Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, June 3, 2015

Million Hearts Cardiovascular Disease (CVD) Risk Reduction model

I would have to say that providing incentives to lower blood pressure or cholesterol may not really be the best way to lower CVD. That is a secondary measure, you really want a primary measure like heart attack deaths or 30day stroke deaths.  It is way too easy to game the system this way. The VA hid bad news for years.
http://www.medpagetoday.com/Cardiology/Prevention/51910?

Medicare providers could could get a bump in their paychecks for keeping patients' heart attack and stroke risks in check, the Centers for Medicare and Medicaid Services announced.
Providers are already paid bonuses for assessing certain cardiovascular metrics, said Darshak Sanghavi, MD, director of the Preventive and Population Health Models Group at the Centers for Medicare and Medicaid Innovation (CMMI).
Advertisement
"They get paid just a little bit extra if they get your blood pressure under a certain target," he said, and to tackle cholesterol as well as ask about smoking, he added.
While providers do a "relatively good job," with this, the Million Hearts Cardiovascular Disease (CVD) Risk Reduction model aims to reward providers for leveraging these metrics in a meaningful way to actually alter 10-year risk scores.
Sanghavi announced the new payment model during a panel on disease prevention at the Bipartisan Policy Center last week.
Each year, 610,000 people die of heart disease in the U.S. -- that's one in every four deaths -- totaling around $315.4 billion annually, according to the Centers for Disease Control and Prevention Services (CDC), noted the CMS press release.
Using data such as age, gender, ethnicity, smoking habits, cholesterol level, and blood pressure, providers can calculate a score that predicts the likelihood a patient will encounter cardiovascular issues. "In other words, we can see into the future right now and tell you in the next 10 years what is your risk of heart attack or stroke," Sanghavi said.
Medicare providers who participate in the Million Hearts CVD Risk Reduction model will design "modification plans" through mutually agreed upon goals set with their patients, noted the press release. After relaying to a patient his or her risk of cardiovascular diseases, providers suggest interventions such as taking daily medications, quitting smoking, or developing better eating habits and then explaining the pros and cons of each strategy, Sanghavi said.
Providers will be rewarded for the 10-year absolute risk reduction of their practice. The basic premise is to marry the incentives with long-term outcomes, Sanghavi said
The original Million Hearts initiative began under former Health and Human Services Secretary Kathleen Sebelius in 2011. The new model spans 5 years and uses a randomized, control design involving 300,000 Medicare beneficiaries from roughly 720 practices. The providers in the control group will also be paid a monthly per-beneficiary payment. The ultimate aim of the program is to stop 1 million heart attacks and strokes by 2017.

No comments:

Post a Comment