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Showing posts sorted by date for query expectancy. Sort by relevance Show all posts
Showing posts sorted by date for query expectancy. Sort by relevance Show all posts

Saturday, December 14, 2019

Top NJ Workers' Compensation Decisions of 2019

It has been an active 2019 for workers’ compensation decisions in New Jersey. There have been two NJ Supreme Court opinions and three reported Appellate Court opinions that are noteworthy. From a review of the pending docket the NJ Supreme Court will be reviewing at least 3 very significant issues in 2020 invoking workers’ compensation issues.

Saturday, July 20, 2019

Court Has Discretion to Award Counsel Fee Based on Dependent's Life Expectancy

After awarding dependent benefits under N.J.S.A. 34:15-13 to the surviving spouse of a worker who succumbed to an occupational disease, the judge of compensation awarded counsel fees based on the spouse's expected lifetime – in accordance with a 1995 amendment to N.J.S.A. 34:15-13(j) which provided that compensation shall be paid to a surviving spouse "during the entire period of survivorship" – as determined from the table of mortality and life expectancy printed as Appendix I to the New Jersey Rules of Court.

Thursday, March 30, 2017

National Asbestos Awareness Week April 1-7, 2017

S. RES. 98 Designating the first week of April 2017 as “National Asbestos Awareness Week”.

IN THE SENATE OF THE UNITED STATES
March 27, 2017
03/29/2017 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent.  (All Actions)
Senator Jon Tester


Mr. Tester (for himself, Mr. Markey, Mr. Isakson, Mr. Daines, Mr. Durbin, Mrs. Feinstein, Ms. Warren, Mr. Merkley, and Mr. Leahy) submitted the following resolution;

Friday, December 2, 2016

Insurance Rating Company Increases Estimate for Net Ultimate U.S. Asbestos Losses to $100 Billion

A.M. Best has increased its estimate for losses that U.S. property/casualty insurers can ultimately expect from third-party liability asbestos claims by approximately 18% to $100 billion. The $15 billion increase to the net ultimate asbestos loss estimate comes as insurers are incurring approximately $2.1 billion in new losses each year while paying out nearly $2.5 billion on existing claims. The updated figures are contained in a new Best’s Special Report, titled “A.M. Best Increases Estimate for Net Ultimate Asbestos Losses to $100 Billion.” The report also states that A.M. Best is not making any change to its $42 billion estimate on net ultimate environmental losses; therefore, A.M. Best’s view of ultimate industry losses for asbestos and environmental (A&E) is now $142 billion.

Monday, July 27, 2015

Home is an Odyssey For The Aging Population

Workers' Compensation over the decades has had a very narrow and limited view of "home improvement" benefits for an aging and disabled workforce. That view is focussed on the immediate and maybe a 5 year plan going into the future. With increasing life expectancy of the entire population the workers' compensation system will need to adapt to what is considered "home" and adapt to new factors in an ever changing world.

Sunday, March 29, 2015

National Asbestos Awareness Week, April 1 to 7, 2015

Designating the first week of April 2015 as ‘‘National Asbestos Awareness Week’’
IN THE SENATE OF THE UNITED STATES

Mr. MARKEY (for himself, Mrs. BOXER, Mr. DURBIN, Mrs. MURRAY, Mr.
CARDIN, Mrs. FEINSTEIN, Mr. REID, Mr. TESTER, Mr. ISAKSON, Mr.
SCHUMER, Ms. WARREN, Mr. DAINES, Mr. BOOKER, Mr. CRAPO, and
Mrs. GILLIBRAND)

RESOLUTION

Designating the first week of April 2015 as ‘‘National
Asbestos Awareness Week’’.

