Issue No. 105

January 19, 2016

 


 
We have marked the passing of another week in this new year. It is already speeding by! It is our sincere hope that 2015 holds good memories and that 2016 finds new challenges and opportunities rewarding.

 Setting goals, making plans, keeping you as our focus. Goal setting and achieving those goals make us, to the degree that we can be, the masters of all that lies ahead. As the healthcare environment changes, TACT serves you and is working hard behind the scenes to move forward in a positive way. we are listening to your needs!

We are committed and are invested in YOU. You truly are partnered in healthcare decisions and with a coverage provider that is thriving. Not only serving you and your industry, but serving you and serving agriculture better in 2016. YOU are our focus. YOU are our business.
 
  
 
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Healthcare in the News

   
 New Hospitals, Health Care Providers Join Successful, Cutting-edge Federal Initiative

Medicare Accountable Care Organization initiatives to improve how the health system cares for patients

Courtesy - HHS.gov
New hospitals and health care providers join successful, cutting-edge federal initiative that cuts costs and puts patients at the center of their care.

The Centers for Medicare & Medicaid Services (CMS) announced 121 new participants in Medicare Accountable Care Organization (ACO) initiatives designed to improve the care patients receive in the health care system and lower costs. With this announcement, ACOs now represent 49 states and the District of Columbia.

"Americans will get better care and we will spend our health care dollars more wisely because these hospitals and providers have made a commitment to change how they do business and work with patients," HHS Secretary Sylvia M. Burwell said. "We are moving Medicare and the entire health care system toward paying providers based on the quality, rather than the quantity of care they give patients. The three new ACO initiatives being launched mark an important step forward in this effort."

ACOs were created to change the incentives for how medical care is paid for in the U.S., moving away from a system that rewards the quantity of services to one that rewards the quality of health outcomes.

Many Americans who have gotten ill or injured have experienced a situation where they have been shuttled from hospital to doctor's office to doctor's office, often enduring duplicative tests or receiving care that isn't coordinated.

ACOs are groups of doctors and hospitals that join together to develop and execute a plan for a patient's care and share information, putting the patient at the center of the health care delivery system. The ACOs are paid not based on how many tests or procedures are performed but by the success of the treatment administered.

ACOs are delivering better care, and they continue to show promising results on cost savings. In 2014, they had a combined total net program savings of $411 million for 333 Medicare Shared Savings Program (Shared Savings Program) ACOs and 20 Pioneer ACOs. Based on 2014 quality and financial performance results for Shared Savings Program ACOs who started the program in 2012, 2013, and 2014, those that reported in both 2013 and 2014 improved on 27 of the 33 quality measures, including patients' ratings of clinicians' communication, beneficiaries' rating of their doctors, screening for tobacco use and cessation, screening for high blood pressure, and Electronic Health Record use. Shared Savings Program ACOs also outperformed group practices reporting quality on 18 out of 22 measures. 

CMS also announced that providers and hospitals have signed up to join new types of ACOs, which in addition to being paid for positive patient outcomes will also receive penalties for negative ones. With new participants in the Shared Savings Program (SSP), the Next Generation ACO Model, Pioneer ACO Model, and the Comprehensive ESRD Care Model, there will now be:
  • Nearly 8.9 million beneficiaries served
  • A total of 477 ACOs across SSP, Pioneer ACO Model, Next Generation ACO Model, and Comprehensive ESRD Care Model
  • 64 ACOs are in a risk-bearing track including SSP, Pioneer ACO Model, Next Generation ACO Model , and Comprehensive ESRD Care Model
The Next Generation ACO Model is a new CMS Innovation Center initiative that builds upon experience from the Pioneer ACO Model and the Shared Savings Program. With 21 participating ACOs, the new model offers a new opportunity in accountable care-one that enables providers and beneficiaries greater opportunities to coordinate care and aims to attain the highest quality standards of care. Unlike other models, this model includes a prospectively (rather than retrospectively) set benchmark, allows beneficiaries to choose to be aligned to the ACO, and tests beneficiary incentives for seeking care at Next Generation providers, including increased availability of telehealth and care coordination services.

