Spring Issue April 2014
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Better Living Through Well Being

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

From the Front Page of TMIS News
Click on links below to view Full Stories.

Peer approach outlined in Affordable Care Act Highlights How To Harness Community Support For Better Health
Leawood, Kansas

Just as seven million Americans obtain health insurance under the Affordable Care Act (ACA), Peers for Progress and NCLR (National Council of La Raza) have released a report that examines how peer support programs improve health outcomes by boosting outreach and education for disease prevention and management. The report, "Peer Support in Health, Evidence to Action," is a guide for health care organizations developing peer support programs that will help people with health problems live healthier lives. Peer support programs are located throughout the U.S. and are included in the ACA as a way to improve health care quality and reduce costs.

The report summarizes findings from the first annual conference of the National Peer Support Collaborative Learning Network. The conference, under the leadership of Peers for Progress, a program of the American Academy of Family Physicians Foundation, and NCLR, convened leaders in health care and peer support to discuss current strengths and future needs in the field.

"We are proud of this report and our work with NCLR to advance an important model of care that makes a difference in the lives of patients," said Edwin Fisher, Ph.D., Global Director for Peers for Progress. "As state and local communities implement the ACA's provisions and face a marked increase in the number of patients, peer support programs will be fundamental to success. We must ensure that peer support programs are reimbursed and available to all."

Peer support programs hold great promise to help people lead healthier, more satisfying lives and achieve the goals of health reform. As the report documents, these programs have quantifiable success in improving the quality of care, lowering costs and reducing health disparities. They help individuals prevent and improve the management of disease through engagement and particularly benefit populations, such as low income groups, that other programs fail to reach. Included in the report is a review of 14 programs for adults with diabetes that demonstrated an average reduction in a key measure of blood sugar control, HbA1c, of 0.86 points, a marked improvement over the 0.50 point reduction that is considered clinically significant.
Full Story

CMS Finalizes One-Year Delay of ICD-10 to October 2015
Wayne, Pennsylvainia

In early April, Congress passed the Sustainable Growth Rate (SGR) Bill that extends the proposed physician rate reduction for one year, but which also includes language that delays the Centers for Medicare & Medicaid Services (CMS) compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding from October 1, 2014, to not before October 1, 2015. President Obama has signed the bill.

"Like everyone in the industry, Precyse has been closely watching the developments related to the SGR Bill and its effect on the transition to ICD-10. We are disappointed with the vote as our clients have spent considerable time and resources ensuring preparedness for October 1, 2014," said Chris Powell, president of healthcare information vendor Precyse. "However, this change to the legislation cannot deter us from our goals to improve the overall level of clinical documentation that will in turn improve the quality of the data that will drive the delivery of the best health care in the world. Consistent with our advice the last time we experienced a delay in ICD-10 implementation, we believe there is still no time to procrastinate. Providers should use this delay to continue staff education efforts, improve their clinical documentation processes and build a strong foundation for process improvement and downstream strategic initiatives embarked upon under the Affordable Care Act, said Powell.

ICD-10 will provide clinical and financial benefits to help drive better clarity about the care that is being delivered. It is critical to stay vigilant and continue to focus on training and developing coders, CDI specialists and others who will use the data and convert it into meaningful information. ICD-10 is a measure of quality. Hospitals and physicians aspire to offer world-class care, and ICD-10 coding will enable that by accurate capturing, organizing and tagging of the clinical data that leads to that outcome.
Full Story

Providers Urged to Continue Plans for ICD-10-CM/PCS Conversion: Deadline Extension Gives Breathing Room, not a Reprieve
Northbrook, Illinois

With Congressional passage of the Protecting Access to Medicare Act of 2014 (H.R. 4302), which includes a delay until October 2015 for required use of ICD-10-CM/PCS as the coding standard for Medicare reimbursement to healthcare providers, Intelligent Medical Objects, Inc. (IMO) urges its customers, vendor-partners and provider organizations to maintain their commitment to the transition from ICD-9-CM to ICD-10-CM/PCS.

