Category Archives: Preventative Medicine

Greek Epidemiology Professor Dr. Dimitrios Paraskevis, the scientist who broke the coronavirus DNA, speaks exclusively to Greek City Times and provides answers on the potential availability of a vaccine against the virus, what we should be mindful of and how the lethal coronavirus started spreading.

By Konstantinos Sarrikostas

What is it actually like running after lethal viruses on a daily basis, 24 hours per day; locating, analyzing and decoding genetic material which leaves a hecatomb of dead people in its wake?

The Father of Medicine Hippocrates became the founder of Orthologic Medicine discouraging his fellow citizens from metaphysical elements, superstitions and even prejudices. Actually, he said that in serious diseases, the most effective method in treatment is absolute accuracy and fastidiousness, which modern doctors, who follow his oath, literally strive for in the healing of their fellow human beings.

Dr. Dimitrios Paraskevis, a modern Hippocrates, is Deputy Professor of Preventive Medicine and Hygienic Epidemiology at the Medical School of the National and Kapodistrian University of Athens. Along with two fellow colleagues, he has managed -in time- to analyse and decode the DNA of the lethal coronavirus which recently broke out in China and has alarmed the international community.

According to Dr. Dimitrios Paraskevis we are in the final stages of discovering a vaccine against the virus, its cause and origin and vital information on how to protect ourselves from it.

As he points out, in a few months time we will have the vaccine against the coronavirus; but what is absolutely essential is the total implementation of hygiene rules and most importantly behave with great composure.

THE INTERVIEW

Professor, the entire planet is discussing the coronavirus and peoples concern is really great. Could you please tell us in simple terms what the coronavirus is and why it has spread so rapidly?

The coronavirus spreads relatively easy for several reasons, the most significant one being that it can be spread by droplets if someone is exposed to them, for instance through sneezing or coughing. Other reasons include the fact that no preventative measures were taken to contain the virus or at the very least limit its spread, especially when it first infected people at the end of November and the beginning of December 2019 a period of prime importance.

This happened because it is an unknown virus and as such there was no awareness amongst the people in China in order that they initiate the necessary control measures. Therefore, when a great number of people have already been infected, you realise that from that point on, it is more difficult to control the infection. Moreover, owing to the fact that universal transfers are really easy nowadays, a disease can easily be spread globally.

From your studies and genetic analysis as the lead scientist of your research team , have you reached a conclusion about how it started? Was it, after all, spread by bats or could it be a lab product: a discussion which exists globally?

The coronavirus belongs to a team which is characterized as B team and its the same team to which the virus which caused the epidemic SARS in 2003 belongs. The genetic material of the virus which has caused this present epidemic, presents a great proportion with the genetic material of the relevant virus infecting bats.

Talking about proportion we mean that it reaches the level of 96%; that is, the possible source of infection is this particular animal, i.e. bats. Of course, we cannot rule out the fact that the infection can be made by another animal, another carrier, another mammal which has been infected by bats and this, in turn, transferred it to humans. This will be hard to find because we have to find the particular animal and locate the truth, the part of the virus which caused the infection. But, on the other hand, it is not of a particular importance either for epidemiology or for research in the creation of vaccines or antivirus drugs.

As to whether the virus has been created in a lab, that is, if it is a product of human intervention, I would like to assure you that such theories exist almost always in every epidemic with every new virus.

There is no possibility scientifically- that something like this has happened. There is no possibility because it was confirmed that this virus exists in animals, the infections from animals to people are very frequent and also all the people from whom it was isolated and characteristically the virus in China during the period of December, had an identical virus, which means that this was the result of infections among diverse people. Therefore, allow me to repeat that human intervention or the possible origin from a lab, should be indisputably ruled out.

The World Health Organization (WHO) has not used the term pandemic yet. Is it, Professor, a pandemic and when does a pandemic exist?

A pandemic, according to WHO, is defined as such when the epidemic has a great spread in, at least, two areas, in two continents. The areas as they are defined by WHO, are not exactly the geographic continents, but they are slightly different. Not to get into many details, the definition of pandemic refers to the geographic spread and not as much to the number of cases.

In Greece, for the time being, there are no certified cases. Do you believe, too, that it is a matter of time before we will be seeing our first case? How well-prepared is our country with the measures that are increasingly updated.

In Greece, there is no certified case. There may be but it is unlikely that there are any. The authorities have taken the appropriate measures, have announced the protection measures to be undertaken by health professionals, by the population and what people who travel should be mindful of.

We are informed about measures in airports and there has been an attempt for a prompt diagnosis of a possible case which is absolutely important to limit further infections.

Is the diagnosis of the specific virus easy and what are the symptoms?

The symptoms are identical to the ones of the flu and the definition of a potential case is related to whether someone has been exposed to other people from areas in which there are cases. That is, a fellow citizen who has not travelled and has flu symptoms, as you realise, does not have this virus.

So, in the first stages and absence of a case in Greece, if someone has symptoms, these symptoms should be accompanied with an exposure to another possible case, obviously and possibly outside Greece so that there may be a realistic possibility that they have been infected. Therefore, our fellow-citizens are more likely to suffer from the flu or another virus rather than the coronavirus.

The documentation of the infection, is feasible at the Paster Institute as well as in other laboratories which can diagnose if an infection is caused by this specific virus.

As far as travelling is concerned and according to WHO, people should not restrict their travels unless they are in areas in which there is a great number of cases. However, they should follow all the instructions which are recommended in reference to the prevention of infection from these viruses. What are some preventative measures?

People should wash their hands with soap for about 20 seconds and especially when they are in congested places such as airports; they should avoid touching their eyes, nose or mouth with their hands. So, when we find ourselves in public places where there are several fellow- citizens, we should bear in mind that we must take great care of our hands hygiene and that they must not touch our face. Also, if we feel symptoms identical to the ones of the flu, we should stay home, so that we dont expose other people to danger; and if symptoms persist, we should ask for medical advice.

Is the mask just some fashion accessory or does it actually contribute to the restriction of the virus spread?

The mask does not constitute the absolute means of protection and it doesnt mean that anyone who wears it is either totally or to a great extent protected from a possible flu infection or coronavirus. The role of the mask is to protect other people from the sufferer who must wear it. If they sneeze while talking, much fewer droplets are exposed, therefore the mask is a way of protection, especially for the protection of others. So, someone wearing a mask should be aware of the fact that they are not totally protected from these viruses.

Professor, why is this virus so lethal? There have have already been 630 deaths and more than 31.400 cases*?

