The Fed’s operate a Medicare Physician Bonus Program to encourage doctors to work in underserved areas and improve access to care for folks on Medicare. Certain physicians (including MDs, DOs, dentists, podiatrists, and chiropractors) are eligible to receive a 10% bonus if they’re providing services to Medicare beneficiaries in a geographic primary care Health Professional Shortage Area (Psychiatrists practicing in a mental health shortage areas are also eligible). It’s the provider’s responsibility to ensure they’re in an eligible area- which can be confirmed here. For any questions, please contact Tracy Lenartz.
Keeping off the pounds is tough at any age. Now seniors are getting a helping hand from Medicare. Last month Medicare announced that it’s adding coverage for nutritional and behavioral counseling for those who are obese as measured by body mass index or BMI. BMI is a tool which measures weight status for adults- and it’s broken into several categories: Underweight (Below 18.5), Normal (18.5 – 24.9), Overweight (25.0 – 29.9) and Obese (30.0 and above). This new program for Medicare beneficiaries is for folks with a BMI of 30 or more. You can use this BMI calculator to see where you stand.
The objective of this new preventive coverage is to reduce the impact of obesity and chronic disease among the 30% of folks men and women within Medicare are obese. For Medicare beneficiaries with a BMI over 30, counseling coverage includes: 1) One face-to-face visit every week for the first month; One face-to-face visit every other week for months 2 – 6; and One face-to-face visit every month for months 7 – 12 if the individual meets their weight-loss goals. Additional information on this exciting new preventive coverage can be found on the Medicare website.
Why is this new benefit important? Because most states now have adult obesity rates over 25%- resulting in higher risks for stroke, heart disease, diabetes, cancer, respiratory diseases and arthritis. In other words- obesity results in all kinds of bad health outcomes and cause a host of expensive down-stream treatment costs.
Disease detection and swift and effective public health interventions are essential to saving lives in a public health emergency. According to a new report from the CDC on Public Health Preparedness, Arizona’s public health system is ready and well-prepared. The CDC report outlines the Department’s ability to detect and respond to a wide range of public health threats including our ability to request, receive, and distribute emergency supplies through the Strategic National Stockpile. This year, we scored 97 out of 100 on the review. The evaluation for the Phoenix metropolitan area rose to 95. You can see the complete report on the CDC’s website.
By the way, the CDC has developed a new National Strategic Plan for Public Health Preparedness and Response- which is a guide for the nation’s public health system. The plan identifies eight core objectives which need to be achieved to reach the vision.
A few months ago our tobacco & chronic disease prevention team was awarded a CDC grant to increase coordination and collaboration on evidence-based interventions addressing the leading causes of chronic diseases in Arizona (heart disease, cancer, pulmonary disease, stroke, diabetes, and arthritis). The Chronic Disease Prevention and Health Promotion grant will look for ways we can leverage community partners to improve the health of all Arizonans through health policy, school-based initiatives, community health impact assessments, increased preventive health screenings, chronic disease self-management and worksite wellness.
From now through December 12th our team will be meeting with stakeholders throughout Arizona in a series of partner meetings to gather input on the development of a chronic disease strategic plan surrounding these issues and interventions. Hundreds of community partners have been invited to participate in sessions taking place in Yuma, Tucson, Flagstaff and Phoenix. Simply visit our Chronic Disease Blog for details.
When we think about holding things in confidence- several relationships come to mind that have a long history built on trust and the sharing of deeply private information. Most of us can name these relationships with ease… husband and wife… lawyer and client… health care providers, public health officials and patients. These relationships exist for a reason. To share one’s deepest thoughts, emotions, challenges, fears or medical conditions with another person requires a sacred trust. That expectation of trust allows us to navigate through life’s challenges… confident that we can overcome whatever may be in our path… certain that we can heal from our wounds… willing to make peace with what may face us along the way.
Patient confidentiality is a cornerstone of public health practice- not just because of patient information protection laws like HIPAA- but because it’s the right thing to do. The effectiveness of the entire public health system rests on a foundation of trust. A covenant within the entire Health Care/Public Health Continuum that gives patients the assurance that their private information will remain private. Without that trust- the critical public health information that we rely on to implement effective public health interventions and save lives would erode.
