Sample records for benefits program medically

  1. 76 FR 49458 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year 2012 Continued Health Care Benefit... Health Care Benefit Program premiums for Fiscal Year 2012. CHCBP is a premium-based health care program...) set forth rules to implement the Continued Health Care Benefit Program (CHCBP) required by 10 United...

  2. Planning and Decision Making for Medical Education: An Analysis of Costs and Benefits.

    ERIC Educational Resources Information Center

    Wing, Paul

    This paper clarifies the role of medical education in the large health care system, estimates the resources required to carry on medical education programs and the benefits that accrue from medical education, and answers a few fundamental policy questions. Cost estimates are developed on a program-by-program basis, using empirical economic…

  3. The DOD Humanitarian and Civic Assistance Program Concepts, Trends, Medical Challenges

    DTIC Science & Technology

    1997-03-01

    program improvements; measuring program performance and effectiveness; and defining military roles relevant to training, long term benefits, and the...support conclusions relevant to trends, benefits, challenges, suggested improvements, and suggested areas for future research. 15. SUBJECT TERMS 16...a Long Term Medical Benefit ................ 28 CONCLUSION

  4. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-10

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved Areas for 2011 AGENCY: Office of Personnel Management. ACTION: Notice. SUMMARY: The U.S. Office of... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is...

  5. 76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2012 AGENCY: U.S. Office of Personnel Management. ACTION: Notice. SUMMARY: The U.S. Office of... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is...

  6. 42 CFR 102.80 - Calculation of medical benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Calculation of medical benefits. 102.80 Section 102... COMPENSATION PROGRAM Calculation and Payment of Benefits § 102.80 Calculation of medical benefits. In calculating medical benefits, the Secretary will take into consideration all reasonable costs for those...

  7. 42 CFR 110.80 - Calculation of medical benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Calculation of medical benefits. 110.80 Section 110... COUNTERMEASURES INJURY COMPENSATION PROGRAM Calculation and Payment of Benefits § 110.80 Calculation of medical benefits. In calculating medical benefits, the Secretary will take into consideration all reasonable costs...

  8. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved Areas for 2013 AGENCY: U.S. Office of Personnel Management. ACTION: Notice of Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health...

  9. 78 FR 43820 - Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... Advantage and the Medicare Prescription Drug Benefit Programs; Correction AGENCY: Centers for Medicare... Medicare Advantage and the Medicare Prescription Drug Benefit Programs final rule and does not make... Register titled ``Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the...

  10. 77 FR 56631 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... Medical Program of the Uniformed Services; Fiscal Year 2013 Continued Health Care Benefit Program Premium Update AGENCY: Office of the Secretary, DoD. ACTION: Notice of updated continued health care benefit program premiums for fiscal year 2013. SUMMARY: This notice provides the updated Continued Health Care...

  11. 42 CFR 110.31 - Medical benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Medical benefits. 110.31 Section 110.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES COUNTERMEASURES INJURY COMPENSATION PROGRAM Available Benefits § 110.31 Medical benefits. (a) Injured countermeasure recipients may...

  12. 42 CFR 110.31 - Medical benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Medical benefits. 110.31 Section 110.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES COUNTERMEASURES INJURY COMPENSATION PROGRAM Available Benefits § 110.31 Medical benefits. (a) Injured countermeasure recipients may...

  13. 42 CFR 110.31 - Medical benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Medical benefits. 110.31 Section 110.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES COUNTERMEASURES INJURY COMPENSATION PROGRAM Available Benefits § 110.31 Medical benefits. (a) Injured countermeasure recipients may...

  14. 42 CFR 110.31 - Medical benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Medical benefits. 110.31 Section 110.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES COUNTERMEASURES INJURY COMPENSATION PROGRAM Available Benefits § 110.31 Medical benefits. (a) Injured countermeasure recipients may...

  15. Translating Medical Effectiveness Research into Policy: Lessons from the California Health Benefits Review Program

    PubMed Central

    Coffman, Janet M; Hong, Mi-Kyung; Aubry, Wade M; Luft, Harold S; Yelin, Edward

    2009-01-01

    Context: Legislatures and executive branch agencies in the United States and other nations are increasingly using reviews of the medical literature to inform health policy decisions. To clarify these efforts to give policymakers evidence of medical effectiveness, this article discusses the California Health Benefits Review Program (CHBRP). This program, based at the University of California, analyzes the medical effectiveness of health insurance benefit mandate bills for the California legislature, as well as their impact on cost and public health. Methods: This article is based on the authors’ experience reviewing benefit mandate bills for CHBRP and findings from evaluations of the program. General observations are illustrated with examples from CHBRP's reports. Information about efforts to incorporate evidence into health policymaking in other states and nations was obtained through a review of published literature. Findings: CHBRP produces reports that California legislators, legislative staff, and other major stakeholders value and use routinely in deliberations about benefit mandate bills. Where available, the program relies on previously published meta-analyses and systematic reviews to streamline the review of the medical literature. Faculty and staff responsible for the medical effectiveness sections of CHBRP's reports have learned four major lessons over the course of the program's six-year history: the need to (1) recognize the limitations of the medical literature, (2) anticipate the need to inform legislators about the complexity of evidence, (3) have realistic expectations regarding the impact of medical effectiveness reviews, and (4) understand the consequences of the reactive nature of mandated benefit reviews. Conclusions: CHBRP has demonstrated that it is possible to produce useful reviews of the medical literature within the tight time constraints of the legislative process. The program's reports have provided state legislators with independent analyses that allow them to move beyond sifting through conflicting information from proponents and opponents to consider difficult policy choices and their implications. PMID:20021589

  16. Translating medical effectiveness research into policy: lessons from the California Health Benefits Review Program.

    PubMed

    Coffman, Janet M; Hong, Mi-Kyung; Aubry, Wade M; Luft, Harold S; Yelin, Edward

    2009-12-01

    Legislatures and executive branch agencies in the United States and other nations are increasingly using reviews of the medical literature to inform health policy decisions. To clarify these efforts to give policymakers evidence of medical effectiveness, this article discusses the California Health Benefits Review Program (CHBRP). This program, based at the University of California, analyzes the medical effectiveness of health insurance benefit mandate bills for the California legislature, as well as their impact on cost and public health. This article is based on the authors' experience reviewing benefit mandate bills for CHBRP and findings from evaluations of the program. General observations are illustrated with examples from CHBRP's reports. Information about efforts to incorporate evidence into health policymaking in other states and nations was obtained through a review of published literature. CHBRP produces reports that California legislators, legislative staff, and other major stakeholders value and use routinely in deliberations about benefit mandate bills. Where available, the program relies on previously published meta-analyses and systematic reviews to streamline the review of the medical literature. Faculty and staff responsible for the medical effectiveness sections of CHBRP's reports have learned four major lessons over the course of the program's six-year history: the need to (1) recognize the limitations of the medical literature, (2) anticipate the need to inform legislators about the complexity of evidence, (3) have realistic expectations regarding the impact of medical effectiveness reviews, and (4) understand the consequences of the reactive nature of mandated benefit reviews. CHBRP has demonstrated that it is possible to produce useful reviews of the medical literature within the tight time constraints of the legislative process. The program's reports have provided state legislators with independent analyses that allow them to move beyond sifting through conflicting information from proponents and opponents to consider difficult policy choices and their implications.

  17. 75 FR 19948 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... on Federal Employee Health Benefit Program employee and agency contributions required for a... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year 2011 Continued Health Care Benefit...

  18. The demise of Oregon's Medically Needy program: effects of losing prescription drug coverage.

    PubMed

    Zerzan, Judy; Edlund, Tina; Krois, Lisa; Smith, Jeanene

    2007-06-01

    In January 2003, people covered by Oregon's Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits. To describe the Medically Needy population and determine how benefit loss affected this population's health and prescription use. A 49-question telephone survey instrument created by the research team and administered by a research contractor. A random sample of 1,269 eligible enrollees in Oregon's Medically Needy Program. Response rate was 35% with 439 individuals, ages 21-91 and 64% women, completing the survey. Demographics, health information, and medication use at the time of the survey obtained from the interview. Medication use during the program obtained from administrative data. In the 6 months after the Medically Needy program ended, 75% had skipped or stopped medications. Sixty percent of the respondents had cut back on their food budget, 47% had borrowed money, and 49% had skipped paying other bills to pay for medications. By self-report, there was no significant difference in emergency department visits, but a significant decrease in hospitalizations comparing 6 months before and after losing the program. Two-thirds of respondents rated their current health as poor or fair. The Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered.

  19. Federal Employees Health Benefits Program miscellaneous changes: Medically Underserved Areas. Direct final rule.

    PubMed

    2014-12-17

    The U.S. Office of Personnel Management (OPM) is issuing a direct final rule to discontinue the annual determination of the Medically Underserved Areas (MUAs) for the Federal Employees Health Benefits (FEHB) Program.

  20. Clinical orientation program for new medical registrars--a qualitative evaluation.

    PubMed

    Rosemergy, Ian; Bell, Damon A; Jayathissa, Sisira K

    2009-02-01

    We present a qualitative evaluation of a clinical orientation program for medical registrars within the Wellington region in New Zealand, designed and implemented by current advanced registrars. This program was intended to improve the transition from house officer to medical registrar. The program was qualitatively evaluated using focus groups comprising participants, presenters and senior nursing staff. Purposive samples were drawn from each of these groups. The most significant finding was the perception of enhanced professional collegiality among medical staff. There were benefits to participants and presenters with improved communication between medical registrars. We believe there are individual, institutional and patient care benefits with a region-specific, clinical orientation for new medical registrars.

  1. 20 CFR 30.411 - What happens if the opinion of the physician selected by OWCP differs from the opinion of the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What happens if the opinion of the physician... Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Medical and Related Benefits Directed Medical...

  2. 42 CFR 102.31 - Medical benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Available Benefits § 102.31 Medical benefits. (a) Smallpox vaccine recipients and vaccinia... estate of a deceased smallpox vaccine recipient or vaccinia contact as long as such benefits were accrued...

  3. 42 CFR 102.31 - Medical benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Available Benefits § 102.31 Medical benefits. (a) Smallpox vaccine recipients and vaccinia... estate of a deceased smallpox vaccine recipient or vaccinia contact as long as such benefits were accrued...