We should clarify the following: The coronavirus is not so lethal in relation to other viruses. The number of deaths concerns a relatively great number of people about whom the coronavirus infection has been documented. Coronavirus as well as flu virus causes, to a great extent, very mild symptoms.

As a result, the number of people who have been infected is much bigger than the number of people whose infection has been documented. So, the denominator, when we estimate death-rate, is much bigger because the real number of the cases is unknown and a lot bigger related to those who have the infection documented.

Until now, the death-rate was considered to be approximately 3% to 4% but it is possibly much less because as I already earlier the real number of the cases is unknown.

Those who are more susceptible to this infection are older people, vulnerable groups and people who suffer from chronic heart diseases, chronic breathing diseases and immunodeficiency. The above categories constitute the percentage of serious symptoms or death.

How far or how close are we for the coronavirus vaccine creation? Can we be optimistic since a relative treatment for very old viruses and lethal diseases has not been found yet?

There are viruses, as you have correctly mentioned, for which it is not easy to develop vaccines. Hopefully, the coronavirus does not have these characteristics.

We consider that the coronavirus vaccine will be available relatively quickly, possibly even in a few months if we also estimate the time required for clinical tests.

Several Institutes and Centres have actively engaged in the creation of the vaccine. It is believed that in some weeks vaccines will be available for clinical tests. In the meantime, protection measures are vital for the restriction of the virus and for our protection.

I would like to point out once more: there are other viruses and diseases that are really dangerous. I realise how worried people are; the coronavirus is something new. However, Greece and the international community have been confronted with similar threats before, over the last 10 years, a fact that fills us with optimism.

We have the experience and the know-how so that we can face this menace effectively. What is really necessary is composure and optimism about the fact that even this disease will be challenged effectively with minimum human cost.

* Data as of the time of interview

This article was researched and written by a GCT team member.

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EXCLUSIVE INTERVIEW: The Greek Professor who 'broke' the coronavirus DNA sees a vaccine coming soon - Greek City Times

China is facing one of its largest public health crises: the outbreak of the novel coronavirus.

But U.S. healthcare officials are far more concerned about the spread of other viruses, like the flu.

WCBU talked to Lori Grooms, director of infection prevention for OSF HealthCare, about why the flu poses a bigger threat.

Dana Vollmer: Explain why people are more at risk of contracting the flu than coronavirus.

Lori Grooms, director of infection prevention for OSF HealthCare, talks to reporter Dana Vollmer.

Lori Grooms: The flu is something that we see every year and it is commonly circulating. The coronavirus that they're hearing on the news, while there are cases in the United States, the chances of coming in contact with the virus itself are very, very low. The flu virus, it's more common. You could come across somebody at the grocery store, because we all feel like we can wait it out. We have a cough, so I can go to the store and I can get the medicine to take care of it. I can go to work when I'm sick, because I'm just that important that I need to be at work. Unfortunately, because we have the idea that the flu is no big deal and we can go to work with it, we tend to spread it on to others.

DV: Why do people tend to worry about things like coronavirus, but not always think of the flu as potentially deadly?

LG:Because it's new. We're always more scared by the things that we don't know about. Because the flu circulates every year, it's something that we're used to seeing. The coronavirus, we don't know a lot about it and we're being told that we don't know a lot about it. That in itself makes people afraid. Even when you hear things from the Centers for Disease Control and Prevention (CDC) or from the World Health Organization, they're still investigating. They can't tell us exactly everything about this virus because it is so new and there's they're still learning about it. That's what makes people afraid.

DV: What role does social media play in spreading misinformation about virus outbreaks?

LG: Social media, while it's a wonderful thing, it can also be a detriment. Not everything you see on the internet is true. With that, misinformation can spread very easily. What I always try to do is defer back to the experts. If you really want information, CDC has a very good website that anyone in the public can get on to and read the World Health Organization the same way. Those are the organizations that are actually investigating and looking at this virus. They have the most up-to-date and the most current information. The Illinois Department of Public Health also has the most current information. You're not always going to find that with every other website.

DV: The coronavirus is not the first major respiratory virus to pop up in recent years.

LG: It happens every two to three years. I've been in my role in infection prevention for over 15 years. Every two or three years, we're having discussions about a virus that has changed and the transmission is a little bit different. We've seen it with SARS, we've seen it with [MERS] in the more recent years. It's not something that is new to the healthcare profession. We've been planning for things like this. And once something like this comes up, infection prevention at your hospitals, your emergency preparedness we're ready to handle it. We keep current on the information and we just make tweaks to what we're doing on an everyday basis.

DV: Is it inevitable that more viruses like this will surface?

LG: Yes. Viruses are genetic makeup, so anytime you have genes you have the ability for them to change as they reproduce. So you will always see changes in viruses. The thing about the coronavirus that you're hearing on the news the one coming out of Wuhan, China is that this was spread from animals to humans at the start. That always causes concern. Once it is caught by humans, we don't know what's going to happen. You're seeing a lot of cases in China because of that because it's a new strain circulating in humans, but it had been in animals for years.

DV: What do you say to people who are still concerned about contracting coronavirus -- should they postpone their travel plans?

LG: My professional answer is to investigate. Would I travel to China right now? Not unless it was essential. CDC has a travel website that anyone can go to and actually put in the country that they are looking to travel to, and they can see whether or not they recommend traveling to that country. At this point in time, Chinais not recommended to travel for leisure and it is only for, like I said, essential travel. Other countries, if you're traveling there, I would go to the website and I would look it up.

DV: Any other advice for people to protect themselves?

LG: All I would say is that with any infection, with any virus it's the basic preventative measures: if there's a vaccine available, get the vaccine; frequent handwashing; avoid touching your eyes, your nose and your mouth without clean without clean hands; coughing into your elbow, coughing into a tissue and throwing it away; cleaning your hands after you've coughed; staying home if you're sick and avoiding purse other persons who are ill.

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Here's Why The Flu Poses A Bigger Risk Than The Coronavirus - Peoria Public Radio

(MENAFN - The Peninsula) More than 800 healthcare professionals gathered in Doha for the Fourth Qatar Diabetes, Endocrinology, and Metabolic Conference (QDEM-4). Hosted by Hamad Medical Corporation's (HMC) Endocrine and Diabetes Division, Department of Medicine, and the Qatar Metabolic Institute (QMI), the conference brought together local and international experts in the fields of endocrinology, obesity, and diabetes to discuss the latest research, treatments, technological advances and preventative measures for these conditions.