The Next Generation Model participants will have the opportunity to take on higher levels of financial risk - up to 100 percent risk - than ACOs in current initiatives. While they are at greater financial risk they also have a greater opportunity to share in more of the Model's savings through better care coordination and care management. In addition, the ACOs will receive their budgets prospectively, in advance of the performance year, to plan and manage care around these financial targets from the outset. The ACOs will also be able to select from flexible payment options, such as infrastructure payments that support ACO investments in care.

The Medicare Shared Savings Program welcomed 100 new ACOs and nearly 150 renewing ACOs on January 1, 2016. Since the start of the ACO program in early 2012, thousands of health care providers have signed on to participate. In 2016, approximately 15,000 more physicians will be participating in ACOs under the program. With the new group of ACOs, CMS will have 434 ACOs participating in the Shared Savings Program next year, serving more than 7.7 million beneficiaries. ACOs have demonstrated increased interest in performance-based risk arrangements, with 22 ACOs now opting for either Track 2 or Track 3 participation. 
Thirty-nine Shared Savings Program ACOs will also participate in the ACO Investment Model (AIM). This model, which has a total of 41 participants, will provide pre-paid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Shared Savings Program ACOs to transition to performance-based risk arrangement. The up-front payments distributed through the AIM support ACOs in improving infrastructure and redesigning care processes to provide beneficiaries with lower cost and higher quality health care.

"Accountable Care Organizations are improving quality of care and spending dollars more wisely. These new initiatives place patients at the center of a coordinated care delivery system and give providers the tools to achieve better outcomes," said Patrick Conway, Deputy Administrator for Innovation and Quality and Chief Medical Officer for CMS.

These initiatives also advance the Administration's goals, announced on January 26, 2015, to move 30 percent of traditional Medicare fee-for-service payments into alternative payment models that pay providers based on the quality rather than the quantity of care they provide patients by 2016 - and 50 percent by 2018. The Affordable Care Act provides tools, such as Medicare ACOs, to move our health care system toward one that rewards doctors based on the quality, not just the quantity, of care they give patients. 

The announcement is part of the Administration's broader strategy to improve the health care system by paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality. More than 4,600 payers, providers, employers, patients, states, consumer groups, consumers and other partners have registered to participate in the Health Care Payment Learning and Action Network, which was launched to help the entire health care system reach these goals.


 
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 UDSA Joins with HHS, Releases New Dietary Guidelines Encouraging Healthy Eating 

The US Department of Agriculture Secretary Tom Vilsack joined with Secretary of Health and Human Services Sylvia M. Burwell to release updated nutritional guidelines that encourage Americans to adopt a series of science-based recommendations to improve how they eat to reduce obesity and prevent chronic diseases like Type 2 diabetes, hypertension, and heart disease.

The 2015-2020 Dietary Guidelines for Americans is the nation's trusted resource for evidence-based nutrition recommendations and serves to provide the general public, as well as policy makers and health professionals with the information they need to help the public make informed choices about their diets at home, school, work and in their communities.

"Protecting the health of the American public includes empowering them with the tools they need to make healthy choices in their daily lives," said Secretary Burwell. "By focusing on small shifts in what we eat and drink, eating healthy becomes more manageable. The Dietary Guidelines provide science-based recommendations on food and nutrition so people can make decisions that may help keep their weight under control, and prevent chronic conditions, like Type 2 diabetes, hypertension, and heart disease."

The newly released 8th edition of the Dietary Guidelines reflects advancements in scientific understanding about healthy eating choices and health outcomes over a lifetime. This edition recognizes the importance of focusing not on individual nutrients or foods in isolation, but on the variety of what people eat and drink-healthy eating patterns as a whole-to bring about lasting improvements in individual and population health.