  4. 42 CFR 102.31 - Medical benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Available Benefits § 102.31 Medical benefits. (a) Smallpox vaccine recipients and vaccinia... estate of a deceased smallpox vaccine recipient or vaccinia contact as long as such benefits were accrued...

  5. 42 CFR 102.31 - Medical benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Available Benefits § 102.31 Medical benefits. (a) Smallpox vaccine recipients and vaccinia... estate of a deceased smallpox vaccine recipient or vaccinia contact as long as such benefits were accrued...

  6. 42 CFR 102.31 - Medical benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Available Benefits § 102.31 Medical benefits. (a) Smallpox vaccine recipients and vaccinia... estate of a deceased smallpox vaccine recipient or vaccinia contact as long as such benefits were accrued...

  7. 20 CFR 725.707 - Reports of physicians and supervision of medical care.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... medical care. 725.707 Section 725.707 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Medical Benefits and...

  8. Cost-benefit study of school nursing services.

    PubMed

    Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

    2014-07-01

    In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money, warranting careful consideration by policy makers and decision makers when resource allocation decisions are made about school nursing positions.

  9. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed. Any...

  10. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed. Any...

  11. 20 CFR 702.409 - Evaluation of medical questions; results disputed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Evaluation of medical questions; results disputed. 702.409 Section 702.409 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT... PROCEDURE Medical Care and Supervision § 702.409 Evaluation of medical questions; results disputed. Any...

  12. 42 CFR 110.83 - Payment of all benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Secretary determines the mechanism of payment of Program benefits. She may choose to pay any benefits under... Secretary has the discretion to make interim payments of benefits under this Program, even before a final... only in exceptional cases. The Secretary may, for example, make an interim payment of medical benefits...

  13. Restructuring Military Medical Care

    DTIC Science & Technology

    1995-07-01

    providers, perhaps under an approach such as the Federal Employees Health Benefits (FEHB) program , discussed later in this chapter. Effects on DoD’s...CARE July 1995 Military Family Association, would give beneficiaries access to care through the Federal Employees Health Benefits program as well as...enrollment levels and BOX 6. THE FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM The Federal Employees Health Benefits (FEHB) program is the source of health

  14. Development of an interdisciplinary pre-matriculation program designed to promote medical students’ self efficacy

    PubMed Central

    Kosobuski, Anna Wirta; Whitney, Abigail; Skildum, Andrew; Prunuske, Amy

    2017-01-01

    ABSTRACT Background and objectives: A four-week interdisciplinary pre-matriculation program for Native American and rural medical students was created and its impact on students’ transition to medical school was assessed. The program extends the goals of many pre-matriculation programs by aiming to increase not only students’ understanding of basic science knowledge, but also to build student self-efficacy through practice with medical school curricular elements while developing their academic support networks. Design: A mixed method evaluation was used to determine whether the goals of the program were achieved (n = 22). Student knowledge gains and retention of the microbiology content were assessed using a microbiology concept inventory. Students participated in focus groups to identify the benefits of participating in the program as well as the key components of the program that benefitted the students. Results: Program participants showed retention of microbiology content and increased confidence about the overall medical school experience after participating in the summer program. Conclusions: By nurturing self-efficacy, participation in a pre-matriculation program supported medical students from Native American and rural backgrounds during their transition to medical school. Abbreviations: CAIMH: Center of American Indian and Minority Health; MCAT: Medical College Admission Test; PBL: Problem based learning; UM MSD: University of Minnesota Medical School Duluth PMID:28178916

  15. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... Areas for 2014 AGENCY: U.S. Office of Personnel Management. ACTION: Notice of Medically Underserved Areas for 2014. SUMMARY: The U.S. Office of Personnel Management (OPM) has completed its annual... Benefits (FEHB) Program for calendar year 2014. This is necessary to comply with a provision of the FEHB...

  16. Value-Based Insurance Design Pharmacy Benefits for Children and Youth With Special Health Care Needs: Principles and Opportunities.

    PubMed

    Helm, Mark E

    2017-05-01

    Value-based insurance design (VBID) represents an innovative approach to health insurance coverage. In the context of pharmacy benefits, the goal of VBID is to minimize access barriers to the most effective and appropriate treatments for specific medical conditions. Both private and public insurance programs have explored VBID pharmacy projects primarily for medical conditions affecting adults. To date, evidence for VBID pharmacy programs for children and youth with special health care needs (CYSHCN) appears lacking. There appears to be potential for VBID concepts to be applied to pharmacy coverage benefiting CYSHCN. An overview of VBID pharmacy principles and guiding principles are presented. Opportunities for the creation of pharmacy programs with a value-based orientation and challenges to the redesign of pharmacy benefits are identified. VBID pharmacy coverage principles may be helpful to improve medication use and important clinical outcomes while lowering barriers to medication use for the population of CYSHCN. Pilot projects of VBID pharmacy benefits for children and youth should be explored. However, many questions remain. Copyright © 2017 by the American Academy of Pediatrics.

  17. The Benefits and Costs of Accreditation of Undergraduate Medical Education Programs Leading to the MD Degree in the United States and Its Territories

    ERIC Educational Resources Information Center

    Muhtadi, Dalal J.

    2013-01-01

    This study assessed the value of accreditation of all 126 fully-accredited four-year undergraduate medical education programs leading to the MD degree in the US through two lenses, "perceived benefits and costs" from the perspective of the leadership of internal stakeholders of the aforementioned programs. The online survey was sent to a…

  18. The Benefits of Physician Training Programs for Rural Communities: Lessons Learned from the Teaching Health Center Graduate Medical Education Program.

    PubMed

    Lee, Marshala; Newton, Helen; Smith, Tracey; Crawford, Malena; Kepley, Hayden; Regenstein, Marsha; Chen, Candice

    2016-01-01

    Rural communities disproportionately face preventable chronic diseases and death from treatable conditions. Health workforce shortages contribute to limited health care access and health disparities. Efforts to address workforce shortages have included establishing graduate medical education programs with the goal of recruiting and retaining physicians in the communities in which they train. However, rural communities face a number of challenges in developing and maintaining successful residency programs, including concerns over financial sustainability and the integration of resident trainees into existing clinical practices. Despite these challenges, rural communities are increasingly interested in investing in residency programs; those that are successful see additional benefits in workforce recruitment, access, and quality of care that have immediate and direct impact on the health of rural communities. This commentary examines the challenges and benefits of rural residency programs, drawing from lessons learned from the Health Resources and Services Administration's Teaching Health Center Graduate Medical Education program.

  19. Iatrogenic disease management: moderating medication errors and risks in a pharmacy benefit management environment.

    PubMed

    Nair, Vinit; Salmon, J Warren; Kaul, Alan F

    2007-12-01

    Disease Management (DM) programs have advanced to address costly chronic disease patterns in populations. This is in part due to the programs' significant clinical and economical value, coupled with interest by pharmaceutical manufacturers, managed care organizations, and pharmacy benefit management firms. While cost containment realizations for many such interventions have been less than anticipated, this article explores potentials in marrying Medication Error Risk Reduction into DM programs within managed care environments. Medication errors are an emergent serious problem now gaining attention in US health policy. They represent a failure within population-based health programs because they remain significant cost drivers. Therefore, medication errors should be addressed in an organized fashion, with DM being a worthy candidate for piggybacking such programs to achieve the best synergistic effects.

  20. 32 CFR 199.26 - TRICARE Young Adult.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.26 TRICARE Young Adult. (a) Establishment. The TRICARE Young Adult (TYA) program offers the medical benefits provided... sponsors who do not otherwise have eligibility for medical coverage under a TRICARE Program at age 21 (23...

  1. 32 CFR 199.26 - TRICARE Young Adult.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.26 TRICARE Young Adult. (a) Establishment. The TRICARE Young Adult (TYA) program offers the medical benefits provided... sponsors who do not otherwise have eligibility for medical coverage under a TRICARE Program at age 21 (23...

  2. Recycling Expensive Medication: Why Not?

    PubMed Central

    Pomerantz, Jay M

    2004-01-01

    New (and proposed) advances in packaging, preserving, labeling, and verifying product integrity of individual tablets and capsules may allow for the recycling of certain expensive medicines. Previously sold, but unused, medication, if brought back to special pharmacies for resale or donation, may provide a low-cost source of patent-protected medicines. Benefits of such a program go beyond simply providing affordable medication to the poor. This article suggests that medicine recycling may be a possibility (especially if manufacturers are mandated to blister-package and bar-code individual tablets and capsules). This early discussion of medication recycling identifies relevant issues, such as: need, rationale, existing programs, available supplies, expiration dates, new technology for ensuring safety and potency, environmental impact, public health benefits, program focus, program structure, and liability. PMID:15266231

  3. Sandia National Laboratories: Careers: Benefits and Perks

    Science.gov Websites

    Medical Leave Act and the California Family Rights Act Extended leave of absence for child, family, or medical care; military duty; and personal reasons Health programs Health programs Medical, dental, and

  4. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... physicians' salaries and fringe benefits attributable to direct graduate medical education (GME); and (2... publications: (i) The Directory of Graduate Medical Education Programs published by the American Medical... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a...

  5. Weaknesses in the USACE Defense Base Act Insurance Program Led to as Much as $58.5 Million in Refunds Not Returned to the U.S. Government and Other Problems

    DTIC Science & Technology

    2011-07-28

    compensation insurance for their employees who work overseas. DBA insurance carriers provide disability and medical benefits to employees for work... insurance carriers provide disability and medical benefits to employees for work-related injuries and death benefits to eligible survivors for work-related...program to determine if contracting with a single DBA insurance provider would help control costs. Under a single provider model , contractors must use

  6. Mentoring programs for medical students--a review of the PubMed literature 2000-2008.

    PubMed

    Frei, Esther; Stamm, Martina; Buddeberg-Fischer, Barbara

    2010-04-30

    Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Mentoring is obviously an important career advancement tool for medical students. In Europe, more mentoring programs should be developed, but would need to be rigorously assessed based on evidence of their value in terms of both their impact on the career paths of juniors and their benefit for the mentors. Medical schools could then be monitored with respect to the provision of mentorships as a quality characteristic.