Whereas dangerous asbestos fibers are invisible and cannot
be smelled or tasted;

Whereas the inhalation of airborne asbestos fibers can cause
significant damage;

Whereas asbestos fibers can cause cancer such as mesothelioma,
asbestosis, and other health problems;

Whereas symptoms of asbestos-related diseases can take 10
to 50 years to present themselves;

Whereas the projected life expectancy for an individual diagnosed
with mesothelioma is between 6 and 24 months; 

Whereas generally, little is known about late-stage treatment
of asbestos-related diseases, and there is no cure for such
diseases;

Whereas early detection of asbestos-related diseases may give
some patients increased treatment options and might improve
their prognoses;

Whereas the United States has substantially reduced its consumption
of asbestos, yet continues to consume hundreds
of metric tons of the fibrous mineral each year for use
in certain products throughout the United States;

Whereas asbestos-related diseases have killed thousands of
people in the United States;

Whereas while exposure to asbestos continues, safety and prevention
of asbestos exposure already has significantly reduced
the incidence of asbestos-related diseases and can further reduce 
the incidence of such diseases;

….
Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thompson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson-Reuters). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Thursday, July 31, 2014

Medicare Experiment Could Signal Sea Change For Hospice

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

Diane Meier is the director of the Center to Advance Palliative Care, a national organization that aims to increase the number of palliative care programs in hospitals and elsewhere for patients with serious illnesses. Meier is also a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City. We spoke about a recently launched pilot program under the health law that allows hospice patients participating in the pilot to continue to receive life-prolonging treatment. This is an edited  version of that conversation.
Q. There’s a lot of confusion about how hospice care differs from palliative care. Maybe we should start by clearing up what those terms mean. 
A. The short, quick elevator answer is that all hospice care is palliative care -- but not all palliative care is hospice. Palliative care is a team-based type of care focused on maximizing the quality of life for people and their caregivers at any stage of illness. It focuses on treating the pain, stresses and symptoms of serious illness. The emphasis is on need, not prognosis or how long you might have to live.
In contrast, the hospice benefit, which was written into the Medicare statutes about 25 years ago, had a number of limits in it to control spending.
Diane Meier (Photo courtesy of Mount Sinai Hospital)
...
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Monday, December 30, 2013

Emily Oster’s graph of the year: Why is the U.S. falling behind in life expectancy?

Today's post was shared by RWJF PublicHealth and comes from www.washingtonpost.com

Time has its "Person of the Year." Amazon has its books of the year. Pretty Much Amazing has its mixtapes of the year. Buzzfeed has its insane-stories-from-Florida of the year. And Wonkblog, of course, has its graphs of the year. For 2013, we asked some of the year's most interesting, important and influential thinkers to name their favorite graph of the year — and why they chose it.

Amidst all the focus on health insurance, I think it’s crucial not to lose focus on the fact that -- insurance or not -- the United States is lagging behind in health status. This chart -- from a broader report -- demonstrates not only how low our life expectancy is relative to other developed countries, but also how far we have fallen even in the last 30 years. Why are we not realizing the same gains that countries with comparable incomes are?

Emily Oster is an associate professor of economics at the University of Chicago Booth School. Her book is "Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong."See all the graphs of 2013 here, including entries from Jonathan Franzen, Bill McKibben, and Ta-Nehisi Coates.

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Friday, December 13, 2013

It’s Doctors versus Hospitals Over Meaningful Use

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com



The Massachusetts Medical Society may be the first to notice that Meaningful Use EHR mandates favor large providers and technology vendors. Control over the Nationwide Health Information Network sets the stage for how physicians refer, receive decision support, report quality, and interact with patients. State health information exchanges and policy makers are caught in the cross-fire over health records interoperability. Are the federal regulations over Stage 2 being manipulated to put physicians and the public at a disadvantage?
On Dec. 7, the Massachusetts Medical Society took what might be the first formal action in the nation. A resolution stating:
“That the Massachusetts Medical Society advocate for a more open, affordable process to meet technology mandates imposed by regulations and mandates; e.g., that all Direct secure email systems, mandated by Meaningful Use stage 2, including health information exchanges and electronic health record systems, allow a licensed physician to designate any specified Direct recipient or sender without interference from any institution, electronic health record vendor, or intermediary transport agent.”
Scott Mace’s column Direct Protocol May Favor Large Providers and Vendors is the first to report on this unusual move by a professional society. Full disclosure: I’m a member of the MMS and the initiator of what became this resolution.
Meaningful Use is intended to support health reform by...
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Wednesday, December 11, 2013

Characterizing the quality of supportive cancer care can guide quality improvement of veterans