Professor Abdul Badi Abou Samra, Chairman of the Department of Internal Medicine at HMC, and QMI Director, said the event provided an important platform for frontline clinicians, scientists, and researchers to discuss strategies and approaches for the management and prevention of diabetes. He said the conference highlighted the work being done in Qatar in the fields of endocrinology and diabetes treatment and management.

'HMC's National Diabetes Centers, located at Hamad General Hospital, Al Wakra Hospital, and the Women's Wellness and Research Center, receive more than 120,000 patient visits annually from around 30,000 patients, said Professor Abou Samra.

'Many of these patients live with other associated complications such as high blood pressure, kidney disease, and vision impairment. It is important for the local and international medical community to meet and discuss trends, best practice, and long-term strategies for the prevention and mitigation of complications related to this disease so we can continue to provide the best care for our patients, added Professor Abou Samra.

Dr Mahmoud Ali Zirie, Senior Consultant and Head of HMC's Endocrinology and Diabetes Division and Chair of the Conference's Organizing Committee, said the conference provided an opportunity to share the work being done here in Qatar and to deliver improvements tailored to the local population. He noted that the event included sessions dedicated to the new World Health Organization (WHO) classification of diabetes and its impact, adrenal disorders, thyroid disorders, cancer, and the latest technology in diabetes management.

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Over 800 healthcare professionals gather for Qatar Diabetes, Endocrinology and Metabolic Conference - MENAFN.COM

New study highlighting the ability of cannabinoids to fight bacteria in dental plaque opens the door for CBD as an effective oral care product.

In recent years, the craze over CBD cannabidiol one of the more popular and well-known cannabinoids of the cannabis plant, has led to a massive uptick in research into its medical properties. Along with this has come a maelstrom of articles suggesting possible uses outside of what has already been studied, with hopes that upcoming scientific research will uncover even more ways that CBD can be useful, including in dental care.

CBD is now often considered a preferred alternative to pharmaceutical medication when it comes to dealing with sleep issues, anxiety, and depression, and is under intense study for its possible efficacy in treating different forms of cancer. It has been linked to research indicating usefulness in dealing with high cholesterol issues, blood pressure stabilization, and even a possible contender in the fight against Alzheimers disease.

Its pathogenic disease fighting properties have also been studied quite a bit at this point with evidence pointing to it being a strong antimicrobial capable of targeting different kinds of infectious agents. Of course, when it comes to pathogenic diseases, there are about a million different places to look for CBD efficacy.

Pathogenic diseases are infectious diseases that come from pathogens like bacteria, viruses, and fungi. So, anything from the common cold, to bacterial bronchitis, to ringworm are all pathogenic diseases. These, of course, account for a large percentage of the illnesses out there, and particularly the spreadable ones.

Whenever you hear a story about a new coronavirus like whats currently going around now or swine flu, or the plague; its all about pathogenic diseases. There are different ways of fighting pathogenic diseases, and oftentimes in pharmaceutical medicine, what works for one, wont work for another, particularly when looking at the necessary treatment methods for viruses vs bacteria, or even two very different viruses.

As always, its good to remember when dealing with CBD that it is not a pharmaceutical medicine, it is, in fact, a naturopathic medicine relating to plant medicine. Because of this, the chemical structure is significantly more complex than pharmaceutical medications that are based off of plant compounds, but generally in a more simplified way (which is what allows for things like antibiotic resistance as the bacteria are more easily able to replicate the simplified structure).

When dealing with plants, its not uncommon for one plant to be useful in many treatments, think of all the applications CBD is already being touted for. And for this reason, there is constantly new research coming out about new ways of using CBD that hadnt been thought of before.

The World Health Organization (WHO) provides some basic information on worldwide dental health. One of the first things to know about oral diseases is that theyre actually the most common non-communicable diseases (non-contagious) out there. In fact, a study on the Global Burden of Disease found that literally half the worlds population suffers from some sort of oral ailment, with tooth decay coming in at #1.

Unfortunately, dental care is often not very affordable, leaving many people in the world to never receive what they need, which often means living life in pain and discomfort. People that come from lower socio-economic backgrounds, or poorer countries, are way more likely to feel the health inequality gap that exists in dental health. For this reason, having better, and more affordable options for basic dental care and oral disease protection becomes very important.

An interesting new study came out in January of 2020 that investigated the efficiency of CBD vs known oral care products in reducing the amount of bacteria in dental plaque, which is responsible for all kinds of mouth ailments like cavities, bleeding gums, tooth decay, and tooth loss. The sixty test subjects in the study were split into six different categories according to the Dutch periodontal screening index. All participants were 18-45 years old.

The methodology of the study was to take dental plaque from all of the participants and spread each sample across two separate petri dishes, with each petri dish split into four parts, making for eight different places to test each specimen.

The eight things being compared for their ability to fight bacteria in dental plaque were: cannabidiol (CBD), cannabichromene (CBC), cannabinol (CBN), cannabigerol (CBG), cannabigerolic acid (CBGA), Oral B, Colgate, and Cannabite F (a toothpaste made from pomegranate and algae). After being sealed and incubated, the number of bacteria colonies were counted. The results of the study showed cannabinoids to actually be more effective than the well-known oral products like Colgate and Oral B.

When it comes to tooth and mouth care in general, most people shop for their standard drugstore products that theyre used to seeing ads for on TV, and which theyve probably been using for years. Some might even believe that what they use every day is the best option out there. In fact, many products like toothpastes and mouthwashes come with dentist recommended statements, leading to even more trust that these products are the best to use.

A study like this one clearly indicates that this might very well not be true at all, and possibly much better options can be found in non-chemical, more natural forms that have the capacity to do a better job.

Another research study done earlier, in 2012, looked at induced periodontitis (inflammation of the gums) in rats, and the role of endocannabinoid anandamide (AEA). All the rats were exposed to stress, and the results were: corticosterone plasma levels, locomotor activity, adrenal gland weight, and bone loss were all increased, as well as less weight gain.

There was also increased inflammation of the gingival (gum) tissue among other factors. Basically, the rats all responded to the stress by showing different forms of stress-related activity in their bodies. An injection was given locally of AEA to one group, and the results showed a decrease in corticosterone plasma levels and the content of certain cytokines (proteins involved in cell signaling). These AEA-induced inhibitions were mediated by CB1and CB2cannabinoid receptors.