  7. Mentoring programs for medical students - a review of the PubMed literature 2000 - 2008

    PubMed Central

    2010-01-01

    Background Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. Methods A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. Results The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Conclusion Mentoring is obviously an important career advancement tool for medical students. In Europe, more mentoring programs should be developed, but would need to be rigorously assessed based on evidence of their value in terms of both their impact on the career paths of juniors and their benefit for the mentors. Medical schools could then be monitored with respect to the provision of mentorships as a quality characteristic. PMID:20433727

  8. Evaluation of a clinical medical librarianship program at a university Health Sciences Library.

    PubMed Central

    Schnall, J G; Wilson, J W

    1976-01-01

    An evaluation of the clinical medical librarianship program at the University of Washington Health Sciences Library was undertaken to determine the benefits of the program to patient care and to the education of the recipients of the service. Results of a questionnaire reflected overwhelming acceptance of the clinical medical librarianship program. Guidelines for the establishment of a limited clinical medical librarianship program are described. A statistical cost analysis of the program is included. PMID:938773

  9. 78 FR 12427 - Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ...This proposed rule would implement medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program under the Patient Protection and Affordable Care Act.

  10. Medical technology advances from space research.

    NASA Technical Reports Server (NTRS)

    Pool, S. L.

    1971-01-01

    NASA-sponsored medical R & D programs for space applications are reviewed with particular attention to the benefits of these programs to earthbound medical services and to the general public. Notable among the results of these NASA programs is an integrated medical laboratory equipped with numerous advanced systems such as digital biotelemetry and automatic visual field mapping systems, sponge electrode caps for electroencephalograms, and sophisticated respiratory analysis equipment.

  11. 20 CFR 10.506 - May the employer monitor the employee's medical care?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false May the employer monitor the employee's medical care? 10.506 Section 10.506 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL EMPLOYEES' COMPENSATION ACT CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED Continuing Benefit...

  12. 20 CFR 10.506 - May the employer monitor the employee's medical care?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false May the employer monitor the employee's medical care? 10.506 Section 10.506 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL EMPLOYEES' COMPENSATION ACT CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED Continuing Benefit...

  13. Early Survey Results from the Minnesota Medical Cannabis Program.

    PubMed

    McGriff, Deepa; Anderson, Susan; Arneson, Tom

    2016-06-01

    As part of its legislative mandate, the Minnesota Department of Health's Office of Medical Cannabis (OMC) is required to study and report on the state's medical cannabis program. This article describes preliminary findings from the OMC's research about who is using the program and whether patients and their certifying health care practitioners are noticing benefits and harms.

  14. Assessing the Benefits of a Geropsychiatric Home-Visit Program for Medical Students

    ERIC Educational Resources Information Center

    Roane, David M.; Tucker, Jennifer; Eisenstadt, Ellen; Gomez, Maria; Kennedy, Gary J.

    2012-01-01

    Objective: Authors assessed the benefit of including medical students on geropsychiatric home-visits. Method: Medical students, during their psychiatry clerkship, were assigned to a home-visit group (N=43) or control group (N=81). Home-visit participants attended the initial visit of a home-bound geriatric patient. The Maxwell-Sullivan Attitude…

  15. Mental Retardation: Determining Eligibility for Social Security Benefits.

    ERIC Educational Resources Information Center

    Reschly, Daniel J., Ed.; Myers, Tracy G., Ed.; Hartel, Christine R., Ed.

    The Social Security Administration (SSA) provides income support and medical benefits for adults with mental retardation unable to perform substantial gainful activity through the Disability Insurance (DI) program and the Supplemental Security Income (SSI) program. SSI benefits are also provided to families of children and adolescents who evidence…

  16. 20 CFR 10.314 - Will OWCP pay for the services of an attendant?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Will OWCP pay for the services of an attendant? 10.314 Section 10.314 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...' COMPENSATION ACT, AS AMENDED Medical and Related Benefits Medical Treatment and Related Issues § 10.314 Will...

  17. 20 CFR 10.336 - What are the time frames for submitting bills?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What are the time frames for submitting bills? 10.336 Section 10.336 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...' COMPENSATION ACT, AS AMENDED Medical and Related Benefits Medical Bills § 10.336 What are the time frames for...

  18. The implementation of medical monitoring programs following potentially hazardous exposures: a medico-legal perspective.

    PubMed

    Vearrier, David; Greenberg, Michael I

    2017-11-01

    Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. We searched the MEDLINE database using the Ovid ® search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance"). The titles and abstracts of the resulted articles were reviewed for relevance. We expanded our search to include non-peer-reviewed publications and gray literature and resources using the same terms as utilized in the MEDLINE search. There were a total of 48 relevant peer-reviewed and non-peer-reviewed publications. Publications excluded contained no information relevant to medical monitoring following potentially harmful toxicologic exposures, discussed only worker screening/surveillance and/or population biomonitoring, contained redundant information, or were superseded by more recent information. Approaches to medical monitoring: A consensus exists in the peer-reviewed medical literature, legal literature, and government publications that for medical monitoring to be a beneficial public health activity, careful consideration must be given to potential benefits and harms of the program. Characteristics of the exposure, the adverse human health effect, the screening test, and the natural history of the disease are important in determining whether an exposed population will reap a net benefit or harm from a proposed monitoring program. Broader interpretations of medical monitoring: Some have argued that medical monitoring programs should not be limited to exposure-related outcomes but should duplicate general preventive medicine efforts to improve public health outcomes although an overall reduction of morbidity, mortality and disability by modifying correctable risk factors and disease conditions. This broader approach is inconsistent with the targeted approach advocated by the Agency for Toxic Substances and Disease Registry and the United States Preventive Services Task Force and the bulk of the peer-reviewed medical literature. Medical monitoring in legal contexts: Numerous medical monitoring actions have been litigated. Legal rationales for allowing medical monitoring claims often incorporate some of the scientific criteria for the appropriateness of monitoring programs. In the majority of cases in which plaintiffs were awarded medical monitoring relief, plaintiffs were required to demonstrate both that the condition for which medical monitoring was sought could be detected early, and that early detection and treatment will improve morbidity and mortality. However, the treatment of medical monitoring claims varies significantly depending upon jurisdiction. Examples of large-scale, comprehensive medical monitoring programs: Large-scale, comprehensive medical monitoring programs have been implemented, such as the Fernald Medical Monitoring Program and the World Trade Center Health Program, both of which exceeded the scope of medical monitoring typically recommended in the peer-reviewed medical literature and the courts. The Fernald program sought to prevent death and disability due to non-exposure-related conditions in a manner similar to general preventive medicine. The World Trade Center Health Program provides comprehensive medical care for World Trade Center responders and may be viewed as a large-scale, federally--funded research effort, which distinguishes it from medical monitoring in a medico-legal context. Synthesis of public health approaches to medical monitoring: Medical monitoring may be indicated following a hazardous exposure in limited circumstances. General causation for a specific adverse health effect must be either established by scientific consensus through a formal causal analysis using a framework such as the Bradford-Hill criteria. The exposure must be characterized and must be of sufficient severity that the exposed population has a significantly elevated risk of an adverse health effect. Monitoring must result in earlier detection of the condition than would otherwise occur and must confer a benefit in the form of primary, secondary or tertiary prevention. Outcome tables may be of use in describing the potential benefits and harms of a proposed monitoring program. In the context of litigation, plaintiffs may seek medical monitoring programs after documented or putative exposures. The role of the clinical toxicologist, in this setting, is to evaluate the scientific justifications and medical risks and assist the courts in determining whether monitoring would be expected to result in a net public health benefit.

  19. 20 CFR 10.810 - How are payments for inpatient medical services determined?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... services determined? 10.810 Section 10.810 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... for inpatient medical services determined? (a) OWCP will pay for inpatient medical services according... the form of the DRG Grouper software program. On this list, each DRG represents the average resources...

  20. Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA); interpretation of "federal public benefit"--HHS. Notice with comment period.

    PubMed

    1998-08-04

    This notice with comment period interprets the term "Federal public benefit" as used in Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Pub. L. 104-193, and identifies the HHS programs that provide such benefits under this interpretation. According to section 401 if PRWORA, aliens who are not "qualified aliens" are not eligible for any "Federal public benefit," unless the "Federal public benefit" falls within a specified exception. A "Federal public benefit" includes "any grant, contract, loan, professional license, or commercial license" provided to an individual, and also "any retirement, welfare, health, disability, public or assisted housing, postsecondary education, food assistance, unemployment benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit." Under section 432, providers of a non-exempt "Federal public benefit" must verify that a person applying for the benefit is a qualified alien and is eligible to receive the benefit. The HHS programs that provide "Federal public benefits" and are not otherwise excluded from the definition by the exceptions provided in section 401(b) are: Adoption Assistance Administration on Developmental Disabilities (ADD)-State Developmental Disabilities Councils (direct services only) ADD-Special Projects (direct services only) ADD-University Affiliated Programs (clinical disability assessment services only) Adult Programs/Payments to Territories Agency for Health Care Policy and Research Dissertation Grants Child Care and Development Fund Clinical Training Grant for Faculty Development in Alcohol & Drug Abuse Foster Care Health Profession Education and Training Assistance Independent Living Program Job Opportunities for Low Income Individuals (JOLI) Low Income Home Energy Assistance Program (LIHEAP) Medicare Medicaid (except assistance for an emergency medical condition) Mental Health Clinical Training Grants Native Hawaiian Loan Program Refugee Cash Assistance Refugee Medical Assistance Refugee Preventive Health Services Program Refugee Social Services Formula Program Refugee Social Services Discretionary Program Refugee Targeted Assistance Formula Program Refugee Targeted Assistance Discretionary Program Refugee Unaccompanied Minors Program Refugee Voluntary Agency Matching Grant Program Repatriation Program Residential Energy Assistance Challenge Option (REACH) Social Services Block Grant (SSBG) State Child Health Insurance Program (CHIP) Temporary Assistance for Needy Families (TANF) While all of these programs provide "Federal public benefits" this does not mean that all benefits or services provided under these programs are "Federal public benefits." As discussed in sections II and III below, some benefits or services under these programs may not be provided to an "individual, household, or family eligibility unit" and, therefore, do not constitute "Federal public benefits" as defined by PRWORA.

  1. 42 CFR 440.345 - EPSDT services requirement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the additional benefits will be provided, how access to additional benefits will be coordinated and... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark... plan benefits or as additional benefits provided by the State for any child under 21 years of age...