Objective  To evaluate nonhospice supportive cancer care comprehensively in a national sample of veterans.
Design, Setting, and Participants  Using a retrospective cohort study design, we measured evidence-based cancer care processes using previously validated indicators of care quality in patients with advanced cancer, addressing pain, nonpain symptoms, and information and care planning among 719 veterans with a 2008 Veterans Affairs Central Cancer Registry diagnosis of stage IV colorectal (37.0%), pancreatic (29.8%), or lung (33.2%) cancer.
Main Outcomes and Measures  We abstracted medical records from diagnosis for 3 years or until death among eligible veterans (lived ≥30 days following diagnosis with ≥1 Veterans Affairs hospitalization or ≥2 Veterans Affairs outpatient visits). Each indicator identified a clinical scenario and an appropriate action. For each indicator for which a veteran was eligible, we determined whether appropriate care was provided. We also determined patient-level quality overall and by pain, nonpain symptoms, and information and care planning domains.
Results  Most veterans were older (mean age, 66.2 years), male (97.2%), and white (74.3%). Eighty-five percent received both inpatient and outpatient care, and 92.5% died. Overall, the 719 veterans triggered a mean of 11.7 quality indicators (range, 1-22) and received a mean 49.5% of appropriate care. Notable gaps in care were that inpatient pain screening was common (96.5%) but lacking for outpatients (58.1%). With opioids, bowel prophylaxis occurred for only 52.2% of outpatients and 70.5% of inpatients. Few patients had a timely dyspnea evaluation (15.8%) or treatment (10.8%). Outpatient assessment of fatigue occurred for 31.3%. Of patients at high risk for diarrhea from chemotherapy, 24.2% were offered appropriate antidiarrheals. Only 17.7% of veterans had goals of care addressed in the month after a diagnosis of advanced cancer, and 63.7% had timely discussion of goals following intensive care unit admission. Most decedents (86.4%) were referred to palliative care or hospice before death. Single- vs multiple-fraction radiotherapy should have been considered in 28 veterans with bone metastasis, but none were offered this option.
Conclusions and Relevance  These care gaps reflect important targets for improving the patient and family experience of cancer care.

Thursday, November 28, 2013

Dying Young: Why your Social and Economic Status May be a death sentence in America

