Tag Archives: Prevention

Rolling Out Health Reform: The Policy & Practice Podcast

Many of the hallmarks of the Affordable Care Act, such as state-based health exchanges to purchase insurance, won’t go into effect until 2014. But, in the meantime, officials at the Department of Health and Human Services are plenty busy rolling out other provisions of the law, making adjustments to some of the law’s programs, and just promoting what they’ve done so far.

Recently, HHS officials announced that they would stop granting exemptions that allow limited-benefit health plans to keep in place low annual coverage limits that are at odds with the Affordable Care Act. HHS has been granting waivers to these so-called “mini-med” plans in an effort to keep the products affordable for consumers. But no more. Starting on Sept. 23, HHS will no longer accept waiver applications or extension requests from these plans. And, in 2014, all health plans will be barred from placing annual limits on coverage under the health reform law.

HHS has also been busy promoting the availability of free preventive services for Medicare beneficiaries. Starting at the beginning of this year, Medicare beneficiaries were eligible to receive recommended preventives services ranging from mammograms to smoking cessation counseling with no copays or deductibles under Medicare Part B.

Photo courtesy National Cancer Institute.

But seniors haven’t flocked to take advantage of the services. Only about one in six Medicare beneficiaries has accessed the free services, according to a government report. So HHS is launching a public outreach campaign that includes radio and TV ads. The government is also reaching out to physicians, asking them to discuss the preventive services with patients.

For more on the implementation of the Affordable Care Act, plus a recap of the American Medical Association’s House of Delegates meeting, check out this week’s edition of the Policy & Practice podcast.

Take a listen and share your thoughts:

The Policy & Practice podcast is taking a break next week, but check back on July 11for all the latest developments in health reform.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

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Filed under Family Medicine, Geriatric Medicine, Health Policy, health reform, IMNG, Obstetrics and Gynecology, Physician Reimbursement, Podcast, Practice Trends

To Get the Teen Away from the Screen, Get a Dog

The physical and psychological health benefits of dog ownership for adults are well known, but data from a new study suggest that Mom isn’t always the one on dog-care duty.

photo by Heidi Splete

In a study published in the March issue of the American Journal of Preventive Medicine, John Sirard, Ph.D., of the University of Virginia and colleagues surveyed 618 teen/parent pairs in Minneapolis about their physical activity levels and how many, if any, dogs they had at home. The teens wore accelerometers to track their physical activity levels for 1 week.

The researchers found that teens with dogs were more active, even after controlling for the usual suspects of gender, race, and socioeconomic status. Both measures of activity – accelerometer counts per minute and the average daily minutes of “moderate to vigorous physical activity” – were significantly greater in teens who had dogs.

But here’s the interesting twist: According to the researchers, “dog walking behavior and active play with the family dog were not assessed in the current study and need to be studied further.”

Although having a dog doesn’t guarantee an increase in activity, the findings suggest that even teens who don’t walk the dog will likely get up off the sofa to let the dog out, and in, and back out. . . even if they don’t put down their phones.

Of course, the study was limited by the use of a homogenous sample, but it is the first to address the impact of dog ownership on activity in teens.

Bonus: A dog gives parents and teens something to talk about, too.

–Heidi Splete (on twitter @hsplete)

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Filed under Family Medicine, IMNG, Internal Medicine, Pediatrics, Primary care

Diabetes Educators Fly Prevention Flag

Currently, 57 million Americans have elevated blood glucose levels that place them at risk for developing diabetes unless there is intervention. Who better than a diabetes educator to intervene? 

That’s the latest stance of the American Association of Diabetes Educators, which is now actively lobbying Congress and calling on private insurers to recognize that the services delivered by its members—which include counseling about nutrition, exercise, and the psychological aspects of lifestyle modification—can bring tangible benefits to those at risk for diabetes as well as those who already have it, AADE president Deborah Fillman said during the association’s annual meeting in San Antonio. 

Photo of Deborah Fillman, CDE by Lagniappe Studio/Courtesy of AADE

Specifically, AADE is asking Congress to further expand the Medicare Prescription Drug Improvement and Modernization Act of 2003 to include coverage for Diabetes Self-Management Education/Training (DSME/T) for people with pre-diabetes in addition to those with diabetes. 

The association cites data from a retroactive claims analysis of 250,000 Medicare beneficiaries showing an average cost savings of $135 per patient per month for those who completed a DSMT program, and an inpatient cost savings of $160 per patient per month. Other data have shown conclusively that lifestyle intervention such as that delivered by diabetes educators reduces the progression from pre-diabetes to diabetes. 

But with a shortage of specialized healthcare providers to meet the needs of the 24 million Americans who are already diagnosed with diabetes, how does AADE envision tackling pre-diabetes as well? “The first key is that we have the skill set to do it. The rest of it we’ll have to work on, including the reimbursement issue and increasing our numbers,” Ms. Fillman, a registered dietitian and a certified diabetes educator, told me. 

At the same time, she added, “We’re already doing behavior change. We already work with family members of people with diabetes. In many ways we’re already doing diabetes prevention. It’s just not recognized.” 

—Miriam E. Tucker (on Twitter @MiriamETucker)

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Filed under Alternative and Complementary Medicine, Cardiovascular Medicine, Endocrinology, Diabetes, and Metabolism, Family Medicine, Geriatric Medicine, Health Policy, health reform, IMNG, Internal Medicine, Pediatrics, Primary care, Uncategorized