Wednesday, June 27, 2018

Bundled Payments May Improve Accountability and Lead to More Efficient EHR Use

Electronic health records are supposed to help cut medical costs, but EHRs still have a way to go to achieve the cost-cutting goal. Healthcare – Medicare in particular -- is moving from volume to value. This means that healthcare payers are going to be more inclined to assess what they get for their money. The payers are going to look at value. One approach to increasing value is the use of a bundled payment system. The bundle payment system could also improve EHR utilization.

Bundled payments may be defined as “A single comprehensive payment made to healthcare providers—hospitals and physicians—for a group of related services, based on the expected costs for a clinically defined episode of care.”

So, the use of bundled payments can improve accountability by outlining the required services and letting the payer know what the specific cost per care, or the cost for the bundled services will be. The use of bundled payments can also simplify the payment process. A single payment method could increase the effectiveness of electronic health records.

At the present, many believe that EHRs are not reducing the cost of medical care. EHRs are not reducing medical costs, some feel, because of the inefficiencies of data input, the difficulties of interoperability, and other problems. Concerning data input, the movement from volume to value that includes the use of bundled payments may make EHR data input easier.

Indeed, one study suggested that a bundled payment system, “where there is one negotiated price for a specific condition covering everything from the patient’s co-pay to any medication needed during the procedure,” might make EHR data input less complicated.

At any rate, the movement from volume to value may be beneficial to the patient, the payer and the healthcare provider, especially as that movement includes bundled payment systems. Data entry costs may also decrease, and payers may have a better idea of what they are getting for their money.

Friday, June 22, 2018

Childhood Obesity and Cancer

Childhood obesity continues to receive a lot of attention. Childhood obesity receives attention because reducing childhood obesity will lower the number of adults with obesity, since obesity in childhood increases the risk of obesity in adulthood. Childhood obesity may lead to type 2 diabetes, heart problems, strokes, asthma and some forms of cancer. And the association between obesity and cancer has received increased consideration recently.

Currently, experts believe that at least 13 cancers are associated with obesity. And 9 of the cancers are increasing in young adults. 

“The nine cancers, and the percentage of new cases in people from 20 to 44, include:

Breast cancer -- 10.5 percent
Colon and rectal cancer -- 5.8 percent
Kidney cancer -- 7.8 percent
Endometrial cancer -- 7.3 percent
Thyroid cancer -- 23.9 percent
Liver cancer -- 2.5 percent
Gastric cardia (cancer at the top of the stomach) -- 6.2 percent
Meningioma (cancer in the lining of the brain and spinal cord) -- 16.8 percent
Ovarian cancer -- 10.6 percent.”

Although there is no hard data to show exactly how obesity during childhood causes cancer later in life, it is known that obesity raises the levels of inflammation, insulin and sex hormones. Obesity also causes epigenetic changes (changes in DNA). And according to researchers, “Those kinds of changes may be lasting, even if someone who was heavy as a child loses weight … “

Some research has given us insight into how obesity, early in life, can affect an individual later in life. “For instance, a 2-year-old who is obese has a 75% chance of being obese at age 35,” according to some investigators. Using this insight, healthcare providers can counsel parents on what to do to prevent childhood obesity, and thus reduce a child’s risk of cancer.

Therefore, healthcare providers should counsel parents on the risks of sugar sweetened beverages and other unhealthy activities. The providers would do well to counsel pregnant mothers, for example, on the importance of following a healthy diet, and encouraging their children to follow a healthy diet. Healthcare providers should emphasize the importance of physical activity. These actions could lessen the risk of obesity related diseases such as type 2 diabetes, heart problems, strokes, asthma and some forms of cancer.

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