Lisa F. Berkman, Ph.D., Thomas D. Cabot Professor of Public Policy and Epidemiology, Director, Harvard Center for Population and Development Studies 
I will discuss two issues today. First, I will describe trends in U.S. life expectancy and the unequal distribution of mortality risk by socioeconomic status in the United States. Secondly, I will elaborate on options for improving the nation’s health, especially related to labor policies for low wage workers. I will frame our options for improving health in terms of what we can do to create a healthy population and prevent disease. 
Subcommittee on Primary Health and Aging Hearing on “Dying Young: Why your Social and Economic Status May be a death sentence in America” 
November 20, 2013 
First, U.S. overall life expectancy—that is the expected number of years someone born today can expect to live—has lost ground compared to that of other nations in the last decades, especially for women. I was a member of a recent National Academy of Science Panel on diverging trends in longevity. It found that the U.S. ranked at the bottom of 21 developed, industrialized nations1 and poor rankings were particularly striking for women. In 1980’s our rankings were in the middle of OECD countries in this study. While it is true that LE improved during this time from by 5.6 years for men and 3.6 years for women, other countries gained substantially more in terms of life expectancy, leaving us behind. Furthermore, almost all those gains were concentrated among the most socioeconomically advantaged segments of the U.S. population. And they were more substantial for men than for women. The poorest Americans experienced the greatest health disadvantage compared to those in other countries2,3. At a recent NIH conference, the discussion was focused on the steps required for the US to reach just the OECD average in the next 20 years—not even the top. It seems we have given up on achieving better than average health. 
More concerning is the widening gap in mortality—or risk of death—between those at the bottom and at the top in the US. These gaps have widened over the last 25 years. These patterns are evident whether we look at education, income or wealth differentials, but because the evidence is clearest that education itself is causally linked to health and functioning4,5, I will focus on these associations. For instance, the mortality for men with less than a high school education in 2007, was about 7 per 100. For those with 16 years or more of education, the rate was less than 2 per 100. This corresponds to a three and half fold risk of dying in 2007, compared to 2.5 times the risk in 1993. For less educated women, their mortality risk actually increased absolutely during this time giving rise to an increased risk from 1.9 to 3 in 20076 and this pattern holds even if we confine our analyses to white women7. While it is true that fewer adults are in the less educated pool in later years, giving rise to questions about selection issues, it is also true that adults in the highest educated categories have grown over this same time suggesting increased compositional heterogeneity in these groups. Overall while selection into education level occurs, it accounts for only a small part of this widening gap. 
While mortality gaps in socioeconomic status have existed for centuries, the magnitude of these differences has grown substantially over time in the United States. These widening disparities suggest that either disparities in the underlying determinants of illness and mortality have also been growing over time or that support to buffer these stressful conditions has changed. In either case, while we may not be able to eliminate health disparities, the fact that the size of the risks varies so much suggests that such large inequalities are not inevitable or innate and, gives hope that there are ways to reduce the burden of illness for our most vulnerable citizens. 
Now, using a public health framework, I discuss the identification of health risks. While health insurance and access to medical care help reduce risks of financial catastrophe and can improve the health of those suffering from illness, health care alone cannot ensure good health and prevent the onset of disease. To illustrate this point, we can think of the aspirin/headache analogy. “While Aspirin cures a headache, lack of aspirin is not the cause of headaches.” Headaches are not caused by aspirin deficiency— to reduce headaches we need to focus on what causes headaches. This is what prevention and public health approaches offer. Obviously it would be better to maintain health than have to treat illness once it occurs. Treatments are financially very costly, but more importantly, waiting to treat disease is costly to the quality of lives of all Americans. 
What would be required to produce better health among Americans and reduce socioeconomic disparities in health? What do poor socioeconomic conditions influence that could cause such increased risk across such a huge number of diseases across all age groups from the infancy to old age? You are all probably thinking about the usual suspects— smoking, poor diet, and lack of exercise. I’m not going to focus on these usual suspects today, not because I don’t believe they pose substantial risks to health, but because we know that it is very hard to change these behaviors without considering the social and economic conditions that shape them. These social and economic conditions are fundamental determinants of health because they influence so many behaviors and access to so many opportunities and resources. Change here will influence a number of channels leading to increased mortality risk. In my testimony I will focus on one of these conditions relating to participation in the labor market 
Several years ago, I embarked on a study to assess the relationships between employment, family dynamics and health. We found that employment was almost always associated with better health. These associations lasted well into old age.
Women who had the lowest mortality risk in later adulthood had spent some time out of the labor market (a few years over the career path) but maintain steady labor force participation for most of their lives until retirement. Drawing on data from the Health and Retirement Study, we find that the among married mothers, those who never worked had an age-standardized mortality rate of 52.6 whereas mothers who took some time off when their children were young but who later joined the work force and mortality rates of around 40. Single mothers who never worked had the highest mortality of 98 compared to 68 for single mothers who worked. 
Selection into the labor force may account for some of this association, but more experimental evidence confirms the positive health benefits of working especially for low-income women and men. 