The basic results showed that The endocannabinoid AEA diminishes the inflammatory response in periodontitis even during a stressful situation. The rats, after receiving the injection of AEA showed a reduction in much of their stress responses. This research implies that since CBD interacts with CB1and CB2cannabinoid receptors, it could possibly be useful in treating gingivitis an inflammation of the gums.

While its true that high quality CBD products arent always cheap, the preventative properties (when it comes to many things) may possibly outweigh the costs of dealing with the resulting health issues that come from not practicing good self-care.

Sometimes this is because people dont know what to do, sometimes people simply lack the motivation to do what they should, and others still just dont have the resources available to them to use preventative healthcare methods. If CBD is actually that effective in reducing bacteria and inflammation in the mouth, this could be incredibly useful for people who dont have as much access to dental care, or cant afford it.

If youre interested in chucking your old, standard, well-known toothpaste brand to try out something else, youll find plenty of products containing CBD and other cannabinoids available. Youll also be able to find mouthwashes, and other products for more specific oral ailments will likely pop up soon. Check online for available products.

Were happy to keep you updated on everything CBD, subscribe to the Medical Cannabis Weekly Newsletter.

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CBD Toothpaste Might Be Better Than Your Current Brand, Research Says - CBD Testers

Pitt faculty and staff members gathered Wednesday evening to explain more about the novel coronavirus, the microscopic virus that has gained global attention.

Pitts Asian Studies Center hosted a Coronavirus Teach-in in a David Lawrence Hall lecture room nearly filled to capacity. The event featured a five-person panel staffed with experts across a variety of scholarly subjects, moderated by Michael Goodhart, the director of the Global Studies Center.

The presentations included background and contextual information about the outbreak, as well as preventative measures that can be taken to prevent the spread of the virus. The health experts on the panel also discussed the research underway to develop vaccines to treat the virus. The novel coronavirus has claimed the lives of more than 1,100 people globally, with 14 current confirmed cases in the United States.

Professor Amy Hartman, a researcher in the Center for Vaccine Research, highlighted the Wednesday announcement that the University is seeking to obtain samples of the novel coronavirus in an effort to develop an intervention, such as a vaccine.

The lab is a hub for researchers trying to understand pathogenesis, Hartman said. We are the only facility on Pitts campus that has the ability to work with emerging coronaviruses.

In order to provide some background on the virus, Dr. Megan Culler Freeman, a pediatric infectious diseases senior fellow in the School of Medicine, described the family tree of the novel coronavirus.

She said 2019-nCoV is just one strain of the coronavirus family of viruses, a group of RNA viruses that cause illnesses ranging from the common cold to more serious respiratory infections to the current disease under scrutiny. The most common COVID-19 symptoms include fever, shortness of breath and a severe cough.

Freeman mentioned two other coronavirus strains that are cousins to 2019-nCoV, Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, which have caused outbreaks in the past. Scientists are gathering information about 2019-nCoV, which originated in Wuhan, China, by comparing it to these earlier viruses, but there are still unknown details surrounding how the novel coronavirus has spread to humans.

For SARS and MERS, it was identified that there were intermediate species, Freeman said. Scientists are still working on what might be the intermediary species between the bat and human for the newest strain of the coronavirus.

Another panel member, East Asian history professor Zhaojin Zeng, discussed how the culture and transportation system in China made the initial spread of the virus easier.

Trains make stops and Wuhan is located right in the center of this massive railroad network, Zeng said. This outbreak occurred in December 2019, then came Chinese New Year, people celebrating want to get together and have big family gatherings and dinners.

Although the virus outbreak has been most severe in and around the Wuhan area, history professor Mari Webel cautioned against strictly attributing the virus to a certain geographical region. Weber said while quarantine and isolation are beneficial in preventing the spread of diseases, they can also have consequences when they are implemented for the wrong reasons. Focusing on people or places of origin when thinking about prevention and control of global disease must be done carefully to avoid racializing a disease or stigmatizing a population, Webel said. For example, Asiatic cholera, that tag stuck and served to stigmatize certain traveling populations.

While there is still more research to be done on the novel coronavirus, health experts on the panel said this new strain is not unavoidable.

Dr. Kristen Mertz, a medical epidemiologist for the Allegheny County Health Department, said traditional public health strategies are applicable in minimizing the extent of the virus.

We try to identify and isolate cases so they dont infect other people, Mertz said. We also increase handwashing and use more personal protective equipment, such as gloves and masks and good disinfection techniques.

Freeman said among those who do contract 2019-nCoV, most fatalities arise from older people with other illnesses that already have weakened immune systems, or from overwhelmed health care professionals who are constantly surrounded by infected people.

When you think about how many people these doctors and nurses were already treating on a day-to-day basis, Freeman said, Im sure that everyone is giving it their best effort, but you can imagine the stress to the system.

While each presenter had their own specialty in analyzing 2019-nCoV, individual speakers also all emphasized the dangers of misinformation fueled by social media and sensational reporting.

Webel said it is vital to respect health organizations warnings and preventative strategies in order to avoid misleading information.

Consult CDC recommendations, there is good health journalism to consult, Webel said. There are resources out there that can give us the best information at the present time.

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Community gathers at teach-in to learn more about novel coronavirus - University of Pittsburgh The Pitt News

Ageing should be classified as a disease to provide better treatment of the elderly, says an international group of leading medics and academics.

They are urging the World Health Organisation (WHO) to rethink the way it classifies illnesses so ageing is no longer seen as a natural process but a disease in its own right that leads to frailty, disability and ultimately death.

They say the WHOs current bible which defines and lists all diseases focuses doctors on individual critical conditions rather than the wider range of degenerative changes as people age.

The 30 experts - from Harvard, Stanford and MIT to Cambridge, Imperial and UCL - said their inclusion would encourage doctors to diagnose and prescribe treatments including drugs, diet and exercise that could prevent age-related conditions developing into critical illnesses.

The WHOs health bible - known as the International Classification of Disease (ICD) - determines what doctors around the world diagnose, treat and record.

However, Dr Stuart Calimport, one of the lead authors, cited inconsistencies such as sarcopenia, an age-related muscle-wasting, which was included in the ICD while age-related wearing out of other organs was not.

Critical to ageing is a process known as senescence in which cells throughout the body age, releasing inflammatory factors and enzymes that the immune system can no longer destroy

When senescent cells build up in the skin causing wrinkles it is considered a natural change. Yet when senescent cells build up in the heart and blood vessels, causing blood vessels to calcify, we call it cardiovascular disease, said Dr Calimport, of Liverpool University.