"ICD-9-CM is over forty years old and does not have the level of specificity necessary for adequate monitoring and evaluating healthcare services in this century. Clinically specific data is required to support current and future healthcare services. Our customers and partners have invested heavily with human and capital resources to make the conversion to ICD-10-CM/PCS, as well as prepare for attestations for Meaningful Use 2 and 3," said Frank Naeymi-Rad, PhD, Chairman and Chief Executive Officer.

He continued, "Many organizations that were behind in their transitions can breathe a sigh of relief, but now is not the time to lose momentum but to continue on course. Transitioning as planned allows organizations to leverage IMO ICD-10 specificity, collaborate with vendor-partners on innovative solutions needed to meet current and future healthcare challenges."
Full Story

Disconnect to Reconnect - Tips for Digitally Distracted Parents
London, England

CEO of MyFamilyClub.co.uk and digital entrepreneur Gemma Johnson was at the recent Work and Family Show talking about digital burnout as part of a panel debate hosted by Sky, discussing how parents need to lead by example with their device usage, how boundaries are set by the parents first and how to spot the signs if you are heading for burnout.

"All too often it's so easy to blame young children, tweens and teens for their unwillingness to maintain eye contact during a conversation as they hammer away at the XBox, their inability to communicate in a meaningful way, or sit at the dinner table without messaging their mates via WhatsApp! But we tend to forget that it starts with us first. We have to take the time out to make our children feel heard, loved and important," Gemma Johnson said.

She added: "I know how hard it can be to wean yourself off using your devices, as checking habits are pretty quick to take hold. My children both scramble for the iPad, usually to watch funny videos on YouTube. My eldest son loves to play Lego Star wars and my daughter is crazy about Barbie on Netflix, even my one year old son tries to grab at my phone at any opportunity but I recognise and understand that this can slowly erode our values as a family and so I ensure I set rules and lead by example to ensure it doesn't escalate".

By the age of seven, the average British child born today will have spent an entire year of his or her life made up of 24-hour days in front of a screen, a statistic that's causing many parents to approach digital devices with horror.

Since launch in April 2012, Gemma has grown MyFamilyClub to reach an audience of over a quarter of a million "highly engaged" parents and the topic of social media overload, news fatigue and genuine concern over adult and their children's usage of technology is a burning topic.
Full Story

Bay Area Nonprofit Mindful Schools Recognized as a Leader in the Worldwide Movement
Emeryville, California

"The Mindful Revolution" cover story in TIME magazine's February 3, 2014 issue introduced the rapidly growing mindfulness movement to a wide audience. By purposefully bringing awareness to one's sensory experience, thoughts, and emotions, mindfulness enables us to objectively notice our experience, allowing us to change habitual reactions to wiser, more skillful responses. Backed by a rapidly growing volume of neuroscience and research, secular mindfulness practice has found its way into many parts of society, including mental health, education, medicine, and business.

Mindful Schools is honored to have been included in the article as the representative of mindfulness & education. As stated in "The Mindful Revolution" TIME Magazine February 3, 2014 Issue, Educators are turning to mindfulness with increasing frequency perhaps a good thing, considering how digital technology is splitting kids' attention spans too. (The average American teen sends and receives more than 3,000 text messages a month.) A Bay Area-based program called Mindful Schools offers online mindfulness training to teachers, instructing them in how to equip children to concentrate in classrooms and deal with stress. Launched in 2010, the group has reached more than 300,000 pupils, and educators in 43 countries and 48 states have taken its courses online. "All of us at Mindful Schools are grateful to our course graduates worldwide, who are working tirelessly to bring mindfulness to youth of all ages, genders, ethnicities, and economic backgrounds around the world," said Randima Fernando, Executive Director of Mindful Schools. "This heartfelt, widespread impact underscores the deep commitment Mindful Schools has to making secular mindfulness increasingly accessible to the world's diverse population of educators, children, and adolescents."
Full Story

Upcoming Full Implementation of Affordable Care Act Spurs a Growing Number of American Doctors to Shift in Part or in Whole to Cash-Based Business
Las Vegas, Nevada

As cash-only practices become more common, an emerging number of patients are following along, opting to leave massive insurance premiums behind. Doctor For Cash, LLC, a company founded to focus on cash-based medical practices, has recently unveiled their DrforCash.com web site. The site allows physicians who have become frustrated with surging insurance costs and dwindling payouts to make contact with new patients who are fleeing sky-high insurance premiums.