For example, the EITC is associated with improvements in infant health and decreases in smoking among mothers8. In an analysis of state variation in the Earned Income tax Credits (EITCs) between 1980 and 2002, Strully finds that EITC’s increase birth weights by, on average, 16 grams. To put that in context, it is equal to about a third of the association between birth weight and having a mother with a high school degree. Living in state with EITC reduces the odds of maternal smoking by 5%, and increases mother’s odds of working and increases her wages and salary. 
Recent evidence from a several studies of maternity leave policies in the United States and Europe suggests that, by protecting employment among mothers in the period around birth, maternity leave leads to better long-term labor market outcomes after maternity including wage level and growth, career prospects, labor market attachment and employability9,10,11,12. Thus not only may maternity leave benefit children and mothers around the period of birth, they may have on term benefits for mothers that extend for decades in later adulthood. 
In an observational study of employees in long term care facilities, we found that workers whose managers were attentive to work-family issues had half the cardiovascular risks as assessed by objective biomarkers from blood or clinical exam and healthier patterns of sleep compared to those who worked for less family-friendly managers13. Specifically, employees whose managers maintained family friendly practices were less likely to be overweight, had lower risk of diabetes and lower blood pressure. Based on objective measures of sleep using actigraphy monitors, these same employees slept almost 30 minutes more per night than their counterparts. For nurses and certified nursing assistants in low and middle wage jobs, these are important risks to which they were exposed. 
Such research suggests that labor policies and practices that support men and women in the labor force and especially help those with caregiving obligations are health promoting. These policies and practices have health effects that are not often “counted” as we think about their costs and benefits. Men and women will need opportunities and flexibility and schedule control to enter and remain in the labor force given the inevitability of having to care for children, parents, or partners at some point in time. Our goal for women should be to enable them to be successful in their productive as well as reproductive lives. Right now, we make this very difficult. Our labor policies challenge working class families to remain committed to work and to their families. For example, over half (54%) of low wage earners lack sick leave or vacation to take care of families and around 30% of middle income families lack such leave14. Even fewer have parental leave. 
We have shown that we can identify the socioeconomic disparities in health with some precision. Solutions that help to maintain low and working class men and women in the paid labor force have clear health benefits. The EITC, pro-family work policies and practices and parental leave are examples of polices that impact health of low income working families. Targets enabling adults to participate in the paid labor force while not risking the health and wellbeing of their family members show particular value. Metrics for evaluating social and economic policies do not currently include health metrics. The health spillovers of such policies would increase the benefits of such policies in any cost-benefit equations. We want to ensure that Americans, particularly those living in poverty and working class families aren’t robbed of healthy years of life. 
 -------------
1 National Research Council (US) Panel on Understanding Divergent Trends in Longevity in High-Income Countries; Crimmins EM, Preston SH, Cohen B, editors. Explaining Divergent Levels of Longevity in High-Income Countries. Washington (DC): National Academies Press (US); 2011. Available from: http://www.ncbi.nlm.nih.gov/books/NBK62369/ 
2 Avendano M, Glymour MM, Banks J, Mackenbach JP. Health disadvantage in US 
adults aged 50 to 74 years: a comparison of the health of rich and poor Americans 
with that of Europeans. Am J Public Health. 2009 Mar;99(3):540-8. doi: 
10.2105/AJPH.2008.139469. Epub 2009 Jan 15. PubMed PMID: 19150903; PubMed Central PMCID: PMC2661456. 
3 Banks J, Marmot M, Oldfield Z, Smith JP. Disease and disadvantage in the 
United States and in England. JAMA. 2006 May 3;295(17):2037-45. PubMed PMID: 
16670412. 
4 Lleras-Muney, Adriana. "The Relationships Between Education And Adult Mortality In The United States," Review of Economic Studies, 2005, v72(250,Jan), 189-221. 
5 Glymour MM, Kawachi I, Jencks CS, Berkman LF. Does childhood schooling affect 
old age memory or mental status? Using state schooling laws as natural 
experiments. J Epidemiol Community Health. 2008 Jun;62(6):532-7. doi: 
10.1136/jech.2006.059469. PubMed PMID: 18477752; PubMed Central PMCID: 
PMC2796854. 
6 Ma J, Xu J, Anderson RN, Jemal A (2012) Widening Educational Disparities in Premature Death Rates in Twenty Six States in the United States, 1993–2007. PLoS ONE 7(7): e41560. doi:10.1371/journal.pone.0041560 
7 Montez JK, Hummer RA, Hayward MD, Woo H, Rogers RG. Trends in the Educational Gradient of U.S. Adult Mortality from 1986 to 2006 by Race, Gender, and Age Group. Res Aging. 2011 Mar;33(2):145-171. PubMed PMID: 21897495; PubMed Central PMCID: PMC3166515. 
8 Strully KW, Rehkopf DH, Xuan Z. Effects of Prenatal Poverty on Infant Health: 
State Earned Income Tax Credits and Birth Weight. Am Sociol Rev. 2010 Aug 
11;75(4):534-562. PubMed PMID: 21643514; PubMed Central PMCID: PMC3104729. 
9 Brugiavini, A., Pasini, G. and E. Trevisan (2013) "The direct impact of maternity benefits on leave taking: evidence from complete fertility histories", Advances in life course research, 18: 46-67 
10 Rossin M. The effects of maternity leave on children's birth and infant health 
outcomes in the United States. J Health Econ. 2011 Mar;30(2):221-39. doi: 
10.1016/j.jhealeco.2011.01.005. Epub 2011 Jan 18. PubMed PMID: 21300415; PubMed Central PMCID: PMC3698961. 
11 Rossin-Slater M, Ruhm CJ, Waldfogel J. The effects of California's paid family 
leave program on mothers' leave-taking and subsequent labor market outcomes. J 
Policy Anal Manage. 2013;32(2):224-45. PubMed PMID: 23547324; PubMed Central 
PMCID: PMC3701456. 
12 Ruhm CJ. Policies to assist parents with young children. Future Child. 2011 
Fall;21(2):37-68. PubMed PMID: 22013628; PubMed Central PMCID: PMC3202345. 
13 Berkman LF, Buxton O, Ertel K, Okechukwu C. Managers' practices related to 
work-family balance predict employee cardiovascular risk and sleep duration in 
extended care settings. J Occup Health Psychol. 2010 Jul;15(3):316-29. doi: 
10.1037/a0019721. PubMed PMID: 20604637; PubMed Central PMCID: PMC3526833. 
14 Heymann SJ. The Widening Gap: Why Working Families Are in Jeopardy and What Can Be Done About It. New York: Basic Books, 2000.  