This is an error of logic and categorisation and not due to the intrinsic nature or complexity of pathology or disease.

An ageing disease classified and assessed for the level of severity in one organ can be unclassified in another.

With a lack of classifications and staging, pathological ageing changes may not be logged. This means that treatment needs may be overlooked, such as atrophy, calcification and ageing in organs and tissues where these are not classified or assessed for severity.

Dr Calimport did not believe the classification of more diseases would provide a bonanza for drug firms to develop treatments that would push up the NHS bill.

He said there were already cheap drugs such as Metformin, which was used to treat diabetes and had been shown to be effective in countering age-related conditions.

It would allow for preventative medicine such as social prescribing or the prescribing of exercise. It might not totally prevent ageing but at the moment we are not even recognising ageing in a way that it can be properly recorded and tracked said Dr Calimport.

If you cant track it, how can you prevent it, or slow it down?

The WHO is currently considering submissions for changes to the ICD which will be published next year. There are major updates every decade.

The proposals comes as the number of elderly are expected more than double from 900 million worldwide aged over 60 to two billion by 2050.

By 2030, one in five people in the UK (21.8 per cent) will be aged 65 or over, 6.8 per cent will be aged 75-plus and 3.2 per cent will be aged 85-plus.

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Ageing should be classed as a disease in itself, say leading academics - Telegraph.co.uk

Photograph by Carl Court, Getty Images

The Diamond Princess cruise ship (shown docked in Yokohama, Japan, on February 10) was quarantined in the city after passengers tested positive for coronavirus.

When passengers booked their vacations on the ill-fated Diamond Princess, they were likely looking forward to hanging out in a hot tub, not a hot zone. Now most of them are quarantined off the coast of Japan, hoping to avoid testing positive for the 2019 novel coronavirus, which has already infected more than 200 people on the cruise ship.

Health officials in protective gear removed suitcases from the Diamond Princess cruise ship in Yokohama, Japan. Its believed they belonged to passengers evacuated and taken to hospitals after testing positive for coronavirus.

The fact that the largest outbreak of COVID-19 outside of mainland China is happening on a cruise cant be reassuring to travelers who are already skittish about health issues on boat-based trips, which are well known incubators of gastrointestinal illnesses. The Center for Disease Control and Prevention (CDC) offers a helpful database of cases, broken down by year.

The vast majority of cruises dont experience any problems. But confined spaces mean that even one sick person can create a serious situation, explains Tullia Marcolongo, executive director of the nonprofit International Association for Medical Assistance to Travelers. Its the domino effect, and you have nowhere to go, she says.

Cruise companies work to minimize the risk of illness by maintaining cleanliness and monitoring health on board their ships. In response to the coronavirus outbreak, Carnivalthe parent company of Princess Cruiseshas introduced expanded protocols, including enhanced onboard sanitation measures with non-toxic materials and pre-boarding medical evaluations, as needed. On its website, Royal Caribbean Cruises touts its health and safety program, such as internal and external inspections, frequent water systems testing, and strict food handling rules.

Passengers can do their part, too. The first thing I would say is that the power is in your hands, Marcolongo says. She means that literally. Frequent hand washing can be a critical preventative measure for norovirus, colds, and other yucky things circulating on a ship. To make sure you scrub long enough, sing Happy Birthday twice, she suggests, and dont miss the spots between your fingers. If theres no soap and water nearby, use an alcohol-based hand sanitizer. Many ships make sanitizer stands readily available to passengers, Marcolongo adds.

David Parenti, director of the George Washington University Travelers Clinic and professor of medicine at the George Washington University School of Medicine and Health Sciences, advises being aware of when youve held handrails and touched other surfaces. Until you can wash your hands, dont stick them in your eyes or mouth.

Unfortunately, Parenti says, there are lots of other ways to get sick, both on ship and on land. It all has to do with luck. If youre on a ship with norovirus, thats bad luck. If you are on a cruise ship, you will need to eat. Those risks are something you dont have a lot of control over, he says.

This is where you should sit on the plane to avoid getting sick.

To be proactive, travelers can set up a pre-vacation doctors appointment to make sure their immunizations are up to date. Depending on your destination, that flu shot might be important even if youre taking off in the middle of the summer. Keep in mind that the U.S. influenza season is the opposite of the Southern Hemisphere, Parenti notes. He recommends getting the vaccine for Hepatitis A and checking on your immunity to measles; you could possibly use another shot. (A measles case was responsible for a different cruise quarantine in May 2019.)

Because of the limited number of medications on board, its smart to pack whatever you think you might need, Marcolongo adds. That includes first-aid basics as well as some standard over-the-counter supplies, which for gastrointestinal issues include Loperamide (Immodium) and oral rehydration salts.

Miami-based attorney Jack Hickey once represented cruise companiesand now sues them over personal injury claims. His advice? What I tell people is get trip insurance and make sure it covers an air ambulance. Travelers who experience emergencies and need to pay for transportation will be in for some serious sticker shock otherwise.

Be realistic about what kind of care you can actually expect on board a ship. If you get sick or injured, get back to the U.S. as quickly as possible, Hickey advises. Although cruises undoubtably excel at hospitality, he says, they tend to be lacking when it comes to medical care. Its not a hospital, but a ship carrying 3,000 to 6,000 people and going to isolated areas of the world, says Hickey, who thinks there typically arent enough doctors and staff to handle a heavy workload, and that the facilities arent adequately equipped. Almost uniformly, they have X-ray machines. But [ships] do not have good machines or people who know how to read films well, he says.

The coronavirus quarantinewhich is keeping people cooped up in tight cabins for weeksis a reminder that mental health problems could also arise, especially for anyone with issues around anxiety or claustrophobia. Travel insurance doesnt necessarily cover that, Marcolongo notes.

Learn how the coronavirus compares to Ebola, flu, and other outbreaks.

As scientists learn more about the virus and how its transmitted, there may be more scrutiny of ventilation systems on cruise ships, Parenti adds. In a hospital, its possible to put a patient in a respiratory isolation room with frequent air exchanges.

Thats not an option for most cruise accommodations. The next best choice, according to Parenti? I would take a window, personally. At least you could open it and get a breeze that way.

Vicky Hallett is a Florence, Italy-based health and travel writer. Follow her on Instagram.

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Republican and Democratic Arkansas lawmakers formed a new legislative caucus focusing on early childhood well-being. The caucus will work with early childhood advocates to create an agenda for the 2021 Arkansas General Assembly.