Violating that sacred trust would also cause irreparable harm to the very people we’re trying to help. Would you be comfortable telling your physician or the public health system private information if you knew it would be shared with your friends, neighbors or complete strangers? Would it instill confidence that the provider and the public health system had your best interest as a priority? The answer to these questions for most people is clearly “No”.
Those are just some of the reasons why we take patient confidentiality so seriously- whether it’s communicable disease information, data from our cancer, birth defects, trauma registries, patient information within the public behavioral health system, or information about the folks that we help at the Arizona State Hospital. As the agency that has the privilege of promoting health and wellness for all Arizonans- it’s important that we also hold the trust and confidence of Arizonans that comes with that privilege.
Kudos to our EMS and Trauma System team for forging some new tools to improve trauma care in AZ. Our Data and Quality Assurance team developed an innovative benchmarking tool that’s shared with each of AZ’s trauma centers. The tool shows each facility their injury specific survival rates and compares those rates to the (blinded) other centers. The report provides a balanced approach that gives good information in a non-threatening manner, yet kindles the competitive spirit of the healthcare field to improve care for Arizonans. Here is a copy of the aggregate report.
Our Trauma team has also been busy adding a technical assistance focus to their website. Over the past couple of years they’ve been working with rural hospitals across the State to bring them into our trauma system, including migrating the documentation required for trauma center designation and site reviews into an electronic format. This will assist the trauma surgeons and trauma managers that are on the site review teams that visit these rural hospitals.
Those of you that were working at our downtown campus last Wednesday afternoon may have seen the 100 or so folks carrying placards in front of our 150 Building. They were asking us to make it easier to have a home-birth in AZ. How can we do that, you ask?
Many of you probably didn’t know that we license the 50 or so Midwives that practice in Arizona. Our licensing rules for Midwives were last revised in the mid 1990’s, our rules are out of date, and the application is too complicated. I met with 4 of the community folks upstairs during the demonstration- and we had a productive discussion. Basically- they asked us to consider revising our Midwife licensing rules to simplify the application process and consider revising their scope of practice. We talked during our meeting about the rulemaking process (both exempt and regular), gave them a realistic forecast of how quickly we could revise the rules using each approach, and set up a dialog so we could come up with a solution together.
Coincidently- there was a study published in the British Medical Journal this week regarding the safety etc. of home births. The study basically suggests that there’s little difference in complications among the babies of women with low-risk pregnancies who delivered in hospitals vs. those who gave birth at home with a midwife. Of course- the article is more complicated than that- so visit the journal article for more info…
The CDC confirmed the birth of a new influenza virus in this week’s MMWR Weekly Report. The newborn is named “Swine-origin Triple Reassortant Influenza A (H3N2) (S-OtrH3N2)”. The hybrid virus was found in a handful of school-age kids in Iowa recently- and luckily the kids recovered and none were hospitalized. Nobody outside the initial cluster has been infected (a good thing) meaning it doesn’t look like the new virus is very good at moving person to person (yet). The scientists think that the new virus is a new re-assortment of the RNA among the run-of-the-mill H3N2 and the 2009 H1H1 pandemic strains. The latest details are in this week’s CDC’s Weekly Report. All you virophiles can find a representation of the virus’s RNA on this special CDC website.
Is this a new pandemic, you ask? Probably not.
Chronic disease often calls up bad images for people because it means living with the disease for a long time. But… there was a time when cancer wasn’t chronic disease because people got sick and died pretty quickly. The same goes for HIV. When it was first discovered in the early 80s people quickly transitioned to AIDS and died shortly after diagnosis. Now science and medicine have advanced so far, that HIV and AIDS are both more like chronic diseases. They’ve even come close to what could be considered a vaccine – a discovery so important researchers released it before the rest of the study was finished. The CDC celebrated World HIV day this week by releasing a new issue of Vital Signs.
We’re also keeping up with the times and changing how we handle HIV & AIDS. The folks who work in HIV/AIDS prevention are moving into our Bureau of Tobacco and Chronic Disease. This makes so much sense – a lot of the messaging is the same. People need to learn to control the symptoms, reduce the stressors (like tobacco use or high blood pressure), exercise, eat well and get regular health screenings. We’ll continue with our surveillance efforts in our Bureau of Epidemiology and Disease Control.