build a relationship with the patient.

Frequently, there is no copay or deductible required for the patient… it is a “free” visit for the patient. Medicare plans pay for 100% of an annual visit with reimbursement codes G0438 and G0439.  Many other plans cover the wellness visit with a variety of codes.  (Physician practices need to confirm with plan providers.)

Consider reaching out to patients who are overdue for preventative measures and schedule them for a yearly wellness visit.  Many physicians find open times in their schedules in the first several months of the year because of the reset of plan deductibles.  Since this evaluation does NOT involve a deductible or copay in most plans, it’s a great opportunity to complete preventative measures that benefit the patient and help physicians provide quality care to their patient population.

This is a great time for primary care physicians to review preventative measures (which are included in pay for performance programs) as well as provide personalized preventative health advice.  An updated health information form could be sent to patients ahead of scheduled appointment times to be filled out prior to the visit.

The Physician Alliance continues to work with physician members and their practice staffs to help close gaps in care. If you have not ordered Wellness exam reminder posters yet for your practice, these forms are complimentary for The Physician Alliance members.  To place an order, go to The Physician Alliance website, click on Learning Center tab, and then click patient education materials.  Or click here.

In addition to the wellness exam posters, The Physician Alliance has created healthy lifestyle self- management forms for both adults and pediatric patients that can be given out to patients during these visits.

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.

To read additional blog articles, please visit our Blog archives page.

%PM, %30 %816 %2018 %18:%May

Barefoot Running, June 2018

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Barefoot running is becoming a more and more popular running trend throughout the running and jogging communities. However, running without shoes also affects the motions of your stride. When barefoot running, choosing to run without shoes is not the only adjustment you will have to make.

Whenever you run normally with shoes, your heel strikes the ground first as you land while you roll over the ball of your foot and push off with the front part and toes. Barefoot runners land on the front part of their feet and not their heels. This shifts the impact from the back to the front of the foot. In order to do this safely and without much injury, runners need to reduce their stride to create softer landings.

One of barefoot running’s biggest advantages is the reduced risk of injury. Landing on the front of your foot with a reduced stride lessens the stress placed on the back of the foot, heels, and ankles. It also works out many muscles in the feet, ankles, and lower legs that you do not normally get to strengthen because of the different motions.  Your posture and balance are also improved with barefoot running, as is your sensory input from your feet to the rest of your body. Studies have shown that countries that have large populations of people who do not wear shoes every day are at lower risk for foot and ankle injuries and complications.

However, there is still some skepticism behind barefoot running because of some disadvantages it brings. One of these is the complete lack of protection for your feet while running. Bruises, scrapes, cuts, and even blisters can easily form when you have no protection from sharp or rough objects on the ground. Landing on the front of your feet can also cause Achilles tendonitis because of the overuse of the Achilles tendon.

Despite this, barefoot running can be made safe and enjoyable if you make a slow transition from your normal running routine into barefoot running. Rather than jumping straight into barefoot running, gradually work your way from walking to jogging to running, increasing the distance each time. It is also recommended to start off on flat, even surfaces that do not contain sharp or dangerous objects because your feet are unprotected. Minimalist running shoes are a great middle ground to start with because they combine the protection of shoes with the fit and feel of barefoot running.

 

Contributed by:  Harvey Lefkowitz, D.P.M., P.C. of Michigan Foot and Ankle located on 641 West Nine Mile Rd., Ferndale, MI 48220. He is also a member of The Physician Alliance, one of Michigan’s largest physician organizations representing more than 2,100 physicians in metro Detroit.

 

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.

%PM, %30 %794 %2018 %18:%Apr

Managing Asthma, May 2018

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According to the Asthma and Allergy Foundation of America, asthma affects close to 25 million Americans. Asthma is a chronic disease that causes airway obstruction in the lungs. The Physician Alliance is working with our physician practices to better manage and close gaps with asthma patients.

It is a chronic disease that causes your airways to become inflamed, making it hard to breathe. Asthma can be managed by avoiding triggers, taking medications to prevent symptoms and being prepared to treat asthma episodes should they take place.