Monday, November 25, 2013

Accelerated aging found in long-term unemployed men

Today's post was shared by RWJF PublicHealth and comes from www.medicalnewstoday.com

Men who are unemployed for more than two years show signs of faster ageing in their DNA, a new study has found.
Researchers at Imperial College London and the University of Oulu, Finland studied DNA samples from 5,620 men and women born in Finland in 1966.
They measured structures called telomeres, which lie at the ends of chromosomes and protect the genetic code from being degraded. Telomeres become shorter over a person's lifetime, and their length is considered a marker for biological ageing. Short telomeres are linked to higher risk of age-related diseases such as type 2 diabetes and heart disease.
The researchers looked at telomere length in blood cells from samples collected in 1997, when the participants were all 31 years old. The study, funded by the Wellcome Trust, found that men who had been unemployed for more than two of the preceding three years were more than twice as likely to have short telomeres compared to men who were continuously employed,.
The analysis accounted for other social, biological and behavioural factors that could have affected the result, helping to rule out the possibility that short telomeres were linked to medical conditions that prevented participants from working.
This trend was not seen in women, which may be because fewer women than men in the study were unemployed for long periods in their 30s. Whether long-term unemployment is more harmful for men than women later in life needs to be addressed in future studies.
The Imperial team...
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These Are The 36 Countries That Have Better Healthcare Systems Than The US

surgery doctors
12 years ago, the World Health Organization released the World Health Report 2000. Inside the report there was an ambitious task — to rank the world's best healthcare systems.
The results became notorious — the US healthcare system came in 15th in overall performance, and first in overall expenditure per capita. That result meant that its overall ranking was 37th.
The results have long been debated, with critics arguing that the data was out-of-date, incomplete, and that factors such as literacy and life expectancy were over-weighted.
So controversial were the results that the WHO declined to rank countries in their World Health Report 2010, but the debate has raged on. In that same year, a report from the Commonwealth Fund ranked seven developed countries on their health care performance — the US came dead last.
So, what can we learn from the report?
NOTE: The rankings are based on an index of five factors — health, health equality, responsiveness, responsiveness equality, and fair financial contribution. As noted above, all data is from 2000 or earlier and these findings have been questioned.
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Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Leslie Kernisan, MD

Last month an intriguing new decision support app launched, created by experts in geriatrics and palliative care. It’s meant to help with an important primary care issue: cancer screening in older adults.
Have you ever asked yourself, when considering cancer screening for an older adult, whether the likely harms outweigh the likely benefits?
Maybe you have, maybe you haven’t. The sentence above, after all, is a bit of wonky formulation for the following underlying questions:
  • How long is this person likely to live, given age and health situation?
  • Given this person’s prognosis, does cancer screening make sense?
The first question seems like one that could easily occur to a person — whether that be a patient, a family member, or a clinician – although I suspect it doesn’t occur to people perhaps as often as it should.
As for the second question, I’m not sure how often it pops up in people’s minds, although it’s certainly very important to consider, given what we now know about the frequent harms of cancer screening in the elderly, and usually less frequent benefits.
Furthermore, there is abundant evidence that “inappropriate” cancer screening remains common. “Inappropriate” meaning the screening of people who are so unwell and/or old that they’re unlikely to live long enough to benefit from screening.
For instance, one astounding study found that 25% of physicians said...
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Sunday, November 3, 2013