The Arkansas Early Childhood Well-Being Caucus will be chaired by Sen. Trent Garner, R-El Dorado, and Rep. Denise Garner, D-Fayetteville. Bipartisan members from the Senate and the House have joined the caucus.

During my career as a nurse practitioner and advocate for behavioral sciences and education, Ive learned the importance of early intervention to insure the best outcome, Rep. Garner said. As around 80% of a childs brain is developed by age 3 and 90% by age 5, its imperative to make certain our children are receiving everything they need to thrive and that we have policies in place to help make that happen.

As a son of a kindergarten teacher, I saw firsthand the importance of early childhood development, Sen. Garner said. Im excited to be part of this group of bipartisan legislators who are working together to move Arkansas in a new and better direction for our children.

There are more than 190,000 children in Arkansas under age 5.

The new caucus will spend the next several months hearing from experts on brain development, nurturing environments, and the impacts of social determinants of health outcomes.

The caucus held its first meeting Thursday (Jan. 16) with 16 legislators in attendance. The meeting featured a presentation on Brain Development by Dr. Nikki Edge, Professor in the Department of Family and Preventative Medicine at UAMS and a presentation on Prenatal to Age 3 by Jamie Morrison Ward, President of the Arkansas Association for Infant Mental Health.

We are thrilled with the opportunity to raise awareness and educate Arkansans on the critical developmental period of prenatal to age 3, said Ward. The formation of the Early Childhood Well-Being caucus is a testament to the importance of the early years, and we are very fortunate to have a legislature that is interested in learning how to positively impact the health and education of our states youngest citizens and their families.

The caucus plans to meet every month or every-other month.

In addition to Garner and Garner, members of the caucus include: State Senators Bruce Maloch, D-Magnolia; Greg Leding, D-Fayetteville; Keith Ingram, D-West Memphis; Will Bond, D-Little Rock; State Representatives Tippi McCullough, D-Little Rock; David Whitaker, D-Fayetteville; Jay Richardson, D-Fort Smith; Don Glover, D-Dermott; LeAnne Burch, D-Monticello; Andrew Collins, D-Little Rock; Dan Douglas, R-Bentonville; Chris Richey, D-West Helena; DeAnn Vaught, R-Horatio; Cindy Crawford, R-Fort Smith; Jeff Wardlaw, R-Warren; and Jon Eubanks, R-Paris.

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STATEN ISLAND, N.Y. -- I never get sick anymore. So, when a bug caught me right before Thanksgiving, I was both annoyed and worried. Getting sick before a family holiday is a big drag, because you want to be with your family, you just dont want to leave them with whatever it is youve got.

When I taught, I was constantly ill. Kids are mobile petrie dishes. I even developed pneumonia from my kids once, a fact my then Principal seemed unaware of when she questioned my six day absence. She also seemed unaware that pneumonia is contagious.

...Sigh...

I dont miss being in that type of environment. I do miss my kids, especially around the holidays.

I read on the WeAreTeachers Helpline Facebook page recently that administrators seemed to be coming out of the walls at one school, making surprise visits into classrooms. Probably looking to catch somebody with their feet on their desk showing a video, like in that movie Bad Teacher.

Yeah. Cause, you know, the day ends at three and we have summers off.NOT!!!

I always played it a bit looser during the holidays because I love celebrations. And, for some of my kids, family holidays werent always that great. So, we created an alternate family in our room. We ate food and watched movies and wrote about the holidays. And, we laughed. A lot. Because, laughter is the way to a persons heart.

And, I mean, you really had to laugh. Here we were, fifteen kids and one teacher stuck in a windowless room by the gym. Hardly anybody knew where we were, unless we called for help. We were an island unto ourselves.

And, I was trying to show my kids how to celebrate. For a lot of them, life was hard. Learning should be both rigorous and joyful. It should never be difficult.

I cant get over the fact that, when I was working, staff were encouraged to come in sick, which is a huge mistake. Youre not at your best, and you need to be because teaching is totally unpredictable. Secondly, youre exposing your kids to germs as well as receiving several handfuls from them. Bad, all the way round. Im glad that the effort to ensure paid sick days is gathering steam. And teachers have 10 sick days a year, which is one a month. But, as one principal told me, that doesnt mean you should use them.

...Sigh...

A teachers job is not to make things easier for their administrator. It is to teach their students how to become compassionate, intelligent, mature individuals in a complex world. Anything else is just window dressing or worse.

So much for Memory Lane. Back to aging.

What are the risk factors for people over 65? According to WHO (The World Health Organization), theres a lot to be concerned about. Injury due to falls is high up there. Patterns of what they term harmful behavior can lead to illnesses later on. Five chronic conditions (diabetes, cardiovascular disease, cancer, chronic respiratory diseases and mental disorders) account for 77% of illness and 85% of death rates. Poverty is higher among older women than older men. Social isolation and exclusion and elder maltreatment often occur.

So, what can we do to stave all of this off? As you know, Im a big believer in preventative medicine, seeking help and treatment before the problems arise. I also believe strongly in acupuncture, chiropractic medicine, massage therapy and good oral health care. All of these factor into general wellness and a breakdown in any part of your system as you age can also affect other areas of your body.

A friend who is exactly 24 hours younger than me (we were born in the same hospital 24 hours apart and only met in 1977!) told me recently he had pneumonia and bells went off in my head. I told him post haste to seek treatment and that pneumonia was nothing to **** with. Trust me, it only gets worse with age, as many things do.

I dont want to sound alarmist, but if we dont take extraordinary care of ourselves now, we wont be around for the really great things in life like grandchildren, cruises, binge watching Netflix and just doin nuthin. This is the time of our lives when all that and more should be available to us and well want to take advantage of them. But, to paraphrase a Billy Joel tune, no sense having an expensive car if you cant drive it because your back problems are too severe.

You have to get proactive because, sadly, our health care system in America is profit driven and there is no profit to be made in a cure. So it benefits certain parties if we all remain sick.

The best way to care for yourself is to listen to your body. You pretty much know when things are off, much as you do with the car you drive. If something feels amiss, have it checked out. Better a false alarm than alarming news.

Be kind to yourself and to others. And, hold those grey heads up!

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January 17, 2020 -What healthcare providers really want is to do is the right thing for their patients. They just need sustainable financial support for doing that, health economist Mark McClellan, MD, PhD, said at the start of an interview with RevCycleIntelligence.