Common asthma symptoms include:

  • Wheezing
  • Shortness of breath
  • Coughing
  • Chest tightness

Click here for information on the Guidelines for the Diagnosis and Management on asthma report.  To date, there is no cure for asthma. 

Different ways of testing for asthma include:

  • Taking a detailed medical history
  • A physical exam
  • Lung function tests
  • Chest or sinus X-ray

Asthma triggers include: mold, outdoor air pollution, tobacco smoke, and colds and flu. Asthma can lead to a potential medical emergency, so it’s key to know the signs of a severe asthma episode/attack.  Medications can help to control asthma, but it is important to note that patient action plans along with regular healthcare can be valuable components of treatment.

Asthma Action Plan Stages1

Green Zone: Doing Well

No cough, shortness of breath, wheeze, or chest tightness; can do all usual activities. Take prescribed long-term control medicine such as inhaled corticosteroids.

Yellow Zone: Getting Worse

Cough, wheeze, chest tightness, or shortness of breath; waking at night; can do some, but not all, usual activities. Add quick-relief medicine.

Red Zone: Medical Alert!

Very short of breath; quick-relief medicines don't help; cannot do usual activities; symptoms no better after 24 hours in Yellow Zone. Get medical help NOW.  Full Action Plan1  

Physicians can help patients better manage asthma through initiating and educating patients on how to avoid triggers along with implementing personal asthma action plans.  Did you know that patient asthma self-management forms are available on The Physician Alliance website?  Click now to download forms.   

Sources: Asthma and Allergy Foundation of America, Centers for Disease Control, American Lung Association

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.

To read additional blog articles, please visit our Blog archives page.

 

%PM, %02 %778 %2018 %17:%Apr

Childhood obesity epidemic, April 2018

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According to the Centers for Disease Control, there are close to 13 million obese children and adolescents in the United States.  Over the last 15 years, childhood obesity has been on the rise and is a growing health issue.  Click here to view the data on the prevalence of obesity in children and adults.

In Michigan alone, 32% of children between the ages of 10-17 years old were considered overweight/obese in 2016. Michigan ranks 10th in the nation for adult obesity at 32.5%. Early evidence-based interventions can help move the mark to lower this percentage of children that go into adulthood overweight.

The Pediatric Childhood Weight Management program (PWMP) at St. John Providence can help to provide overweight children with structured and multi-disciplinary approaches to achieve healthier body weights while increasing knowledge on healthy living.

This program was designed for children ages 7 - 17 years with body masses greater than 85th percentile for their age/gender. It can help to motivate children through nutrition education, along with education on exercise programs.

PWMP includes:

  • Initial evaluation
  • 12 group sessions (weekly)
  • Post evaluation
  • Follow-up evaluations (long term)

Physicians can help improve the quality of life for their overweight pediatric patients by referring these patients to the weight management program.  This process involves completion of an initial evaluation form. Click here to download form.  Patients must be referred by their physician/pediatrician.

Since childhood obesity can lead to increased risk for diabetes type 2 and hypertension, it is important to educate patients and the community on preventing obesity through improved nutrition and increased physical activity.  For questions regarding Pediatric Childhood Weight Management program, please contact St. John Providence Children’s Hospital office at 313-343-7047.

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.

Sources: Centers for Disease Control, St John Providence Children’s Hospital, State of Obesity

To read previous blog articles, visit our Blog Archives page.

 

 

%PM, %08 %885 %2018 %20:%Mar

Preventive screenings can save lives, March 2018

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Colorectal cancer screenings for individuals 50 years of age and older is the most effective way to prevent and detect colorectal cancer. Yet, only 25% of patients aged 50-64 years old are up to date with their colorectal cancer screenings, equating to 75% of this patient population not in compliance with getting this important health screening.

According to the Centers for Disease Control, up to 60% of deaths from colorectal cancer could be prevented if individuals 50 years and older got the recommended screening for colorectal cancer.