  2. 38 CFR 1.551 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... or other individual who has received benefits (including medical benefits) or has applied for benefits pursuant to title 38, United States Code. Benefits records means an individual's records, which pertain to programs under any of the benefits laws administered by the Secretary of Veterans Affairs...

  3. 38 CFR 1.551 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or other individual who has received benefits (including medical benefits) or has applied for benefits pursuant to title 38, United States Code. Benefits records means an individual's records, which pertain to programs under any of the benefits laws administered by the Secretary of Veterans Affairs...

  4. 38 CFR 1.551 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... or other individual who has received benefits (including medical benefits) or has applied for benefits pursuant to title 38, United States Code. Benefits records means an individual's records, which pertain to programs under any of the benefits laws administered by the Secretary of Veterans Affairs...

  5. Fringe Benefits Among US Orthopedic Residency Programs Vary Considerably: a National Survey.

    PubMed

    Clement, R Carter; Olsson, Erik; Katti, Prateek; Esther, Robert J

    2016-07-01

    Residency programs compete to attract applicants based on numerous factors. Previous research has suggested that medical students consider quality of life among the most important factors in selecting a program. One aspect of workplace quality of life is the cadre of non-monetary benefits offered to employees. However, with federal funding for graduate medical education (GME) under consideration for spending cuts, the source and continuation of such benefits may be in question. This study aimed to determine the level and variability of benefits beyond standard salary and insurance options available to trainees at US orthopedic residency programs and to assess the source of funding for those benefits. A 26-question survey investigating various benefits and funding sources was circulated by email to all ACGME-accredited orthopedic residency programs. The survey was sent to 153 programs and 69 responded (45%). The majority offers their residents discretionary funds (77%) and conference funding (96%), most of which comes from the department, followed by the hospital or GME funding. Forty-one percent of respondents permit their residents to moonlight. The majority of respondents provide meal stipends (93%), free parking (71%), gym benefits (63%), surgical loupes (53%), and maternity/paternity leave beyond vacation time (55%). No statistically significant differences were found among top ranked residencies, top ranked orthopedic hospitals, or academic centers compared to their counterparts. While some benefits are commonly offered, there is great variation in the availability and level of others. However, these differences were independent of program and hospital reputation as well as academic center status. Departments currently bear a substantial amount of the cost of these benefits internally.

  6. 17 CFR 256.926 - Employee pensions and benefits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Employee pensions and benefits... UTILITY HOLDING COMPANY ACT OF 1935 2. Expense § 256.926 Employee pensions and benefits. This account... employee benefit programs such as medical and surgical benefits, disability benefits, life insurance...

  7. Medical-device risk management and public safety: using cost-benefit as a measurement of effectiveness

    NASA Astrophysics Data System (ADS)

    Hughes, Allen A.

    1994-12-01

    Public safety can be enhanced through the development of a comprehensive medical device risk management. This can be accomplished through case studies using a framework that incorporates cost-benefit analysis in the evaluation of risk management attributes. This paper presents a framework for evaluating the risk management system for regulatory Class III medical devices. The framework consists of the following sixteen attributes of a comprehensive medical device risk management system: fault/failure analysis, premarket testing/clinical trials, post-approval studies, manufacturer sponsored hospital studies, product labeling, establishment inspections, problem reporting program, mandatory hospital reporting, medical literature surveillance, device/patient registries, device performance monitoring, returned product analysis, autopsy program, emergency treatment funds/interim compensation, product liability, and alternative compensation mechanisms. Review of performance histories for several medical devices can reveal the value of information for many attributes, and also the inter-dependencies of the attributes in generating risk information flow. Such an information flow network is presented as a starting point for enhancing medical device risk management by focusing on attributes with high net benefit values and potential to spur information dissemination.

  8. 5 CFR 841.108 - Disclosure of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the retirement application, health benefits and life insurance eligibility, medical records supporting... to benefits under the Federal Employees Health Benefits Program. (v) Documentation of claims made for life insurance and health benefits by annuitants under a Federal Government retirement system other...

  9. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  10. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  11. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  12. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  13. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  14. A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

    PubMed

    Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

    Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for patients with poorly controlled asthma or who may be at risk for poor asthma control, to include services that address triggers in the home environment.

  15. Dual and parallel postdoctoral training programs: implications for the osteopathic medical profession.

    PubMed

    Burkhart, Diane N; Lischka, Terri A

    2011-04-01

    Students in colleges of osteopathic medicine have several options when considering postdoctoral training programs. In addition to training programs approved solely by the American Osteopathic Association or accredited solely by the Accreditation Council for Graduate Medical Education (ACGME), students can pursue programs accredited by both organizations (ie, dually accredited programs) or osteopathic programs that occur side-by-side with ACGME programs (ie, parallel programs). In the present article, we report on the availability and growth of these 2 training options and describe their benefits and drawbacks for trainees and the osteopathic medical profession as a whole.

  16. 5 CFR 630.1211 - Health benefits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title 5...

  17. 5 CFR 630.1211 - Health benefits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title 5...

  18. 5 CFR 630.1211 - Health benefits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Health benefits. 630.1211 Section 630... LEAVE Family and Medical Leave § 630.1211 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title 5...

  19. 5 CFR 630.1209 - Health benefits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Health benefits. 630.1209 Section 630... LEAVE Family and Medical Leave § 630.1209 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title 5...

  20. 5 CFR 630.1209 - Health benefits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Health benefits. 630.1209 Section 630... LEAVE Family and Medical Leave § 630.1209 Health benefits. An employee enrolled in a health benefits plan under the Federal Employees Health Benefits Program (established under chapter 89 of title 5...

  1. 42 CFR 408.50 - When premiums are considered paid.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Deduction From Monthly Benefits § 408.50 When... benefit was paid in error; but (2) A finding that a monthly benefit was erroneously withheld does not...

  2. 42 CFR 408.50 - When premiums are considered paid.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Deduction From Monthly Benefits § 408.50 When... benefit was paid in error; but (2) A finding that a monthly benefit was erroneously withheld does not...

  3. 45 CFR 86.56 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Fringe benefits. 86.56 Section 86.56 Public... Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.56 Fringe benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital...

  4. 45 CFR 86.56 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Fringe benefits. 86.56 Section 86.56 Public... Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.56 Fringe benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital...

  5. 45 CFR 86.56 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Fringe benefits. 86.56 Section 86.56 Public... Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.56 Fringe benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital...

  6. 45 CFR 86.56 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Fringe benefits. 86.56 Section 86.56 Public... Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.56 Fringe benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital...

  7. 45 CFR 86.56 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Fringe benefits. 86.56 Section 86.56 Public... Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.56 Fringe benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital...

  8. Roadmap for creating an accelerated three-year medical education program

    PubMed Central

    Leong, Shou Ling; Cangiarella, Joan; Fancher, Tonya; Dodson, Lisa; Grochowski, Colleen; Harnik, Vicky; Hustedde, Carol; Jones, Betsy; Kelly, Christina; Macerollo, Allison; Reboli, Annette C.; Rosenfeld, Melvin; Rundell, Kristen; Thompson, Tina; Whyte, Robert; Pusic, Martin

    2017-01-01

    ABSTRACT Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development – meeting regulatory requirements, attaining institutional buy-in and resources necessary to support the programs, including student assessment and mentoring – and program evaluation. Accelerated programs offer opportunities to innovate and integrate a mission benefitting students and the public. Abbreviations: CAMPP: Consortium of accelerated medical pathway programs; GME: Graduate medical education; LCME: Liaison committee on medical education; NRMP: National residency matching program; UME: Undergraduate medical education PMID:29117817

  9. Roadmap for creating an accelerated three-year medical education program.

    PubMed

    Leong, Shou Ling; Cangiarella, Joan; Fancher, Tonya; Dodson, Lisa; Grochowski, Colleen; Harnik, Vicky; Hustedde, Carol; Jones, Betsy; Kelly, Christina; Macerollo, Allison; Reboli, Annette C; Rosenfeld, Melvin; Rundell, Kristen; Thompson, Tina; Whyte, Robert; Pusic, Martin

    2017-01-01

    Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development - meeting regulatory requirements, attaining institutional buy-in and resources necessary to support the programs, including student assessment and mentoring - and program evaluation. Accelerated programs offer opportunities to innovate and integrate a mission benefitting students and the public. CAMPP: Consortium of accelerated medical pathway programs; GME: Graduate medical education; LCME: Liaison committee on medical education; NRMP: National residency matching program; UME: Undergraduate medical education.

  10. How the medical practice employee can get more from continuing education programs.

    PubMed

    Hills, Laura Sachs

    2007-01-01

    Continuing education can be a win-win situation for the medical practice employee and for the practice. However, in order education programs must become informed consumers of such programs. They must know how to select the right educational programs for their needs and maximize their own participation. Employees who attend continuing education programs without preparation may not get the full benefit from their experiences. This article suggests benchmarks to help determine whether a continuing education program is worthwhile and offers advice for calculating the actual cost of any continuing education program. It provides a how-to checklist for medical practice employees so they know how to get the most out of their continuing education experience before, during, and after the program. This article also suggests using a study partner system to double educational efforts among employees and offers 10 practical tips for taking and using notes at a continuing education program. Finally, this article outlines the benefits of becoming a regular student and offers three practical tips for maximizing the employee's exhibit hall experience.

  11. A proposal to establish master's in biomedical sciences degree programs in medical school environments.

    PubMed

    Ingoglia, Nicholas A

    2009-04-01

    Most graduate schools associated with medical schools offer programs leading to the PhD degree but pay little attention to master's programs. This is unfortunate because many university graduates who are interested specifically in biomedical rather than pure science fields need further education before making decisions on whether to enter clinical, research, education, or business careers. Training for these students is done best in a medical school, rather than a graduate university, environment and by faculty who are engaged in research in the biomedical sciences. Students benefit from these programs by exploring career options they might not have previously considered while learning about disease-related subjects at the graduate level. Graduate faculty can also benefit by being compensated for their teaching with a portion of the tuition revenue, funds that can help run their laboratories and support other academic expenses. Faculty also may attract talented students to their labs and to their PhD programs by exposing them to a passion for research. The graduate school also benefits by collecting masters tuition revenue that can be used toward supporting PhD stipends. Six-year outcome data from the program at Newark show that, on completion of the program, most students enter educational, clinical, or research careers and that the graduate school has established a new and significant stream of revenue. Thus, the establishment of a master's program in biomedical sciences that helps students match their academic abilities with their career goals significantly benefits students as well as the graduate school and its faculty.

