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12 superbugs that pose the greatest danger to human health

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http://www.fiercehealthcare.com/population-health/who-releases-list-12-priority-pathogens-to-encourage-drug-development?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWkRjeU1tTTFPVEUyTjJaaCIsInQiOiJBNGU4aWlDQkpcL3l6eURqQUMyR2w3aVFtNStxVzBraUpQcTVOamQ4SVNEVUNDeXFQQ1RDWG5qdmptMjI4VWpiVTdHUDltN0ZTMG5ObWlHOWl0cXRmVEpjQ0h2bFU1NXJKM2YzaHBrcnc2VlVJVkoyTHJrQjBndGI5b3BGWmdJV1oifQ%3D%3D

Bacteria

The World Health Organization has released a list of 12 antibiotic-resistant superbugs that pose the greatest danger to human health.

The purpose of the list of “priority pathogens,” according to WHO, is to promote continued research and development of drugs that can be used to treat patients with these resistant infections.

The agency has divided the list according to the urgent need for new antibiotics. The bacteria considered the most critical pose a particular threat to hospitalized patients who may require blood catheters or ventilators. These bacteria, which can cause severe and deadly infections, such as bloodstream infections and pneumonia, are also resistant to drugs designed as a last line of defense for patients.

“This list is a new tool to ensure R&D responds to urgent public health needs,” Marie-Paule Kieny, Ph.D., assistant director-general for health systems and innovation at the WHO, said in an announcement. “Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”

Three bacteria resistant to carbapenem, an antibiotic that often treats bacteria that are resistant to other drugs, are listed as critical. Six bacteria are ranked as high-priority and the final three are listed as medium-priority. Bacteria listed as high- or medium-priority are increasingly becoming resistant to different antibiotics and are producing hard-to-treat strains of common conditions, such as gonorrhea and salmonella.

One of the three critical bacteria, carbapenem-resistant Enterobacteriaceae, or CRE, resulted in the death of a Nevada woman last year, and estimates suggest the infection may be more widespread than previously thought.

Global health experts have increasingly warned that superbugs are poised to be a significant threat to patient health. In the next decades, drug-resistant infections could kill more people than cancer. Providers can do their part by focusing on antibiotic stewardship. National healthcare organizations, including the Centers for Medicare & Medicaid Services, have offered guidelines.

Here is the complete list compiled by WHO:

Value-based payment: Why practices need to get on board now

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http://www.fiercehealthcare.com/healthcare/practices-smart-to-get-board-now-value-based-payment

For an industry traditionally scrutinized for low executive pay, one has to wonder what our executives are actually making.

The smartest move physician practices can make right now is to move ahead with value-based payment arrangements, experts say.

The transition from fee-for-service to value-based care is inevitable and practices that embrace new payment methods will be ahead of the curve, according to Physicians Practice. If doctors are still unsure, here are a few of the reasons it makes sense for practices to move ahead with value-based care:

You’ll be better prepared for MACRA. The new payment systems implemented under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) are here to stay, and getting in on a payer’s value-based system will get you ahead on changes you need to make, such as tracking quality patient data, says Mott Blair, M.D., a family physician, whose practice has added a health coach and can identify high-risk patients and be pro-active to keep them healthy.

You won’t get left out in the cold. As local hospitals start setting up a system of providers, you want to be included in order to get referrals, particularly for specialty practices, Elizabeth Woodcock, president of the consulting firm Woodcock and Associates, told the publication.

You’ll get paid for more patient care. Under fee-for-service arrangements, practices don’t get reimbursed for some of the time they spend on patient care, such as returning patient calls or following up on missed appointments. With a value-based arrangement, you will be rewarded for these activities that lead to better patient care.

While there’s lots of questions about the future of healthcare, experts say the push to value-based care will likely continue under President Donald Trump’s administration. Dozens of leading healthcare organizations have called on Trump to continue the federal government’s push to value-based, patient-centered payment models that reward providers for improved quality and cost-effective care.

Can ACOs survive a repeal and replacement of the Affordable Care Act?

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Doctor patient

Just as the fate of the Affordable Care Act is up in the air, so is the future of accountable care organizations, which were established under the healthcare reform law to improve care and reduce costs.

But one leading health policy expert predicted that even if Republican lawmakers come up with a plan to repeal and replace the healthcare reform law, ACOs will survive. They will just need to adapt to the new regulatory landscape.

“ACOs are here to stay,” wrote Paul Keckley, Ph.D., managing editor of The Keckley Report, in a post for Hospitals & Health Networks. “How they fit into a medical group or health system’s contracting and population health strategies will change as regulations like MACRA kick in and as employers, insurers, Medicare and Medicaid assess their value.”

More than 850 ACOs currently provide care to more than 28 million patients across the country. This year 570 ACOs will participate in Centers for Medicare & Medicaid Services models, including the Shared Savings Program  (MSSP), Next Generation ACO Model and The Comprehensive ESRD Care Model.

Two recent studies showed evidence that ACOs do lead to quality improvements and cost reductions, but those benefits grow over time. The problem is that Tom Price, the new head of the Department of Health & Human Services, doesn’t support some value-based care initiatives, such as Medicare’s mandatory bundled payment initiatives for hip and knee replacements.

But Keckley predicted physician-led ACOs that follow practices to standardize care and incentives for clinicians linked to cost savings will survive. However, in order to survive the organizations must focus on primary care driven care coordination, he said. “From these primary care centric models, virtual ACOs that incorporate rural health and teleconnectivity, and clinical models that include social determinants of health in assessing risks and care coordination tactics will evolve,” he wrote.

He also predicted that CMS will change quality measures and simplify reporting requirements under MSSP ACOs. And if Congress does move to Medicaid block grants, he expects Medicaid ACOs will be a growth opportunity.