"The Dietary Guidelines for Americans is one of many important tools that help to support a healthier next generation of Americans," said Secretary Vilsack. "The latest edition of the Dietary Guidelines provides individuals with the flexibility to make healthy food choices that are right for them and their families and take advantage of the diversity of products available, thanks to America's farmers and ranchers."

The specific recommendations fit into five overarching guidelines in the new edition:
  • Follow a healthy eating pattern across the lifespan. Eating patterns are the combination of foods and drinks that a person eats over time
  • Focus on variety, nutrient-dense foods, and amount
  • Limit calories from added sugars and saturated fats, and reduce sodium intake
  • Shift to healthier food and beverage choices
  • Support healthy eating patterns for all
Healthy eating patterns include a variety of nutritious foods like vegetables, fruits, grains, low-fat and fat-free dairy, lean meats and other protein foods and oils, while limiting saturated fats, trans fats, added sugars and sodium. A healthy eating pattern is adaptable to a person's taste preferences, traditions, culture and budget.

Importantly, the guidelines suggest Americans should consume:
  • A variety of vegetables, including dark green, red and orange, legumes (beans and peas), starchy and other vegetables
  • Fruits, especially whole fruits
  • Grains, at least half of which are whole grains
  • Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
  • A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), soy products, and nuts and seeds
  • Oils, including those from plants: canola, corn, olive, peanut, safflower, soybean, and sunflower. Oils also are naturally present in nuts, seeds, seafood, olives, and avocados
Further, Americans should be encouraged to consume:
  • Less than 10 percent of calories per day from added sugars. ChooseMyPlate.gov provides more information about added sugars, which are sugars and syrups that are added to foods or beverages when they are processed or prepared. This does not include naturally occurring sugars such as those consumed as part of milk and fruits
  • Less than 10 percent of calories per day from saturated fats. The Nutrition Facts label can be used to check for saturated fats. Foods that are high in saturated fat include butter, whole milk, meats that are not labeled as lean, and tropical oils such as coconut and palm oil
  • Less than 2,300 milligrams (mg) per day of sodium for people over the age of 14 years and less for those younger. The Nutrition Facts label is a helpful tool to check for sodium, especially in processed foods like pizza, pasta dishes, sauces, and soups
Based on a review of current scientific evidence on nutrition, the 2015 edition includes updated guidance on topics such as added sugars, sodium, and cholesterol and new information on caffeine. For example, the 2015-2020 Dietary Guidelines is the first edition to recommend a quantitative limit to consume less than 10 percent of calories from added sugars. This edition also reaffirms guidance about the core building blocks of a healthy lifestyle that have remained consistent over the past several editions, and suggests there is still work to be done to encourage more Americans to follow the recommendations outlined in the Dietary Guidelines.

The 2015-2020 Dietary Guidelines was informed by the recommendations of the 2015 Dietary Guidelines Advisory Committee, which was composed of prestigious researchers in the fields of nutrition, health, and medicine, and by consideration of public and federal agency comments.

Since 1980, HHS and USDA have shared a responsibility to the American public to ensure that advancements in scientific understanding about the role of nutrition in health are incorporated into the Dietary Guidelines, which is updated every five years. USDA has also released updates for consumers on ChooseMyPlate.gov, and new resources will soon be available on Health.gov from HHS that will help health professionals support their clients and patients in making healthy choices.

The 2015-2020 Dietary Guidelines for Americans is available at dietaryguidelines.gov.



 
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 Healthful Hint
  
a healthier you... 
Keeping Your Resolution!
 
Portions By: Levi Memmer (CSCS) 
Intensity Training Systems
The tradition of setting New Years Resolutions dates back more than 4,000 years. Ancient Babylonians celebrated the new Year, not in January, but in March when the spring harvest came. Centuries later, the ancient Romans practiced similar traditions to celebrate, which also started in march. It wasn't until around 300 BC that the traditions switched to January 1.