Preventative and routine screenings, along with scheduled immunizations, are vital to reducing death and disability while improving the health of Americans. These services both prevent and detect illnesses and diseases—from flu to cancer—in their earlier, more treatable stages leading to significantly reduced risks for illness, disability, early death, and medical care costs.

Yet, despite the fact that many of these services are covered by Medicare, Medicaid, and many private insurance plans under the Affordable Care Act, millions of children, adolescents, and adults go without clinical preventive services.  Preventative health screenings can save lives through early diagnosing, intervention, and treatment.

Now is a great time to connect with your patient population by initiating conversations around recommended preventive health screenings.  Physician practices can reach out to patients to remind patients of important health screenings and to schedule appointments for follow up on:

  1. Breast cancer screening
  2. Cervical cancer screening
  3. Colorectal cancer screening for adults over 50
  4. Obesity screening and counseling

Physicians and their staff can help motivate patients to be proactive and compliant in the disease prevention arena and to make positive and lasting healthy lifestyle changes by making sure that patients are keeping up with recommended screenings. 

Regular patient outreach coordination can also help to monitor whether patients are up to date on their immunization vaccines.  To order preventive screening posters along with valuable patient education materials through The Physician Alliance website, click here now.

Sources:  Healthfinder.gov, Centers for Disease Control, Choosing Wisely

This blog is for informational purposes only and should not be considered medical advice.

To read additional blog articles, please visit our Blog archives page. 

%PM, %21 %669 %2018 %15:%Feb

Diabetic Measures Updates, February 2018

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Did you know that someone is diagnosed with diabetes every 21 seconds?  In 2015, 9.4 percent of the American population had diabetes, equaling out to over 30 million Americans1.  The Physician Alliance is working with physician practices to improve quality measures including diabetes.

The Healthcare Effectiveness Data and Information Set (HEDIS) measures performance on specific care and service dimensions.  It is a tool that is utilized by over 90% of America's health plans in collecting data.  The following are highlights of the 2018 HEDIS measurement for effectiveness of care for comprehensive adult diabetes care:

  • Bilateral eye enucleation has been added to the Eye Exam (Retinal) Performed indicator
  • Revised language in step 1 of the BP Control <140/90 mm Hg numerator and added notes clarifying the intent when excluding BP readings from the numerator.
  • Clarified medical record requirements for evidence of ACE inhibitor/ARB therapy (for the Medical Attention for Nephropathy indicator).
  • Replaced medication table references with references to medication lists
  • Added “sacubitril-valsartan” to description of Antihypertensive combinations in the ACE Inhibitor/ARB Medications List

To view the full table of summary table of HEDIS measure changes, click here or you can download condition specific care directly from The Physician Alliance website. Now is the time to reach out to diabetic patients to help improve the health of your patient population. Also available on The Physician Alliance website are diabetes self-management forms that can be downloaded and given to patients to help in managing diabetes along with several other patient self-management forms. Posters on diabetic care management are also available on the website.

Sources: (12/12/2018, diabetes.org/diabetes-basics/statistics1), American Diabetes Association, Centers for Disease Control, National Committee for Quality Assurance (NCQA.org).

This blog is for informational purposes only and should not be considered medical advice. Please consult with your doctor for more information or if you have a medical concern.

To read additional blog articles, please visit our Blog archives page.

%PM, %31 %856 %2018 %19:%Jan

What are Achilles Tendon Injuries? January 2018

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The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull to severe pain, an increased flow of blood to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not properly warm up before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health.

It is important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Lefkowitz--30-final-H.jpg - 58.75 kB

Contributed by:  Harvey Lefkowitz, D.P.M., P.C. with Michigan Foot and Ankle located at 641 West Nine Mile Rd., Ferndale, MI 48220. Dr. Lefkowitz is also a member of The Physician Alliance, one of Michigan’s largest physician organizations representing more than 2,200 physicians in metro Detroit.

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern. To read additional blog articles, please visit our Blog archives.

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