  12. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... problem and who uses the results in the management of the beneficiary's specific medical problem... the results in the management of the beneficiary's specific medical problem. Nonphysician... SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services...

  13. 49 CFR 25.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Fringe benefits. 25.525 Section 25.525... Employment in Education Programs or Activities Prohibited § 25.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  14. 49 CFR 25.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Fringe benefits. 25.525 Section 25.525... Employment in Education Programs or Activities Prohibited § 25.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  15. 49 CFR 25.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Fringe benefits. 25.525 Section 25.525... Employment in Education Programs or Activities Prohibited § 25.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  16. 49 CFR 25.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Fringe benefits. 25.525 Section 25.525... Employment in Education Programs or Activities Prohibited § 25.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  17. 42 CFR 409.100 - To whom payment is made.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... insurance benefits only to a participating provider. (2) For home health services (including medical... PROGRAM HOSPITAL INSURANCE BENEFITS Payment of Hospital Insurance Benefits § 409.100 To whom payment is... or consulting arrangement). (b) Exceptions. Medicare may pay hospital insurance benefits as follows...

  18. Case outsourcing medical device reprocessing.

    PubMed

    Haley, Deborah

    2004-04-01

    IN THE INTEREST OF SAVING MONEY, many hospitals are considering extending the life of some single-use medical devices by using medical device reprocessing programs. FACILITIES OFTEN LACK the resources required to meet the US Food and Drug Administration's tough quality assurance standards. BY OUTSOURCING, hospitals can reap the benefits of medical device reprocessing without assuming additional staffing and compliance burdens. OUTSOURCING enables hospitals to implement a medical device reprocessing program quickly, with no capital investment and minimal effort.

  19. A marketing plan for health care in the financial district of San Francisco.

    PubMed

    Evans, S

    1987-01-01

    The development of a corporate health marketing program for the Medical Pavilion was based on three assumptions. 1. Medical Pavilion will contribute positively to health care cost containment for employers by providing convenient, quality medical care which will help to reduce employee time lost from work due to physician visits, and through health screening, early diagnosis, and out-patient procedures, decrease unnecessary hospitalization. 2. The level of awareness among chief executive officers, benefits directors, corporate medical directors, and employees will be positively related to utilization of health services at the Medical Pavilion. 3. The Medical Pavilion will be organized on a private practice model; although special programs related to employer coverage and specific benefits may be considered separately. The recommended goals of the corporate health program of the Medical Pavilion were as follows: 1. To develop demographic profiles based on current utilization of medical services in a random sample to corporations in the Financial District. 2. To design a survey of corporate leadership to determine a needs assessment strategy for the development of preventive health services programs to be offered at the Medical Pavilion. 3. To select an advertising and public relations agency; and determine the marketing bridges, for the first year and the following five year period. 4. To evaluate effectiveness of the corporate health marketing plan referral data collected through the Management Information System to be established at the Medical Pavilion.

  20. [Social impact of screening and of medical surveillance on people exposed to asbestos].

    PubMed

    Bergeret, A; Terrasson De Fougères, G

    1999-12-01

    A medical screening program has collective and individual impact. The collective benefit of medical screening for people exposed to asbestos would be financial (better compensation of occupational diseases related to asbestos). The cost of compensation would be attributed to the special assurance fund for occupational diseases. A medical screening of asbestos diseases would set an example for other Public health problems. It would be important for admission of social damage for the French nation. For individuals, social benefits would be better (compensation during work stop and annuities). But screening can have a negative psychological impact for asymptomatic persons. Persons exposed to asbestos and patients with asbestos diseases are able to quit their job for anticipated retirement. Is it a benefit for patients with mesothelioma or lung cancer? It is a very important benefit for asbestosis. The risk is to change the objective of medical screening into a social screening. The financial and medical benefits of screening for hyaline plaques is very poor. Awarding social damage is important for individuals.

  1. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services...

  2. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services...

  3. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services...

  4. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services...

  5. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services...

  6. 5 CFR 831.106 - Disclosure of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., health benefits and life insurance eligibility, medical records supporting disability claims, and designations of beneficiaries. (iv) Claims review and correspondence files pertaining to benefits under the Federal Employees Health Benefits Program. (v) Suitability determination files on applicants for Federal...

  7. Internships | NREL

    Science.gov Websites

    Apply here Contact: nrel.education@nrel.gov Benefits and Opportunities at a Glance NREL Undergraduate NREL's sponsored internships. Learn more Benefits Option to enroll in medical benefits (if working 30 undergraduate education and research program. Learn more SULI Benefits Salary - $625 per week Regional

  8. 10 CFR 1042.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Fringe benefits. 1042.525 Section 1042.525 Energy... Education Programs or Activities Prohibited § 1042.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life...

  9. 22 CFR 146.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Fringe benefits. 146.525 Section 146.525... Employment in Education Programs or Activities Prohibited § 146.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  10. 44 CFR 19.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  11. 22 CFR 146.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Fringe benefits. 146.525 Section 146.525... Employment in Education Programs or Activities Prohibited § 146.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  12. 22 CFR 229.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Fringe benefits. 229.525 Section 229.525... Employment in Education Programs or Activities Prohibited § 229.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  13. 22 CFR 229.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Fringe benefits. 229.525 Section 229.525... Employment in Education Programs or Activities Prohibited § 229.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  14. 44 CFR 19.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  15. 44 CFR 19.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  16. 28 CFR 54.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Fringe benefits. 54.525 Section 54.525... in Employment in Education Programs or Activities Prohibited § 54.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  17. 10 CFR 1042.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Fringe benefits. 1042.525 Section 1042.525 Energy... Education Programs or Activities Prohibited § 1042.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life...

  18. 22 CFR 229.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fringe benefits. 229.525 Section 229.525... Employment in Education Programs or Activities Prohibited § 229.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  19. 22 CFR 229.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Fringe benefits. 229.525 Section 229.525... Employment in Education Programs or Activities Prohibited § 229.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  20. 22 CFR 146.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Fringe benefits. 146.525 Section 146.525... Employment in Education Programs or Activities Prohibited § 146.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  1. 28 CFR 54.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Fringe benefits. 54.525 Section 54.525... in Employment in Education Programs or Activities Prohibited § 54.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  2. 44 CFR 19.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  3. 28 CFR 54.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Fringe benefits. 54.525 Section 54.525... in Employment in Education Programs or Activities Prohibited § 54.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  4. 22 CFR 146.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fringe benefits. 146.525 Section 146.525... Employment in Education Programs or Activities Prohibited § 146.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  5. 22 CFR 229.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Fringe benefits. 229.525 Section 229.525... Employment in Education Programs or Activities Prohibited § 229.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  6. 28 CFR 54.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Fringe benefits. 54.525 Section 54.525... in Employment in Education Programs or Activities Prohibited § 54.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  7. 10 CFR 1042.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Fringe benefits. 1042.525 Section 1042.525 Energy... Education Programs or Activities Prohibited § 1042.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life...

  8. 22 CFR 146.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Fringe benefits. 146.525 Section 146.525... Employment in Education Programs or Activities Prohibited § 146.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  9. 44 CFR 19.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  10. 10 CFR 1042.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Fringe benefits. 1042.525 Section 1042.525 Energy... Education Programs or Activities Prohibited § 1042.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life...

  11. 10 CFR 1042.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Fringe benefits. 1042.525 Section 1042.525 Energy... Education Programs or Activities Prohibited § 1042.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life...

  12. 38 CFR 17.272 - Benefits limitations/exclusions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MEDICAL Civilian Health and Medical Program of the Department of Veterans Affairs (champva)-Medical Care... required to provide necessary medical care. (7) Services and supplies related to an inpatient admission... center (RTC). (10) Custodial care. (11) Inpatient stays primarily for domiciliary care purposes. (12...

  13. 38 CFR 17.272 - Benefits limitations/exclusions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MEDICAL Civilian Health and Medical Program of the Department of Veterans Affairs (champva)-Medical Care... required to provide necessary medical care. (7) Services and supplies related to an inpatient admission... center (RTC). (10) Custodial care. (11) Inpatient stays primarily for domiciliary care purposes. (12...

  14. Teaching medical students how to teach: a national survey of students-as-teachers programs in U.S. medical schools.

    PubMed

    Soriano, Rainier P; Blatt, Benjamin; Coplit, Lisa; CichoskiKelly, Eileen; Kosowicz, Lynn; Newman, Linnie; Pasquale, Susan J; Pretorius, Richard; Rosen, Jonathan M; Saks, Norma S; Greenberg, Larrie

    2010-11-01

    A number of U.S. medical schools started offering formal students-as-teachers (SAT) training programs to assist medical students in their roles as future teachers. The authors report results of a national survey of such programs in the United States. In 2008, a 23-item survey was sent to 130 MD-granting U.S. schools. Responses to selective choice questions were quantitatively analyzed. Open-ended questions about benefits and barriers to SAT programs were given qualitative analyses. Ninety-nine U.S. schools responded. All used their medical students as teachers, but only 44% offered a formal SAT program. Most (95%) offered formal programs in the senior year. Common teaching strategies included small-group work, lectures, role-playing, and direct observation. Common learning content areas were small-group facilitation, feedback, adult learning principles, and clinical skills teaching. Assessment methods included evaluations from student-learners (72%) and direct observation/videotaping (59%). From the qualitative analysis, benefit themes included development of future physician-educators, enhancement of learning, and teaching assistance for faculty. Obstacles were competition with other educational demands, difficulty in faculty recruitment/retention, and difficulty in convincing others of program value. Formal SAT programs exist for 43 of 99 U.S. medical school respondents. Such programs should be instituted in all schools that use their students as teachers. National teaching competencies, best curriculum methods, and best methods to conduct skills reinforcement need to be determined. Finally, the SAT programs' impacts on patient care, on selection decisions of residency directors, and on residents' teaching effectiveness are areas for future research.

