Encouraging Integrated Health Systems

Effective as of January 2012, The Affordable Care Act, provides incentives for physicians to join together to form “Accountable Care Organizations. (ACOs)” In these groups, doctors can better coordinate patient care and improve the quality, help prevent disease and illness, and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save.  How can ACOs work to reduce costs?

ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities.  The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first.  Patient and provider participation in an ACO is purely voluntary.

Today, more than half of Medicare beneficiaries have five or more chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These patients often receive care from multiple physicians. A failure to coordinate care can often lead to patients not getting the care they need, receiving duplicative care, and being at an increased risk of suffering medical errors.  On average, each year, one in seven Medicare patients admitted to a hospital has been subject to a harmful medical mistake in the course of their care.  And nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – a readmission many patients could have avoided if their care outside of the hospital had been aggressive and better coordinated.

Improving coordination and communication among physicians and other providers and suppliers through Accountable Care Organizations will help improve the care Medicare beneficiaries receive, while also helping lower costs.

According to the analysis of the proposed regulation for ACOs, Medicare could potentially save as much as $960 million over three years.

How can ACOs provide better care for Patients?

Any patient who has multiple doctors (Crohn’s Disease patients) probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, duplicated medical procedures, or having to share the same information over and over with different doctors.  Accountable Care Organizations are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions.  People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients’ medical history and can communicate with a patient’s other doctors.  Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients choosing to receive care from providers participating in ACOs will have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.

Any patient who is familiar with the level of care provided at a Mayo Clinic knows that teams of doctors and other caregivers work as a team to resolve medical problems that are put before them.  The teams freely communicate with each other often in person or over the phone to develop plans for treating a patient’s ailment.  The team based approach allows for better care and often results in more efficient and more timely diagnosis and treatment for patients.

Proven Techniques and Novel Research Help Control Crohn’s Disease

The following is a guest post written by Brian Flora on behalf of IU Health

Introduction
Crohn’s disease, which is one of the irritable bowel diseases, occurs when you have chronic inflammation in your gastrointestinal tract. If you have Crohn’s disease or you are close to someone who does, you probably know that the condition can lead to some embarrassing situations. However, careful management allows most people with Crohn’s disease to lead full and active lives. Whether Crohn’s disease is new to you or not, you can continue to test old and new treatment strategies to put the condition in remission.

The Basics of Crohn’s Disease

Crohn’s disease is an autoimmune disorder, which means that your immune system reacts against cells in your own body. This leads to chronic inflammation, especially in the large intestine, or colon, and small intestine. Similar to Type I diabetes, which is another autoimmune disease, you are most likely to develop Crohn’s disease when you are under 30 years old. Young children can also have Crohn’s disease. Individuals with a family history are at highest risk.

Symptoms of Crohn’s disease vary, but most often include diarrhea, stomachaches, vomiting, pain in the joints and fatigue from lack of nutrient absorption. Flare-ups involving bloody diarrhea and long-lasting fever require urgent medical attention. Endoscopy, MRI and ultrasound imaging, blood tests and stool samples can confirm the disease in children or adults. Once you have the diagnosis, you can begin treatment to put the disease into remission and prevent complications, such as ulcers, fistulas, colon cancer and bowel obstruction.

Medicinal and Nutritional Treatment

Crohn’s disease is chronic condition with no known cure, but treatment helps relieve symptoms and reduce inflammation to make episodes less severe. Anti-inflammatory medications include amino-salicylates, or 5-ASAs, and corticosteroids. Each individual has a different response to treatment, and surgery to remove part of the intestine can help children who do not respond to these medications, according to IUHealth Riley.

Nutritional therapy for Crohn’s disease helps prevent symptoms of malnutrition resulting from malabsorption. You will need to experiment to see which foods are best for you, since people have different responses. You may have lactose intolerance and need to limit your intake of dairy products, and chances are good that you can benefit from limiting saturated fat, which is in butter, cream and high-fat meats. Many people find that cabbage, broccoli and raw fruits and vegetables make symptoms worse, but you may be able to get your fiber from cooked fruits and vegetables instead. Children who eat more fruits and vegetables have a lower risk for developing Crohn’s disease.

Dietary supplements can counter the effects of malabsorption and keep you healthy. Vitamin B-12 injections can prevent anemia and growth stunting in children. Calcium and vitamin D supplements support strong bones. Children can take advantage of intravenous feeding to get more calories and protein and support normal growth. Emerging research suggests that omega-three fatty acids, which are in fatty fish and cod liver oil, may reduce inflammation. Supplements of probiotics, or healthy bacteria, can help fight diarrhea. Specialists in digestive diseases can help you develop an appropriate diet and supplement plan to stay healthy.

Support

Support is a critical, often overlooked, component of managing Crohn’s disease. Support groups are encouraging settings to make friends and exchange information. Because they are highly aware of their special treatment and differences from their classmates, children with Crohn’s disease have an especially great need for interacting with their peers with the same condition. Associations such as the Crohn’s and Colitis Foundation of America have local chapters to organize meetings.

Support groups reduce stress and make daily life easier for caregivers. These meetings give caregivers the chance to leave the home and talk to people in their situations. Activities completely unrelated to caregiving, such as group exercise classes at a local gym, are great stress relievers, too.

Conclusion

Crohn’s disease may not have a cure, but you can certainly do your part to control it. If you have Crohn’s disease, or you are helping to care for someone who does, remember that your extra effort can keep flare-ups milder and less frequent. Explore the dietary and lifestyle changes to find the ones that are best for your individual situation, and keep watching the news for the latest research on understanding and treating Crohn’s disease.

Symptoms in mouth associated with Crohn’s Disease

I found a great article here concerning mouth lesions in Crohn’s Disease patients.  Crohn’s Disease is frequently referred to as a disease of the small intestine, however, Crohn’s can impact any portion of a patient’s digestive tract from mouth to anus.  This article highlights concerns about the mouth in Crohn’s Disease patients.  There is frequent swelling of the lips and painful ulcers that manifest themselves in the mouth.  There are also frequent over-growths of skin in the mouth.  Cavities are a big concern in Crohn’s Disease sufferers and they occur quite often.  It is recommended that Crohn’s Disease patients go to the dentist for routine checkups and cleaning at minimum every six months.