Mastering Civility

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Mastering Civility

« Asking the Right Questions Often Leads to the Best Answer | Leading Blog Main Page

02.27.17

Mastering Civility

Mastering Civility

Civility costs nothing, and buys everything.

— M. W. Montagu

CIVILITY has a way of winning people over and garnering influence.

Civility isn’t just the absence of incivility. In Mastering Civility, Christine Porath explains that “Civility in the fullest sense requires something more: positive gestures of respect, dignity, courtesy, or kindness that lift people up.”

Incivility impacts our health and performance. It depletes our “immune system, causing cardiovascular disease, cancer, diabetes, and ulcers.” It also robs us of our “cognitive resources, hijacks our performance and creativity, and sidelines us from our work. Even if we want to perform at our best, we can’t, because we’re bothered and preoccupied by the rudeness.”

Incivility is contagious. “When you’re exposed to hostility or aggression, you behave differently. Incivility sneaks into your subconscious. It’s easy to see how plagues of incivility can take shape and spread.” But you don’t have to succumb to incivility. “When you follow a rude experience with a polite one, the polite one ‘overwrites’ the rude one, loosening the hold it has on your mind.”

Civility starts with a few basic behaviors and it grows from there. Simple things like saying please and thank you make a difference in how we are perceived by others and the influence we have on them. “Most of us are in a hurry to prove our competence, but warmth contributes significantly more to others’ evaluations. Warmth is the pathway to influence.”

Other basic behaviors include acknowledging people and listening. They signal caring, commitment and connection. Show respect for others by sharing resources, the limelight, and positive feedback. “The highest performers offer more positive feedback with their peers; in fact, high-performing teams share six times more positive feedback than average teams. Meanwhile, low-performing teams share twice as much negative feedback than average teams.”

Healthcare frauds and settlements in 2017: Running list

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http://www.healthcarefinancenews.com/slideshow/biggest-healthcare-frauds-2017-running-list?mkt_tok=eyJpIjoiWXpVMk16RXlNV00zTm1OayIsInQiOiIzS3NXdllRRU1HNHZlb0Q1aVBYV0hFazRSbGk4dWc3S0FvZERGbHJDeW53Z2ZTb0xCdFhhWEVPcHBBUlVcLytBR1dkTTF0cElHTDRxU0NMSXJ0bWhQUUNvSzl1TVFtaVh2SUhiYkxNTVozNW54SmJCRXhCWDhZT2VGcGNGNlZSdXYifQ%3D%3D

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Single payer healthcare proposal introduced in California Senate

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http://www.healthcarefinancenews.com/news/single-payer-healthcare-proposal-introduced-california-senate?mkt_tok=eyJpIjoiWXpVMk16RXlNV00zTm1OayIsInQiOiIzS3NXdllRRU1HNHZlb0Q1aVBYV0hFazRSbGk4dWc3S0FvZERGbHJDeW53Z2ZTb0xCdFhhWEVPcHBBUlVcLytBR1dkTTF0cElHTDRxU0NMSXJ0bWhQUUNvSzl1TVFtaVh2SUhiYkxNTVozNW54SmJCRXhCWDhZT2VGcGNGNlZSdXYifQ%3D%3D

Legislation introduced in the California Senate last week would set the state on a path toward the possible creation of a single-payer health care system ― a proposal that has failed to gain traction here in the past.

The bill, which is a preliminary step, says that it is the “intent of the Legislature” to enact a law that would establish a comprehensive, single-payer health care program for the benefit of everyone in the state. The legislation, introduced by state Sen. Ricardo Lara (D-Bell Gardens), does not offer specifics of what the plan would look like, nor does it mention a timetable.

A single-payer system would replace private insurance with a government plan that pays for coverage for everyone. Proponents argue that single-payer systems make health care more affordable and efficient, but opponents say they raise taxpayer costs and give government too much power.

Medicare, the federally-funded health coverage for the elderly, is often held up as a model of what a single-payer system might look like.

Lara said in an interview late last week that the state needs to be prepared in case the Affordable Care Act is repealed, as President Donald Trump and Congressional Republicans have promised.

“The health of Californians is really at stake here and is at risk with what is being threatened in Congress,” Lara said, as the debate continued in Washington about the future of President Barack Obama‘s signature health law. “We don’t have the luxury to wait and see what they are going to do and what the plan is,”

Lara noted that while the Affordable Care Act expanded health coverage for many Californians, it left others uninsured or underinsured. He said the single-payer bill builds upon his “health for all kids” legislation, which resulted in coverage beginning last May for 170,000 immigrant children here illegally.

 

DOJ joins whistleblower lawsuit against UnitedHealth Group, WellMed

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The Department of Justice has joined a whistleblower lawsuit against UnitedHealth Group and subsidiary WellMed Medical Management, claiming the insurer allegedly defrauded Medicare of hundreds of millions in risk adjustment payments.

UnitedHealth Group is accused of improperly inflating risk scores for Medicare Part C managed care and Part D prescription drug payments by claiming its members were treated for conditions they either did not have or were not treated for, according to the lawsuit.

The suit was originally brought in 2011 by a whistleblower through attorney Constantine Cannon in San Francisco.

The civil case names UnitedHealth Group, WellMed Medical Management, Health Net, Arcadian Management Services, Tufts Associated Health Plans, Aetna, Blue Cross and Blue Shield of Florida, Blue Cross Blue Shield of Michigan, Health, Inc., EmblemHealth, Inc., Managed Health dba Healthfirst New York, Humana, Medica Holding Company, WellCare Health Plans and MedAssurant.

All of the organizations are still named as defendants in the civil case, according to Jessica Moore, co-lead counsel on the case. The DOJ intervened only in the case against UnitedHealth Group and WellMed.