Tuesday, 10 January 2017


The background and implication of the ESRD PPS, are as follows:

· In August 2012, CMS released an analysis of patient claims in the new ESRD prospective payment system, which showed that this payment system has had no negative effects on patients’ health.

· The ESRD PPS, first implemented in 2011, expands renal dialysis services included in the single bundled payment to the dialysis facilities and provides for patient case-mix adjustments, facility level adjustments, and outlier payments.  It is intended to improve efficiency.

· CY 2013 will be the third year of a four-year transition to the new payment system.  The overall impact of the CY 2013 changes is projected to be a 3.0 percent increase in payments. Hospital-based ESRD facilities have an estimated 3.6 percent increase in payments compared with freestanding facilities with an estimated 2.9 percent increase. Urban facilities are expected to receive an estimated payment increase of 3.0 percent compared to an estimated 2.9 percent increase for rural facilities.

·The ESRD QIP aims to promote continued improvement in the quality of care provided to patients with ESRD. The final rule focuses on clinical measures and has added the following QIP reporting measures to cover a broader range of patients who receive dialysis care:

o   To evaluate anemia management

Anemia Management, a reporting measure.

o   To evaluate dialysis adequacy
  • A clinical Kt/V measure for adult hemodialysis patients.
  • A clinical Kt/V measure for adult peritoneal dialysis patients.
  • A clinical Kt/V measure for pediatric in-center hemodialysis patients. 

 · The overall economic impact of the ESRD QIP is an estimated $24.6 million for PY 2015. The total expected payment reductions will be approximately $12.1 million, and the costs associated with the collection of information requirements for certain measures to be approximately $12.4 million.

· The estimated payment reduction will continue to incentivize facilities to provide higher quality care to beneficiaries. The reporting measures that result in costs associated with the collection of information are critical to better understanding the quality of care beneficiaries receive, particularly a patient's experience of care, and will be used to incentivize improvements in the quality of care provided.

Keep Your Independence Day Safe

Three-quarters of Americans plan to enjoy the outdoor cookout experience to celebrate the Fourth of July Holiday.  With all that fun, come some obvious and not so obvious dangers.  Read on to see tips on keeping everyone happy and healthy in the backyard or at the park.

Do this to reduce your risk:

1.Marinade meats for 30 minutes prior to grilling to reduce Hetercyclic Amines (HCA’s)

2. Cook meat properly.  Burnt meat contains HCA’s
causes gene damageConsumption of HCA’s can cause damage to genes.  This can often be related to increased cancer risk.

3.Eat only 4-6 oz. of red meat per meal (18 oz. per week) or instead eat chicken, fish, fruits and veggies made on the grill.
causes gene damageRed meat increases the risk of colon cancer.
mosquito borne illness]

Ants are famous for crashing the picnic, but the mosquito is much more harmful.  Keep everyone comfortable and disease free by reviewing this information on those pesky, flying pests.

causes gene damage Mosquitoes spread dangerous diseases like West Nile Virus, Dengue and Malaria.  Mosquitoes infect nearly 225 million people annually with Malaria resulting in approximately 781,000 deaths.

1.Mosquitoes are attracted by dark colors, body heat and smells from body chemicals like carbon dioxide and lactic acid.  Dress in lightly colored protective clothing and use repellent containing DEET.

2.Eliminate breeding areas by draining all standing water where they lay their eggs.

3.Avoid peak mosquito hours: early morning and evening.

heat stress

We all wish for a bright sunny day for our holiday activities, but be cautious of the effects that summer time heat can have on your body.

1.Drink plenty of fluids, avoiding sugar sweetened drinks.
2.Protect your skin with sunscreen and wear loose-fitting, lightweight and light colored clothing.
3.Be aware of symptoms of heat-related illnesses like heat stroke and heat exhaustion.   

You can go to the CDC website to see a full guide on heat stress illnesses. 

causes gene damage Excessive heat above 80 degrees with 40% or more humidity can have even more serious consequences for those people with diabetes.  Diabetics should:

Check medication and test strips packaging and their glucose meter regarding effects of exposure to high temperatures.  Take the necessary precautions to protect them and insulin pumps from the heat.

Keep insulin cool, preferably in a cooler without direct contact with ice or frozen gel packs.

For those on a restricted liquid intake, they should discuss with their doctor how best to adjust to their intake during times of high heat.

National HIV Testing Day

 June 27th has been designated by the US Department of Health and Human Services to be National HIV Testing Day.

millions of people in the United States alone.   The CDC estimates more than 1.1 million people in the United States are living with HIV infection currently and about 50,000 new cases are diagnosed each year.

The CDC also reports that almost 1 in 5 (18.1%) of infected individuals are unaware of their infection.  As with any disease, the ideal way to fight the spread of HIV is with early detection.  It allows those who are diagnosed to initiate treatment as soon as possible, increasing survival chances and quality of life. This also helps to eliminate the chance of unknowingly spreading the disease to others. 

Healthcare professionals should take this opportunity to encourage high risk individuals to be screened for HIV.  Information on testing that is geared to provider education is provided on the aids.gov website.

For patients, a screening location finder can be found on the CDC website by clicking here or also at http://aids.gov/.

The table below lists basic on the Medicare coverage for HIV Screening.  Please consult the CMS Preventive Services website for complete detailed information.

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