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The deadline has passed and the goal has been reached for over seven million Americans signed up for health insurance under the Affordable Care Act (ACA). This comprehensive health reform legislation aims to transform healthcare in the United States by increasing access to health insurance to previously uninsured Americans, improving the affordability of health insurance, reducing health disparities by focusing on vulnerable populations, increasing public health preparedness, expanding the healthcare workforce, improving the quality of healthcare delivery, and lowering healthcare expenditures. The ACA also endorses peer support programs in promoting several of its key objectives. Because they are integrated into community-based care, peer support services have the potential to improve the quality of healthcare delivery, lower healthcare expenditures, and reduce health disparities. Peer support programs have been around long enough to gather scientific evidence that shows they are a critical and effective strategy for ongoing healthcare and sustained behavioral change for people with chronic diseases and other conditions, and its benefits can be extended to community, organizational, and societal levels. More information on state and local funding mechanisms can be found in the brief, “Opportunities for Peer Support in the Affordable Care Act” on the Peers for Progress website.

Peers for Progress is a nonprofit organization dedicated to promoting peer support in healthcare and prevention around the world. They have just released a report, “Peer Support in Health: Evidence to Action” that documents the quantifiable success of peer support programs in improving quality of care, lowering costs and reducing health disparities. As one peer support leader states, “In every neighborhood, there is always someone everyone else relies on for good advice and common sense wisdom. She may not be a doctor, but she knows just what to do for a child suffering from a high fever. She may not be a nutritionist by trade, but she knows where to get the best and cheapest fruits and vegetables.” The report reveals how peer support provided by community health workers (CHWs), lay health advisors, promotores, patient navigators, and other nonprofessionals can make important contributions to health, healthcare, healthcare prevention, and the ability for people to manage “on their own” through patient education, self-management programs, and community programs.


Even though it had been delayed by Congress by one year already last year, few in the healthcare industry saw the recent unusually quick action coming, but Congress succeeded in passing a law delaying implementation of ICD-10 for another year. The International Classification of Disease (ICD) is a system of coding created by the World Health Organization that notes diseases, symptoms, abnormal findings, and external causes of injury within reports in a patient’s medical record. It has become the coding standard for Medicare reimbursement to healthcare providers and its rules and implementation is overseen by the Center for Medicare & Medicaid Services (CMS). The current version, ICD-9, has been in use for over 30 years and lacks the level of specificity to adequately monitor and evaluate healthcare services in our present day.

Now that implementation of ICD-10 has been delayed until at least October 1, 2015, the challenge for the healthcare industry is to continue to increase clinical documentation programs for physicians and other caregivers under ICD-9 in order to be better prepared for ICD-10. Improved documentation skills, and even minor changes such as more specificity in notes, can create both financial and non-financial rewards through fewer claims denials, reduced audit exposure, improved case mix index, and improved cash flows. Most importantly, patient care is improved when downstream clinicians can review and rely upon more complete chart notes, and better data is available for analytics and comparative studies.


More and more digitally overloaded parents struggle to juggle work and family life and the demands of existing in a digital world and real life in parallel. A recent report by Public Health England found that excessive “screen time,” or more than four hours a day, was linked to anxiety and depression in children. By the age of seven, the average British child born today will have spent the equivalent of an entire year of his or her life in front of a screen. This same statistic could easily be applied to the children in the United States or any other developed country. The digital world is part of these children’s childhoods, and parents need to set boundaries for them to avoid digital burnout, but parents also need to lead by their own example. Parents need to find ways to take control of their own digital usage as studies show that sleep deprivation, links between low self-esteem and social media usage are real threats to both our emotional and physical well being.


Mindful Schools is a nonprofit organization that provides multi-tiered online courses to learn mindfulness and teach it to children and adolescents. Among benefits found in the classroom, educators who practice mindfulness are able to cultivate a powerful tool to manage their own attention, anxiety, and general stress levels, thus reducing burnout and increasing their resilience. Extensive quantitative and qualitative research shows that mindfulness improves student behavior, giving teachers a highly effective classroom management tool. There is also guidance for working with emotional and behavioral resistance. For children who regularly face turmoil inside or outside of school, mindfulness helps to regulate their emotions and increase their aptitude for learning. Increased focus helps counteract the constant shortening of a child’s attention span trained by the media and the proliferation of digital devices. The ability to focus is a critical factor in completing any meaningful project, whether in academics, music, sports, or beyond.


Other articles of interest in this Spring 2014 TMIS eNewsletter:

* As cash-only practices become more common, an emerging number of patients are following along, opting to leave massive insurance premiums behind.

* New executive briefing defines seven key market drivers worth watching in U.S. healthcare.

* Pending state legislative approval, Florida Power & Light Company will launch a pilot program leading to a voluntary pricing program designed to allow more customers to support solar energy.


I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our products and services at TM Information Services are always welcome.

- Mary Michele McLaughlin

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