Modern New Year Resolutions...we all begin the year with high hopes and big goals for our health and fitness. But, only 30 days into the year, just 6 out of 10 people are likely to be on track to "lose weight", "exercise more", or "eat healthy".  And, by the end of the year, only 1 out of 10 people have sustained their New Year Resolution to be healthier. What about you? Do you fall into the wrong side of statistics?

Bad habits cannot be erased - they must be replaced! Health and fitness is a journey, slowly materializing into reality. There will be plateaus, there will be obstacles, there will be temptations. BUT, with repetition and community, you have the tools to reinforce behavior, elevate your passion and overcome! 

A critical piece to the puzzle of achieving your resolution is to focus on behavior instead of outcome. You can't control outcome, but what you can control is the behavior that leads to the outcome that you want. Instead of setting the goal of losing 10 pounds, set a behavior goal of committing to 3 strength training workouts per week or eating protein at each meal. 

This year, set behavior resolutions, goals, intentions that will move you closer to your desired outcome. Behavior goals are small, manageable tasks that are within your control and can be done consistently. Behavior goals are things that you can begin now! They spur action!

It's resolution season, what direction are you headed? This is the time for commitment. This year is all about_________. This year, I will be awesome!





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weighing in... 
TACT/TABA Staff Employs Health, Fitness as Part of Beginning 2016 

This January 1, the TACT/TABA office began a New Year Health and Fitness Challenge. Though not a requirement, employees are encouraged to share fitness advice, share healthy recipes, post workouts and encourage one another.

Week one proved to be very successful! Recipes, tid-bits of advice and workouts were shared. Office atmospheres underwent small makeovers, now showcasing healthy snacks and drinks. And, though the Amarillo office can proudly boast of daily climbing flights of stairs, it seems that Winter Storm Goliath undoubtedly trumped all workouts by prompting a need for massive snow shoveling - exercise that amounted to days and hours and hundreds of calories burned!

Week One boasted a cumulative amount of almost 10 pounds have been lost by staff! Week 2 was equally as successful! Encouragement abounds as the challenge continues into its third week of striving for weightloss, fitness and overall health. Even family members of staff have gotten in on the fitness fun!


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January - Glaucoma Awareness Month
January is National Glaucoma Awareness Month, an important time to spread the word about this 
sight-stealing disease.

Currently, more than 3 million people in the United States have glaucoma. The National Eye Institute projects this number will reach 4.2 million by 2030, a 58 percent increase.

Glaucoma is called "the sneak thief of sight" since there are no symptoms and once vision is lost, it's permanent. As much as 40% of vision can be lost without a person noticing.

Glaucoma is the leading cause of preventable blindness. Moreover, among African American and Latino populations, glaucoma is more prevalent. Glaucoma is 6 to 8 times more common in African Americans than Caucasians.

Over 3 million Americans, and over 60 million people worldwide, have glaucoma. Experts estimate that half of them don't know they have it. Combined with our aging population, we can see an epidemic of blindness looming if we don't raise awareness about the importance of regular eye examinations to preserve vision. The World Health Organization estimates that 4.5 million people worldwide are blind due to glaucoma.

TACT Assisting You
Assisting you with routine eyecare - yearly exams and eyewear, TACT has partnered with Ameritas Group/VSP to offer all TACT members a vision benefits program. Ameritas Group/VSP provides group vision care benefit plans through a nationwide network of private practice and retail optical providers. To see this fantastic program, visit www.txagcoop.com and download the PDF of the benefits plan by going to the forms page.

  
   
 
What can we do to help you? What questions do you have?  We are here to answer your questions.

 
You are a partner in decision making and you are partnered with a thriving coverage provider. 
Keeping YOU the priority. Keeping YOUR NEEDS in perspective. 

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Next Issue:  February 2, 2016 
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