  15. Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

    PubMed

    Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

    2015-01-01

    Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities. Challenges noted by PRIME-US students and non-PRIME students, faculty, and staff included the stress of additional workload, perceived inequities in student educational opportunities, and some negative comments from physicians in other specialties regarding primary care careers. Over the first 4 years of the program, PRIME-US students and non-PRIME students, faculty, and staff experienced educational benefits consistent with the intended program goals. Long-term evaluation is needed to examine the participants' medical careers and impacts on California's healthcare workforce and patient outcomes. Attention should also be paid to the challenges of implementing new medical education enrichment programs.

  16. 6 CFR 17.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 6 Domestic Security 1 2014-01-01 2014-01-01 false Fringe benefits. 17.525 Section 17.525 Domestic... in Employment in Education Programs or Activities Prohibited § 17.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, the term fringe benefits means any medical...

  17. 40 CFR 5.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Fringe benefits. 5.525 Section 5.525... in Employment in Education Programs or Activities Prohibited § 5.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  18. 41 CFR 101-4.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Fringe benefits. 101-4... in Employment in Education Programs or Activities Prohibited § 101-4.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  19. 43 CFR 41.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Fringe benefits. 41.525 Section 41.525... in Employment in Education Programs or Activities Prohibited § 41.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  20. 43 CFR 41.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Fringe benefits. 41.525 Section 41.525... in Employment in Education Programs or Activities Prohibited § 41.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  1. 14 CFR 1253.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Fringe benefits. 1253.525 Section 1253.525... in Employment in Education Programs or Activities Prohibited § 1253.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  2. 41 CFR 101-4.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Fringe benefits. 101-4... in Employment in Education Programs or Activities Prohibited § 101-4.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  3. 40 CFR 5.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Fringe benefits. 5.525 Section 5.525... in Employment in Education Programs or Activities Prohibited § 5.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  4. 41 CFR 101-4.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Fringe benefits. 101-4... in Employment in Education Programs or Activities Prohibited § 101-4.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  5. 41 CFR 101-4.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Fringe benefits. 101-4... in Employment in Education Programs or Activities Prohibited § 101-4.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  6. 14 CFR 1253.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Fringe benefits. 1253.525 Section 1253.525... in Employment in Education Programs or Activities Prohibited § 1253.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  7. 6 CFR 17.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Fringe benefits. 17.525 Section 17.525 Domestic... in Employment in Education Programs or Activities Prohibited § 17.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, the term fringe benefits means any medical...

  8. 14 CFR 1253.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Fringe benefits. 1253.525 Section 1253.525... in Employment in Education Programs or Activities Prohibited § 1253.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  9. 43 CFR 41.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Fringe benefits. 41.525 Section 41.525... in Employment in Education Programs or Activities Prohibited § 41.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  10. 14 CFR 1253.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Fringe benefits. 1253.525 Section 1253.525... in Employment in Education Programs or Activities Prohibited § 1253.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  11. 40 CFR 5.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Fringe benefits. 5.525 Section 5.525... in Employment in Education Programs or Activities Prohibited § 5.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  12. 6 CFR 17.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 6 Domestic Security 1 2013-01-01 2013-01-01 false Fringe benefits. 17.525 Section 17.525 Domestic... in Employment in Education Programs or Activities Prohibited § 17.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, the term fringe benefits means any medical...

  13. 6 CFR 17.525 - Fringe benefits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Fringe benefits. 17.525 Section 17.525 Domestic... in Employment in Education Programs or Activities Prohibited § 17.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, the term fringe benefits means any medical...

  14. 6 CFR 17.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 6 Domestic Security 1 2012-01-01 2012-01-01 false Fringe benefits. 17.525 Section 17.525 Domestic... in Employment in Education Programs or Activities Prohibited § 17.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, the term fringe benefits means any medical...

  15. 43 CFR 41.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Fringe benefits. 41.525 Section 41.525... in Employment in Education Programs or Activities Prohibited § 41.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  16. 41 CFR 101-4.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Fringe benefits. 101-4... in Employment in Education Programs or Activities Prohibited § 101-4.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  17. 43 CFR 41.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Fringe benefits. 41.525 Section 41.525... in Employment in Education Programs or Activities Prohibited § 41.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  18. 40 CFR 5.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Fringe benefits. 5.525 Section 5.525... in Employment in Education Programs or Activities Prohibited § 5.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  19. Carrots and sticks: impact of an incentive/disincentive employee flexible credit benefit plan on health status and medical costs.

    PubMed

    Stein, A D; Karel, T; Zuidema, R

    1999-01-01

    Employee wellness programs aim to assist in controlling employer costs by improving the health status and fitness of employees, potentially increasing productivity, decreasing absenteeism, and reducing medical claims. Most such programs offer no disincentive for nonparticipation. We evaluated an incentive/disincentive program initiated by a large teaching hospital in western Michigan. The HealthPlus Health Quotient program is an incentive/disincentive approach to health promotion. The employer's contribution to the cafeteria plan benefit package is adjusted based on results of an annual appraisal of serum cholesterol, blood pressure, tobacco use, body fat, physical fitness, motor vehicle safety, nutrition, and alcohol consumption. The adjustment (health quotient [HQ]) can range from -$25 to +$25 per pay period. We examined whether appraised health improved between 1993 and 1996 and whether the HQ predicted medical claims. Mean HQ increased slightly (+$0.47 per pay period in 1993 to +$0.89 per pay period in 1996). Individuals with HQs of less than -$10 per pay period incurred approximately twice the medical claims of the other groups (test for linear trend, p = .003). After adjustment, medical claims of employees in the worst category (HQ < -$10 per pay period) were $1078 (95% confidence interval $429-$1728) greater than those for the neutral (HQ between -$2 and +$2 per pay period) category. A decrease in HQ of at least $6 per pay period from 1993 to 1995 was associated with $956 (95% confidence interval $264-$1647) greater costs in 1996 than was a stable HQ. The HealthPlus Health Quotient program is starting to yield benefits. Most employees are impacted minimally, but savings are accruing to the employer from reductions in medical claims paid and in days lost to illness and disability.

  20. The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

    ERIC Educational Resources Information Center

    Singleton, Perry

    2009-01-01

    I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

  1. Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2016. Final rule.

    PubMed

    2015-02-27

    This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics.

  2. 20 CFR 30.701 - How are medical bills to be submitted?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

  3. 20 CFR 30.701 - How are medical bills to be submitted?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

  4. 20 CFR 30.701 - How are medical bills to be submitted?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

  5. 20 CFR 30.701 - How are medical bills to be submitted?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

  6. 20 CFR 30.701 - How are medical bills to be submitted?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

  7. Putting a premium on medical staffs. A novel way to insure physician liability (and loyalty).

    PubMed

    Jones, T M; O'Hare, P K

    1989-05-01

    The physician malpractice insurance crisis is having an adverse financial impact on both hospitals and their medical staffs. Innovative hospitals are exploring ways to create insurance arrangements to cover the professional liability of their medical staffs. Hospital risk managers often have theorized that if the same insurer covered both hospitals and their staff physicians, providers and their patients would benefit. These programs--often referred to as "channeling" or "channeled programs"--use a common risk management program, common claims administration, and a common claims defense for insured hospitals and their medical staffs, reducing costs, unfavorable verdicts, and, thus, premiums. Unfortunately only a few commercial carriers now offer such a program. Some hospitals and systems have therefore turned to "captive" insurance companies to provide the benefits of a channeled program. Hospitals or systems and their medical staffs can establish a captive (i.e., a controlled insurance company designed to insure its owners and their affiliates) either offshore (typically in a tax-free jurisdiction such as the Cayman Islands, Barbados, or Bermuda) or onshore (typically in a state with facilitating legislation). The Tax Reform Act of 1986, together with the Liability Risk Retention Act of 1986, generally tips the regulatory balance in favor of onshore captives by allowing these entities to operate as risk retention groups (RRGs).

  8. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

  9. 15 CFR 8a.525 - Fringe benefits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Fringe benefits. 8a.525 Section 8a.525... in Employment in Education Programs or Activities Prohibited § 8a.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  10. 15 CFR 8a.525 - Fringe benefits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Fringe benefits. 8a.525 Section 8a.525... in Employment in Education Programs or Activities Prohibited § 8a.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  11. 15 CFR 8a.525 - Fringe benefits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Fringe benefits. 8a.525 Section 8a.525... in Employment in Education Programs or Activities Prohibited § 8a.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  12. 15 CFR 8a.525 - Fringe benefits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Fringe benefits. 8a.525 Section 8a.525... in Employment in Education Programs or Activities Prohibited § 8a.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital...

  13. 49 CFR 25.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and services. Subject to § 25.235(d), in providing a medical, hospital, accident, or life insurance benefit...

  14. 10 CFR 1042.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services. 1042.440... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service...

  15. 5 CFR 890.702 - Payment to any licensed practitioner.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

  16. 5 CFR 890.702 - Payment to any licensed practitioner.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

  17. 5 CFR 890.702 - Payment to any licensed practitioner.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

  18. 5 CFR 890.702 - Payment to any licensed practitioner.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Benefits in Medically Underserved Areas..., if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost...

  19. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  20. 28 CFR 345.65 - Inmate medical work limitation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Inmate medical work limitation. 345.65... PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.65 Inmate medical work limitation. In addition to any prior illnesses or injuries, medical limitations also include any illness or...

  1. 28 CFR 345.65 - Inmate medical work limitation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Inmate medical work limitation. 345.65... PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.65 Inmate medical work limitation. In addition to any prior illnesses or injuries, medical limitations also include any illness or...