While the ACA has indisputably had a positive impact on some, it is difficult to make gross legislative sweeps work for every medical practice and patient. Some of the provisions of the legislation make for a more costly route to care than certain demographics might otherwise be able to attain, and certain regulations are likely to put more strain on some doctors than others. As a result, an increasing number of physicians have been converting to cash-based models in the face of shifting healthcare regulations.

This is good news for those Americans whose health and financial situation are better suited to a cash-centric model. Despite the provisions of the ACA related to insurance requirements, many of those in good health may find that a high deductible insurance plan will keep them from being penalized, while allowing them the freedom to operate on a cash basis with their doctor.
Full Story

Medicaid Expansion, Medicare Reimbursement And The Next Level Of Healthcare Information Technology: U.S. Managed Markets Continue Titanic Shifts In 2014
Burlington, Massachusetts

Decision Resources Group's team of subject matter experts have analyzed the market forces affecting U.S. Healthcare in 2014, and outlined forward-thinking insight for each major market driver in a new Executive Briefing. Healthcare reform, which touched every part of the nation's healthcare industry in 2013, will remain at the core of continuing, unparalleled change throughout 2014.

Decision Resources Group's newest Executive Briefing, entitled "2014 In Focus: Seven Market Drivers to Watch in U.S. Managed Markets," discusses seven key market drivers that will force further evolution of the U.S. healthcare industry:

* Telehealth and telemedicine capabilities will expand to provide routine care in rural or underserved areas.
* Pressure from hospitals and providers, as well as the enticing federal match, will drive more states to expand Medicaid.
* Star ratings will take on even more prominence, as the average rating for all Medicare Advantage plans increases.
* Accountable Care Organizations (ACOs) will consolidate to form "Super ACOs."
* Prospective bundled payments, with their potential for cost savings, will be pushed by payers.
* More rural area physicians will seek hospital employment to share risk, access resources and avoid burnout.

The full Executive Briefing can be downloaded here.
Full Story

FPL proposes voluntary, community-based solar partnership pilot to continue advancing affordable, clean energy in Florida
Juno Beach, Florida

Florida Power & Light Company has announced that, in an effort to offer more customers the choice to support solar power, it is proposing a voluntary, community-based, solar partnership pilot for consideration by the Florida Public Service Commission (PSC). If approved, FPL will install new solar-powered generating facilities in Florida communities, funded by voluntary contributions from FPL customers who choose to participate in the pilot program. Key to its design, and unlike current solar rebate programs, the pilot will not increase electric bills for customers who choose not to participate.

"As the leader in providing the most solar power in the Sunshine State, FPL has long been committed to planning for Florida's clean-energy future, and we, along with our customers, believe solar should play an increasing role in Florida's energy mix," said Eric Silagy, president of FPL. "For customers who care deeply about advancing clean energy, including those who may not have the ability or desire to install their own solar systems, we are proposing to create a voluntary, community-based partnership that is designed to help grow solar in Florida without costing a penny for those who choose not to participate."

Through this voluntary pilot program, FPL customers will have the opportunity to elect to contribute to advancing solar power in Florida for $9 a month. During the next three years, FPL projects that the program could support the construction of as many as 25 commercial-scale, distributed solar arrays, each roughly 10 to 15 times larger than a typical residential rooftop installation, for an estimated total of up to 2,400 kilowatts (2.4 megawatts), depending on customer participation.

"We know that some of our customers have an affinity for solar power, but we also know that for a variety of reasons, many are not able to install it themselves. This pilot program will allow us, along with the PSC, to truly gauge customer interest in supporting solar power," said Silagy. "Ultimately, any program we offer must be designed to benefit all of our customers, and this voluntary, community-based solar program is designed with that goal in mind."