The healthcare industry has in earnest attempted to transform not only clinical outcomes, but also the financial aspect of care for about a decade now. Yet progress with the adoption of alternative payment models (APMs) has been slow, explained McClellan, the former CMS administrator and current Robert J. Margolis MD Professor of Business, Medicine and Policy, Fuqua School of Business.

One in three healthcare payments flows through an APM, the Health Care Payment Learning & Action Network (LAN) which McClellan also serves as co-chair for their Guiding Committee recently found using the latest data from 62 health plans, seven fee-for-service Medicaid states, and traditional Medicare.

But fee-for-service still dominates even a decade later.

According to LANs data, approximately 39 percent of healthcare payments made in 2018 were under fee-for-service. Another 25 percent were fee-for-service with some link to quality and/or value. These payments included pay-for-reporting or pay-for-performance incentive payments.

The general consensus in healthcare is that fee-for-service is one of the primary reasons why the industry is sinking. The financing mechanism encourages providers to protect their bottom lines by delivering more services, which results in unnecessary costs and utilization, as well as a sick care system.

APMs aim to get the healthcare system back to one that incentivizes just that health. The models tie provider reimbursement to the value of care, meaning providers get paid based on their patient outcomes and/or costs.

So, what is preventing widespread adoption of the models that promise to fix healthcare? And what needs to be done to hit the value-based tipping point? RevCycleIntelligence spoke with McClellan and other industry experts, as well as those on the frontline of value-based care, to explore the state of payment reform and strategies for progress.

The status quo is no longer working in healthcare.

National healthcare spending increased to $3.6 trillion in 2018 and is slated to reach nearly $6 trillion in the next seven years. Meanwhile, patients are not seeing the benefits of greater healthcare spending. According to data from the Kaiser Family Foundation, the US lags behind similarly wealthy countries. In some cases, such as with rates of all-cause mortality, premature death, death amenable to healthcare, and disease burden, the US is not improving as quickly as their peers.

The failings of the current healthcare system are not new to healthcare stakeholders, but there is a fresh push to fix the problems, according to Theresa Dreyer, MPH, lead of value-based care at the Association of American Medical Colleges (AAMC).

There's a new urgency as the cost of care continues to increase to really adopt some ideas that have been existing in the market for decades and apply them to broader and broader patient groups, she said.

Those ideas? Value-based care.

One of the things that we see out of our teaching hospitals is a real readiness to understand that the status quo may not be the way that healthcare is provided going forward, said Dreyer, who leads three AAMC collaboratives for teaching hospitals that participate in alternative payment models. Many organizations see value-based care as a way of continuing to invest in the clinical changes that they are dedicated to.

While most hospitals and physicians feel that value-based care is the right thing to do for their patients, the stakeholders are not getting on board with the vehicles being used to convey value-based care.

Harold D. Miller, president and CEO, CHQPR

The data shows that the healthcare industry is about a third of the way with adopting a value-based reimbursement system. But the data does not tell the whole story, Harold D. Miller, president and CEO for the Center for Healthcare Quality and Payment Reform argued.

We have moved backwards rather than forwards, said Miller, a former member of the federal Physician-Focused Payment Model Technical Advisory Committee that was created by Congress to advise the HHS Secretary on the creation of APMs.

The payment models that are being used by and large are actually making things worse rather than better in most cases, he elaborated. They are very problematic for patients in many cases because they create incentives to reduce spending without appropriate quality protections built into them. They are forcing many small practices and hospitals out of business.

Physicians have been skeptical about accountable care organizations (ACOs), bundled payments, and other popular APMs. A 2018 survey of over 3,400 physicians found that many doctors (41 percent) feel value-based care and reimbursement will have a negative impact on patient care as a whole and many more (61 percent) feel the APMs will have a negative impact on their bottom lines.

Another survey published in NEJM Catalyst that same year also found that only about half of clinicians believe the alternative payment method will take off.

There is data to support their skepticism. A recent report from the non-profit Catalyst for Payment Reform showed that APMs in the commercial sector only realized small care quality improvements. Additionally, hospital readmission rates one of the most popular care quality metrics used in APMs barely improved under the value-based arrangements.

CMS has also expressed concerns about one of its largest APM demonstrations. According to the federal agency, the Medicare Shared Savings Program, which currently governs 517 accountable care organizations (ACOs), has actually increased Medicare spending.

We've learned in the last few years that it's not enough just to pay a healthcare provider fee-for-service and give them a little bonus or a penalty for doing something we think we'd like them to do, like buy an electronic record system or report on a quality measure, McClellan said.

Pay-for-performance, shared savings, and other similar APMs are a good place to start, but the models are not enough for sustainable, effective support for truly better care models that can improve outcomes and lower costs significantly, he added.

CMS and other major payers have started to recognize that APMs built on fee-for-service are not leading to the results they had hoped for a decade ago, and these stakeholders are refining their value-based care strategies to hold providers more accountable for outcomes as result.

After six years of experience, the time has come to put real accountability in accountable care organizations, CMS Administrator Seema Verma said in 2018 after announcing the agencys plan to revamp the Medicare Shared Savings Program.

What she meant by accountability was downside financial risk. In risk-based APMs, providers are accountable not only for the savings they achieve through the model, but also financial losses. If providers in APMs with downside financial risk exceed their spending benchmarks, they must repay a portion or all of the losses to the payer.

CMS sees financial risk as the future of value-based care, according to Dreyer. The agency believes that holding providers financially accountable for losses will result in more meaningful changes and outcomes.

However, downside financial risk may not be the key to unlocking value-based care success in APMs, industry experts contended.

The notion that somehow if you push financial risk onto physicians or hospitals, you are going to get better quality care or lower cost is just wrong. It is an insurer view of things, Miller said. The main issue with risk is that current APMs put providers at risk for outcomes they cannot control, he explained.

Miller pointed to APMs for oncology care as a prime example.

The biggest cost of cancer care is drugs and one of the places where you've seen the fastest increases in drug prices has been in oncology drugs, he said. It doesn't do anything to promote better care to try to put physicians at risk for that. What we have seen is small oncology practices going out of business because they can't afford to actually treat their patients and the payment models don't solve that.

Focusing the future of value-based care on risk-based APMs could also alienate many providers from the transition away from fee-for-service, Dreyer added.

There's a risk of leaving behind organizations that are newer on the value-based care journey, she said. The new models are focused explicitly on organizations that already have experience and if you don't already have this experience, it'll become harder and harder to enter into the market.