  2. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  3. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  4. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  5. 42 CFR 409.24 - Medical social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

  6. Implementation of a comprehensive pharmaceutical care program for an underserved population.

    PubMed

    Mascardo, Lisa A; Spading, Kimberly A; Abramowitz, Paul W

    2012-07-15

    The implementation of a prescription benefit program for low-income patients emphasizing clinical pharmacist services and strict formulary control is described, with a review of program expenditures and cost avoidance. In 2006, University of Iowa Hospitals and Clinics (UIHC) launched a program to provide a limited prescription benefit to indigent patients under the IowaCare Medicaid demonstration waiver. Sudden dramatic growth in IowaCare enrollment, combined with sharp budget cuts, forced UIHC pharmacy leaders to implement creative cost-control strategies: (1) the establishment of an ambulatory care clinic staffed by a clinical pharmacy specialist, (2) increased reliance on an almost exclusively generic formulary, (3) collaboration with social services staff to help secure medication assistance for patients requiring brand-name drugs, (4) optimized purchasing through the federal 340B Drug Pricing Program, and (5) the imposition of medication copayments and mailing fees for prescription refills. Now in its seventh year, the UIHC pharmacy program has expanded indigent patients' access to pharmaceutical care services while reducing their use of hospital and emergency room services and lowering program medication costs by an estimated 50% (from $2.6 million in fiscal year 2009 to $1.3 million in fiscal year 2010). The UIHC ambulatory care pharmacy implemented a prescription program in collaboration with social service workers to address the medication needs of the state's low-income and uninsured patients in a fiscally responsible manner by managing purchasing contracts, revising a generic formulary, implementing copayments and mailing fees, and reviewing medication profiles.

  7. Coordination of health coverage for Medicare enrollees: living with HIV/AIDS in California.

    PubMed

    Eichner, J; Kahn, J G

    2001-08-01

    Because Medicare does not cover a large part of the health care that its enrollees living with HIV/AIDS require, they need other coverage to supplement Medicare. Medicaid is a major source of that supplemental coverage. In California, Medicare enrollees with HIV/AIDS who were also enrolled in Medi-Cal (California's Medicaid program) had total payments from both programs of $177 million, or an average of $28,956 per person in the fee-for-service-system in 1998. Of that total, Medicare paid for 38 percent, mainly for inpatient visits and ambulatory care, while Medi-Cal paid 62 percent, mainly for prescription drugs. For these dual enrollees, many of Medicare's benefit gaps--including a large share of prescription drugs, nursing facility services and home care--are being filled by Medi-Cal. Data in this Medicare Brief indicate that the incremental cost to the federal government of filling gaps in the Medicare benefits package would be considerably less than the full cost of the additional benefits. Through Medicaid and other programs, the federal government is already paying a substantial part of public program expenditures for dual enrollees with HIV/AIDS. Other issues to consider are how the dual Medicare-Medicaid funding streams affect the programs' cost efficiency, and from the perspective of Medicare enrollees and providers, how well the dual programs coordinate to meet the needs of people with HIV/AIDS and other chronic conditions.

  8. Charitable remainder trust strategies for health care organizations.

    PubMed

    Goeppele, H A

    1998-01-01

    While availability of tax-exempt financing and exemption from income and property taxes have been viewed as the primary benefits of tax exemption, an underutilized benefit is the eligibility to receive charitable contributions. This article, using acquisition of a medical practice as an example, demonstrates one way planned giving can benefit both the health care organization and its physicians, and how such giving programs can be tailored to individual donor needs. Rather than selling a medical practice directly to a hospital, both the physician and the tax-exempt health care organization realize greater benefits through the illustrated charitable remainder trust strategy.

  9. 76 FR 9646 - Copayments for Medications After June 30, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ...; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical Care Benefits; 64.010, Veterans Nursing... Prosthetic Appliances; 64.014, Veterans State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64...; Medical research; Mental health programs; Nursing homes; Philippines, Reporting and recordkeeping...

  10. Emergency medical service providers' role in the early heart attack care program: prevention and stratification strategies.

    PubMed

    MacDonald, G S; Steiner, S R

    1997-01-01

    Emergency Medical Services-Early Heart Attack Care (EMS-EHAC) is a community-based program where paramedics increase the consumer's awareness about early chest pain symptom recognition. EMS-EHAC prevention, along with seamless chest pain care (between the paramedic and chest pain emergency department) can be the basis for an outcome-based study to examine the impact of advanced life support EMS. Studies that show the impact of care given by paramedics on the outcome of patient care must be designed to demonstrate the value and the cost benefit of providing advanced life support (ALS). Third party payers are going to examine if there are significant quality differences between ALS and basic life support (BLS) services. If significant benefits of ALS care cannot be demonstrated, the cost differences could potentially place the future of advanced life support paramedic programs in jeopardy. A positive outcome resulting in a lower acute cardiac event, and the realization of the cost benefits from the EMS-EHAC program could be utilized by EMS management to justify or expand advanced life support programs.

  11. Correlates of Physician Retention at Tripler Army Medical Center

    DTIC Science & Technology

    1991-12-01

    benefits each program produces, the explicit and implicit values of those benefits, and the program’s direct and indirect costs. For the most part, there...data is also remarkably accurate (within sampling error). A survey of a particular group can give a very accurate picture of the groups values , beliefs...opportunity to teach and administer training programs. - Military medicine is exciting, challenging, and varied. Because of the value of written comments

  12. Marketing Program: Tripler Army Medical Center, Hawaii

    DTIC Science & Technology

    1990-12-01

    advertising agency. Good deeds are only effective when accompanied by good words. Thp qrimarv bEnefit of r P-,essful marketing program are improved...professional advertising agency. Good deeds are only effective when accompanied by good words. The primary benefits of a successful marketing program are... market plan itself. MARKET PLAN A market plan is not just advertising and gimmicks. It is only of value if it is a means of assisting people to satisfy

  13. Medicaid Eligibility

    MedlinePlus

    ... recover for other Medicaid benefits, except for Medicare cost-sharing benefits paid on behalf of Medicare Savings Program beneficiaries. Third Party Liability: Third Party Liability (TPL) refers to third ... or all of the cost of medical services provided to a Medicaid beneficiary. ...

  14. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    PubMed

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  15. Comparison of Drug Benefits Provided by Veterans Affairs Canada and the Canadian Forces Health Services Group.

    PubMed

    Chow, Matthew; Wicks, Charles J; Ma, Janice; Grenier, Sylvain

    2017-05-23

    Drug benefits are provided at public expense to all actively serving Canadian Armed Forces (CAF) personnel, with ongoing drug coverage offered by Veterans Affairs Canada (VAC) for selected conditions following termination of employment. Differences in drug coverage between these programs could introduce risks for treatment disruption. Work was undertaken to establish a process that would allow systematic comparison of the entire VAC and CAF formularies, and to identify and explain discordant listings in 14 therapeutic categories that pose risk of adverse outcomes with sudden treatment interruption. Lists of medications were created for each program, including regular benefit and restricted use drugs, using files obtained from the claims processor in January 2015. Products were coded using the Anatomic-Therapeutic-Chemical (ATC) system. Degree of alignment within therapeutic categories was assessed based on the percentage of fifth-level ATCs that were covered in common. Discordantly listed drugs in 14 categories of concern were reviewed to identify similarities in product characteristics. A total of 1124 medications were identified in 80 therapeutic categories. Coverage of medications was identical in 11 categories, and overall, almost three-quarters of identified drugs (73.4%, n = 825) were covered in common by both plans. Many discordant listings reflected known differences in the programs' operating procedures. A number of discrepancies were also identified in newer therapeutic categories. There is significant overlap in the medications covered by the CAF and VAC drug benefit programs. Application of the ATC coding system allowed for discrepancies to be readily identified across the entire formulary, and in specific therapeutic categories of concern. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  16. Asthma medication adherence among urban teens: a qualitative analysis of barriers, facilitators and experiences with school-based care.

    PubMed

    Blaakman, Susan W; Cohen, Alyssa; Fagnano, Maria; Halterman, Jill S

    2014-06-01

    Teens with persistent asthma do not always receive daily preventive medications or do not take them as prescribed, despite established clinical guidelines. The purpose of this study was to understand urban teens' experiences with asthma management, preventive medication adherence and participation in a school-based intervention. Teens (12-15 years) with persistent asthma, and prescribed preventive medication, participated in a pilot study that included daily observed medication therapy at school and motivational interviewing. Semi-structured interviews occurred at final survey. Qualitative content analysis enabled data coding to identify themes. Themes were classified as "general asthma management" or "program-specific." For general management, routines were important, while hurrying interfered with taking medications. Forgetfulness was most commonly linked to medication nonadherence. Competing demands related to school preparedness and social priorities were barriers to medication use. Independence with medications was associated with several benefits (e.g. avoiding parental nagging and feeling responsible/mature). Program-specific experiences varied. Half of teens reported positive rapport with their school nurse, while a few felt that their nurse was dismissive. Unexpected benefits and barriers within the school structure included perceptions about leaving the classroom, the distance to the nurse's office, the necessity of hall passes and morning school routines. Importantly, many teens connected daily medication use with fewer asthma symptoms, incenting continued adherence. Teens with asthma benefit from adherence to preventive medications but encounter numerous barriers to proper use. Interventions to improve adherence must accommodate school demands and unique teen priorities. The school nurse's role as an ally may support teens' transition to medication independence.

  17. Data warehousing in disease management programs.

    PubMed

    Ramick, D C

    2001-01-01

    Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.

  18. Cost-benefit analysis on the use of telemedicine program of Kosova for continuous medical education: a sustainable and efficient model to rebuild medical systems in developing countries.

    PubMed

    Latifi, Kalterina; Lecaj, Ismet; Bekteshi, Flamur; Dasho, Erion; Doarn, Charles R; Merrell, Ronald C; Latifi, Rifat

    2011-12-01

    The Ministry of Health of Kosova has recently announced the Telemedicine Program of Kosova (TMPK) as the official institution responsible for managing and coordinating the nation's Long-Distance Continuous Medical Education (CME) program. There are a lack of studies on cost-benefit analysis (CBA) and other economic evaluations of telemedicine programs (TMP), in particular the financial value of CME offered through such a service. In addition, there is lack of prospective studies on Monitoring & Evaluation (M&E) of TMP. The goal of this study was to conduct a retrospective CBA of prospective data collected at TMPK over a 5-year period (2005-2010) in order to determine the cost benefit as opposed to the alternative method of delivery of this model for developing countries whose healthcare systems are in disarray. We reviewed data on the number of participants in virtual lectures both at the Telemedicine Center of Kosova (TCK) as well as the number of participants at six Regional Telemedicine Centers throughout Kosova, the number of lectures broadcasted, the clinical cases reviewed and transmitted for international consultation, and other quantitative data. Only in 2009, approximately 2,000 CME certificates were awarded to physicians and nurses of Kosova, 18 international teleconsultations were conducted, 138 videoconferences, lectures, and seminars were held, and there were over 9,000 visitors at the TCK e-library. Data analysis shows that the TMPK has been an efficient mechanism for CME and sustainable model for rebuilding the medical system. TMPK has been successful in offering physicians, nurses, and other medical professions access to electronic information. TMP is an efficient mechanism to ensure CME and rebuilding medical systems in developing countries. There is a need for prospective CBA of any TMP and the establishment of M&E programs in any future telemedicine initiatives in developing countries.