Stable Jobs = Healthier Lives

Today's post was shared by RWJF PublicHealth and comes from www.rwjf.org

The NewPublicHealth National Prevention Strategy series is underway, including interviews with Cabinet Secretaries and their National Prevention Council designees, exploring the impact of jobs, transportation and more on health. “Stable Jobs = Healthier Lives” tells a visual story on the role of employment in the health of our communities.
Some highlights:
  • Since 1977, the life expectancy of male workers retiring at age 65 has risen 6 years in the top half of the income distribution, but only 1.3 years in the bottom half.
  • 12.3 million Americans were unemployed as of October 2012.
  • Laid-off workers are 54% more likely to have fair or poor health, and 83% more likely to develop a stress-releated health condition.
  • There are nearly 3 million nonfatal workplace injuries each year.
  • The United States is one of the few developed nations without universal paid sick days.
Also check out our previous infographics exploring the connection between transportation and health, and education and health.
For more on employment and health, read a related issue brief.View the full infographic below.
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Wednesday, October 23, 2013

Questioning Statins for Older Patients

Limiting medication can reduce overall patient care costs. The efficacy of controlling cholesterol in the "very old" population is now being discussed. Today's post was shared from the NYTimes.com.

Should older adults take statins if they have elevated cholesterol but no evidence of heart disease? It’s a surprisingly controversial question, given the number of seniors taking statins.

Recently AMDA, a professional group representing physicians working in nursing homes, highlighted the issue in a list of five questionable medical tests and treatments. The list was drawn up as part of the national “Choosing Wisely” campaign, which alerts consumers to inappropriate or overused medical interventions, an effort that caregivers would do well to follow.

The standout item on the AMDA list: “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.” That means anyone older than 70, according to the medical society.

Dr. Hosam Kamel, an Arkansas geriatrician who is vice chair of AMDA’s clinical practice committee, said that there is scarce scientific evidence supporting the use of statins by 70- or 80-year-olds without pre-existing cardiovascular disease. Only a handful of studies have focused on outcomes (heart attacks, strokes, premature death) in this older population.

Most of the data on the benefits of statin use come from larger studies that looked at adults of varying ages. The results...
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Wednesday, September 4, 2013

Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010

The US CDC reports that deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

Friday, March 29, 2013

CMS Publishes Brand New Reference Guide for Medicare Set-Aside Arrangements


A new Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted and is available to be downloaded on the CMS (Centers for Medicare & Medicad Services) website.This reference guide was created to consolidate  information currently found within the Workers’ Compensation Agency Services webpages and CMS Regional Office Program Memorandums, while providing WCMSA information to attorneys, Medicare beneficiaries, claimants, insurance carriers, representative payees, and
WCMSA vendors.   

CMS cautions that parties should continue to visit their website for future updates to the reference guide, including additional details regarding the Workers’ Compensation Review Contractor’s review process.


Read more about WCMSA and workers' Compensation:
Feb 21, 2013
Effective immediately, if a WCMSA proposal amount was originally submitted via the web-portal, a re-evaluation of an approved WCMSA amount can be requested through the WCMSA web portal, if the claimant or submitter ...

Thursday, February 21, 2013

CMS Announces New WCMSA Re-Evaluation Procedure

February 12, 2013

Effective immediately, if a WCMSA proposal amount was originally submitted via the web-portal,  a re-evaluation of an approved WCMSA amount can be requested through the WCMSA web portal, if the claimant or submitter believes that a CMS determination:

• contains obvious mistakes, such as mathematical errors or a failure to recognize that medical records already submitted show a surgery CMS priced has already occurred, or
• misinterpreted evidence previously submitted, a re-evaluation maybe requested.  

Please refer to  Question # 12 of the July 11, 2005, procedure memorandum located in the “downloads” section of this page for detailed information regarding when a  re-evaluation request maybe submitted.  The CMS Regional Offices will continue to review the requests submitted through the portal.

Posted on CMS Workers Compensation Agency Services

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