The pilot program is expected to begin accepting voluntary customer contributions in 2015. FPL plans to provide the initial necessary funding so that the installation of at least the first two to five solar arrays can begin in early 2015, in anticipation of receiving sufficient funding from customers. The arrays will be constructed by local, Florida-based solar installers selected through a competitive bid process.
Full Story

Recommended Books

Alternative Medicine Psychotherapist Launches Groundbreaking Alternative Guide for Mental Health
Tallahassee, Florida

The year 2014 is poised to bring a sigh of relief to the 450 million people around the world with mental and emotional issues and diagnoses, thanks to Amelia Kemp, Ph.D., LMHC. Dr. Kemp, a licensed psychotherapist, metaphysician and board certified alternative medical practitioner, has released a groundbreaking self-help book, "From Psychotherapy to Sacretherapy - Alternative Holistic Descriptions & Healing Processes for 170 Mental & Emotional Diagnoses Worldwide." The book is the first to offer alternative holistic ways to describe, interpret and treat all 170 mental and emotional diagnoses in an attempt to remove the stigma and pathology associated with mental and emotional issues and restore sufferers' sense of value and worth, while bringing them back into alignment with their inherent wellness.

Dr. Kemp, a psychotherapist for 18 years, believes traditional interventions are "fragmented" and they label people with "disorders" the label itself causing them to feel sick and defective. She boldly breaks the mold, exchanging the stigmatized word "disorder" with "reaction" and prescribes holistic treatments that honor the whole person - mind, body and spirit. Dr. Kemp tells sufferers, "You're not sick, you're sacred." The book addresses mental health through universal spiritual principles that are metaphysical in nature in order to get to the essence of the matter. It offers eight steps to mental and emotional well-being, along with a chapter specifically devoted to healing suicidal thoughts and behaviors since hopelessness is often the result of stigma and reduced self esteem. The book also honors other alternative healing modalities including herbal remedies, which are usually minimized in the American mental health community.
Full Story

Online Therapy: Healing Your Memories Doesn't Have to Be Painful
Woodbine, New Jersey

Who said that therapy had to be painful? "Heal Your Memories, Change Your Life," a new book, is written with humor, inspirational stories, and exercises that will leave readers feeling free to enjoy their lives and move on to happy and successful futures.

"Are there memories that keep popping into your head?" said author Frank Healy, a Licensed Professional Counselor in the State of New Jersey who counsels people with depression and anxiety. He is also a medical miracle who remembers every day of his life since he was six years old. "Maybe you suffer from depression or anxiety because there is a traumatic memory that you can't seem to recover from. Or you may wish that you remember more of a happy memory."

"Heal Your Memories, Change Your Life" takes readers on an adventurous journey through their own memories, and gives them tools to heal from past hurts. The book uses exercises to help readers remember more of the good times, and let go of the pain from past hurts, said Healy, who is known as the "Memory Healer." Readers also will be able to join a memory support group on his website.
Full Story

New SharpBrains Book Offers Groundbreaking Guidance to Help Consumers Improve Brain Health
Washington, DC

Just days after the White House's launch of its new BRAIN Initiative, a new how-to guide is shedding much-needed light on a practical approach to preserving and optimizing brain health and performance at any age, tackling this complex topic with refreshing new guidance and personalized lifestyle and brain training tips.

Featuring a foreword by Misha Pavel, Ph.D., Program Director at the National Science Foundation, the new "The Sharpbrains Guide to Brain Fitness: How to Optimize Brain Health and Performance at Any Age," cuts through the misconceptions, superficial and conflicting media coverage, and aggressive marketing claims with a common sense approach that empowers readers to take control of their own brain health. The book is available today in paperback and e-book in the U.S., Canada and the U.K.

"In today's increasingly high-demand, fast-paced world, we all need to process information faster, boost working memory and resilience and delay age-related problems," said Alvaro Fernandez, CEO of SharpBrains and co-author of the guide, who was also named a Young Global Leader by the World Economic Forum in 2012. "Instead of waiting for the elusive 'magic pill' for cognitive enhancement or Alzheimer's treatment, we need to pay more attention to lifestyle and research-based brain training tools. This book provides an easy-to-follow guide to understanding and harnessing the natural properties of the brain so that more readers can thrive in the 21st century."
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