If risk-based APMs are not the appropriate next step for the value-based care transition, then what is? According to McClellan, the answer lies in episode- or population-based payments.

Source: Xtelligent Healthcare Media

APMs should be less about the level of financial risk involved and more about supporting the activities and infrastructure providers need to engage with value-based care, McClellan insisted.

What really works is giving healthcare organizations payments that are more tied to the people and the whole episodes of care that they are providing, he said.

Population- and episode-based payments give providers the flexibility they need to deliver care, he explained. With the flexible payments, providers can invest more resources into things like paying for team-based approaches to care or paying for services that aren't medical and weren't paid for under fee-for-service models.

But along with that, they do have more accountability for improving quality outcomes and keeping total costs of care down, he stressed.

Only about 5 percent of healthcare payments made in 2018 flowed through one of these models, LAN reported. And payers do not expect much growth in these types of payments. A survey of payers conducted by LAN found that payers expect the most growth in upside-only and two-sided risk APMs.

Mark McClellan, MD, PhD, co-chair of LAN's Guiding Committee

To progress with value-based care and related payment reforms, Miller suggested that the healthcare industry start with identifying a metric to improve. Successful APMs target opportunities to reduce spending or improve quality, which may include cutting spending on services with little benefit to the patient or avoiding complications of a specific treatment.

Payers and providers then need to identify changes in services, as well as barriers in the current payment system, that prevent changes in care delivery. Once stakeholders do that, they can design the APM to overcome the barriers and deliver higher-value care.

With an APM design, payers and providers must determine how to operationalize the model (i.e., create CPT/HCPCS codes and modifiers, determine patient eligibility, adjust payments for performance). Finally, stakeholders can implement the model, assess its performance, make improvements.

What sets Millers APM approach apart from others is his emphasis on changes in care delivery, which he believes will result in value-based care that leads to positive outcomes.

It's not the payment model that comes first, it's the care delivery, he said. And you have to know what the care delivery model is in order to know how to pay for it.

Source: Health Care Payment Learning & Action Network

The healthcare industry is not as far along the value-based care continuum as industry experts predicted a decade ago, and many believe reform is needed for current payment reform efforts. But those on the frontline of care delivery are still pushing forward with care and payment transformations in anticipation of a more advanced world.

With advancements in technology, healthcare is heading in a new direction. Community-oriented, coordinated, team-based care is now possible thanks to new and improved data sharing, consumer-facing healthcare apps, telemedicine, and other capabilities.

But fee-for-service does not align with this version of care delivery.

The right APMs can help providers develop the capabilities they need to deliver higher quality, lower cost care. For example, an ACO agreement enabled an independent primary care practice in Louisiana to get the data it needed to start performing wellness visits consistently, improve coding, advance chronic disease management, and other value-adding activities.

Darrin D. Menard, MD, FAAFP, local medical director for Aledades Louisiana and Southeast ACO

That, in turn, started increasing revenue, said full-time physician at the practice Darrin D. Menard, MD, FAAFP. Once the dollars from savings started coming in, that helped us go further with value-based care.

APMs have contributed to an uptick in, among many capabilities, preventative care and care management, population health management tool implementation, connected health use, and social determinants of health strategies.

But engaging with an APM to bolster care quality and lower costs is not easy for certain providers.

It's very difficult for an independent primary care practice to enter into the world of value-based care by themselves. Value-based care by definition is team-based care, Menard explained. I tried for many years on my own to work with Blue Cross to increase reimbursement for value-based care and I failed over and over again.

Gary Stuck, DO, chief medical officer at Advocate Aurora Health, knows about the benefits of size. Advocate Aurora Health is one of the largest non-profit health systems in the country, and its scale helped the health system to succeed in the Medicare Shared Saving Program, Stuck said in an interview.

But the chief medical officer attributed the health systems $61 million in savings to more than scale.

We use many strategies to get to that number, but the key here is that we focus on getting patients the right safe, high-quality care at the right time and the right place. We know that we can provide high quality care at a lower cost when we coordinate care across the continuum, he said.

Specifically, the health system has invested in expanding its integrated care management and post-acute care networks to optimize the control of chronic conditions and focus on the right level of care including a home-first mentality, Stuck stated.

Advocate Aurora Health also partners with a platform called NowPow to address the social determinants of health, which can impact between 10 and 20 percent of outcomes.

Gary Stuck, DO, chief medical officer, Advocate Aurora Health

Our care team members use it to screen for non-clinical barriers to good health and then make referrals to programs, accessing a database of thousands of community resources to help with transportation, food banks or other services, Stuck explained. Then, patients can be connected to the resources that better enable them to get on the road to better health.

Menard was able to break into this value-based world and start engaging in similar activities through an ACO, too. But his ACO was run by Aledade, which brought local primary care practices together to establish a value-based contract and help them implement value-based care.

They gave me the tools to become successful and then having their voice with the different insurance companies, said Menard, who eventually became the local medical director for Aledades Louisiana and Southeast ACO. The ACO gave us a whole team of practices across the state that we could actually finally move the needle on value-based care in a lot of these practices.

With access to infrastructure and resources, Menard is now part of a risk-based ACO and Track 2 of Medicares Comprehensive Primary Care Plus program. The practice leader plans to continue taking on risk through APMs, but he still had some suggestions for improvement.

For one, benchmarking that does not solely rely on historical expenditure data could help providers stick with APMs, he stated. Attribution could also use some improvement. When payers switch an enrollees primary care provider, that can knock those patients off of a small practices cohort of patients eligible for an APM. Additionally, new independent physicians starting out do not have the patient base necessary to engage in current APMs even if they are providing some of the best quality care around.

Current APMs may have some flaws, but providers are dedicated to continuing their journey to value-based care through the models.

Bottom line: We have embraced value-based care as a way to deliver better health. Advocate Aurora Health will continue to pursue whatever program makes the most sense for the system and our patients, Stuck said.

As they currently stand, APMs may not be perfect but industry experts and providers agree that value-based care is the future of healthcare. As provider organizations and payers prepare to take on more advanced APMs, the healthcare industry needs to step back and assess its progress with value-based care implementation thus far.

As Miller pointed out in his APM development guide, assessing and improving how to approach care delivery and payment reform is key. And these improvements will be critical to accelerating the transition to higher quality, lower cost care.

We need payment reform goals that are aligned with where we'd like to get, McClellan said, and hopefully, by 2025 not just by 2030 or 2035.

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Entering the Next Phase of Value-Based Care, Payment Reform - RevCycleIntelligence.com