  19. Gait or Walking Problems

    MedlinePlus

    ... be frank and upfront with your PT about cost, payment plans, and the benefits you can expect from therapy. Weakness Muscle weakness ... medical equipment) may be available through private or public insurance, community ... benefits if you have done military service. Reimbursement programs ...

  20. 78 FR 50359 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed...

  1. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... in the 80000 series of the Current Procedural Terminology published by the American Medical... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

  2. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Procedural Terminology published by the American Medical Association. (vii) Diagnostic tests performed by a... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

  3. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Procedural Terminology published by the American Medical Association. (vii) Diagnostic tests performed by a... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

  4. 28 CFR 345.65 - Inmate medical work limitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate medical work limitation. 345.65... PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.65 Inmate medical work... injury sustained by an inmate which necessitates removing the ill worker from an FPI work assignment. If...

  5. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...

  6. 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

  7. 32 CFR 161.16 - Benefits for transitional health care members and dependents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... members and dependents. This section shows the benefits for THC members and their eligible dependents. THC... Defense Authorization Act of for Fiscal Year 2005” made the THC program permanent and made the medical... years' commissary and exchange benefits to THC members. Section 734 of Public Law 110-417, “National...

  8. Five features of value-based insurance design plans were associated with higher rates of medication adherence.

    PubMed

    Choudhry, Niteesh K; Fischer, Michael A; Smith, Benjamin F; Brill, Gregory; Girdish, Charmaine; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

    2014-03-01

    Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

  9. Cost-benefit analysis of childhood asthma management through school-based clinic programs.

    PubMed

    Tai, Teresa; Bame, Sherry I

    2011-04-01

    Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

  10. 5 CFR 870.1103 - Election procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... require a medical examination before making a decision. In these cases, OFEGLI is financially responsible... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Living Benefits § 870.1103 Election procedures. (a) The insured individual must request information on Living Benefits and an application form...

  11. Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

    PubMed Central

    Stillwaggon, Eileen; Sawers, Larry; Rout, Jonathan; Addiss, David; Fox, LeAnne

    2016-01-01

    Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense. PMID:27573626

  12. 42 CFR 423.150 - Scope.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement... utilization management programs, quality assurance measures and systems, and medication therapy management... organization (QIO) activities. (f) Compliance deemed on the basis of accreditation. (g) Accreditation...

  13. 42 CFR 423.150 - Scope.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement... utilization management programs, quality assurance measures and systems, and medication therapy management... organization (QIO) activities. (f) Compliance deemed on the basis of accreditation. (g) Accreditation...

  14. 42 CFR 423.150 - Scope.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements... utilization management programs, quality assurance measures and systems, and medication therapy management... organization (QIO) activities. (f) Compliance deemed on the basis of accreditation. (g) Accreditation...

  15. 42 CFR 423.150 - Scope.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement... utilization management programs, quality assurance measures and systems, and medication therapy management... organization (QIO) activities. (f) Compliance deemed on the basis of accreditation. (g) Accreditation...

  16. Patient financial management as a community benefit.

    PubMed

    Shank, Corey

    2007-03-01

    Steps to take in documenting medical assistance advocacy include: Designating the program as a social service, not a collections effort. Detailing the program's practices. Identifying outcomes. Sharing the impact of advocacy efforts with the community.

  17. Understanding Rates of Marijuana Use and Consequences Among Adolescents in a Changing Legal Landscape.

    PubMed

    D'Amico, Elizabeth J; Tucker, Joan S; Pedersen, Eric R; Shih, Regina A

    2017-01-01

    There is not one answer to address whether marijuana use has increased, decreased, or stayed the same given changes in state legalization of medical and non-medical marijuana in the USA. Evidence suggests some health benefits for medical marijuana; however, initiation of marijuana use is a risk factor for developing problem cannabis use. Though use rates have remained stable over recent years, about one in three 10th graders report marijuana use, most adolescents do not view the drug as harmful, and over 650,000 youth aged 12 to 17 struggle with cannabis use disorder. Although the health benefits of medical marijuana are becoming better understood, more research is needed. Intervention and prevention programs must better address effects of marijuana, acknowledging that while there may be some benefits medically, marijuana use can affect functioning during adolescence when the brain is still developing.

  18. The Medical Home: Every Child Deserves One! Program Services Paper.

    ERIC Educational Resources Information Center

    Vitaglione, Tom

    Noting that health benefits for children should be one of the principal goals of comprehensive early childhood initiatives, this Smart Start brochure provides information on "medical homes" and their importance to the overall health of children; the brochure also describes community strategies to help promote a medical home for all…

  19. 76 FR 26147 - Caregivers Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-05

    ... VA's medical benefits package, which include but are not limited to ``noninstitutional geriatric...'s Physical Evaluation Board, and a date of medical discharge has been issued.'' This term is used to... will include evaluation of the eligible veteran's and caregiver's physical and emotional states...

  20. 75 FR 43178 - Medicare Program; Solicitation for Proposals for the Medicare Imaging Demonstration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ..., medical specialty societies, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, and... societies. The Centers for Medicare & Medicaid Services (CMS) worked with medical specialty societies and...

  1. Consumer perspectives of the Australian Home Medicines Review Program: benefits and barriers.

    PubMed

    White, Lesley; Klinner, Christiane; Carter, Stephen

    2012-01-01

    The Australian Home Medicines Review (HMR) is a free consumer service to assist individuals living at home to maximize the benefits of their medicine regimen and prevent medication-related problems. It consists of a pharmacist reviewing a person's medicines and collaborating with the general practitioner to optimize the individual's medicine management. The uptake of this service has remained below the projected use, although the program has shown to successfully identify medication-related problems and improve drug knowledge and adherence of the patient. This study investigates the perceived benefits and barriers of the patients regarding the HMR service who have used the service and who are eligible for it but have never used it. Consumer perceptions were drawn from 14 semistructured focus groups, with patients and carers belonging to the general HMR target population and consumer segments that have been postulated to be underrepresented with regard to this service. The major benefits reported were acquisition of medicine information, reassurance, feeling valued and cared for, and willingness to advocate medication changes to the general practitioner. Perceived barriers were concerns regarding upsetting the general practitioner, pride and independence, confidence issues with an unknown pharmacist, privacy and safety concerns regarding the home visit, and lack of information about the program. Participants agreed that the potential benefits of the service outweighed its potential barriers. It is expected that direct-to-consumer promotion of HMRs would increase the uptake of this valuable service. It would be necessary to ensure that the process and benefits of the service are communicated clearly and sensitively to eligible patients and their carers to obviate common consumer misconceptions and/or barriers regarding the HMR service. Furthermore, any direct-to-consumer promotion of the service must enable patient/carer self-identification of eligibility. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Work/training programs for international health science librarians in American medical school libraries.

    PubMed Central

    Brennen, P W; Gorman Sullivan, M B

    1989-01-01

    World understanding is more than a desirable goal today: it may be crucial to our survival. Many universities realize this and have in the past decade spent a great deal of time and money to ensure a steady flow of faculty and students between the U.S. and other countries. Librarians with faculty or academic status may benefit from promoting such relationships themselves. Job exchanges and training programs offer librarians in the United States the opportunity to become acquainted with their counterparts in other countries. Such programs enable librarians of various countries to become aware of one another's special needs and common problems, and allow them to share ideas and expertise. This paper presents an overview of international training programs for foreign librarians in the United States, focusing on programs for health sciences librarians in United States medical school libraries. Information is given on the availability and types of institutionally sponsored programs, as well as on MLA's Cunningham Fellowship Program. Some of the difficulties and the benefits of such programs are discussed. PMID:2720220

  3. Editorial comment on Malkin and Keane (2010).

    PubMed

    Voigt, Herbert F; Krishnan, Shankar M

    2010-07-01

    Malkin and Keane (Med Biol Eng Comput, 2010) take an innovative approach to determine if unused, broken medical and laboratory equipment could be repaired by volunteers with limited resources. Their positive results led them to suggest that resource-poor countries might benefit from an on-the-job educational program for local high school graduates. The program would train biomedical technician assistants (BTAs) who would repair medical devices and instrumentation and return them to service. This is a program worth pursuing in resource-poor countries.

  4. Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. Final rule.

    PubMed

    2016-03-08

    This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.

  5. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  6. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  7. Regulating compassion: an overview of Canada's federal medical cannabis policy and practice.

    PubMed

    Lucas, Philippe G

    2008-01-28

    In response to a number of court challenges brought forth by Canadian patients who demonstrated that they benefited from the use of medicinal cannabis but remained vulnerable to arrest and persecution as a result of its status as a controlled substance, in 1999 Canada became the second nation in the world to initiate a centralized medicinal cannabis program. Over its six years of existence, this controversial program has been found unconstitutional by a number of courts, and has faced criticism from the medical establishment, law enforcement, as well as the patient/participants themselves. This critical policy analysis is an evidence-based review of court decisions, government records, relevant studies and Access to Information Act data related to the three main facets of Health Canada's medicinal cannabis policy--the Marihuana Medical Access Division (MMAD); the Canadians Institute of Health Research Medical Marijuana Research Program; and the federal cannabis production and distribution program. This analysis also examines Canada's network of unregulated community-based dispensaries. There is a growing body of evidence that Health Canada's program is not meeting the needs of the nation's medical cannabis patient community and that the policies of the Marihuana Medical Access Division may be significantly limiting the potential individual and public health benefits achievable though the therapeutic use of cannabis. Canada's community-based dispensaries supply medical cannabis to a far greater number of patients than the MMAD, but their work is currently unregulated by any level of government, leaving these organizations and their clients vulnerable to arrest and prosecution. Any future success will depend on the government's ability to better assess and address the needs and legitimate concerns of end-users of this program, to promote and fund an expanded clinical research agenda, and to work in cooperation with community-based medical cannabis dispensaries in order to address the ongoing issue of safe and timely access to this herbal medicine.

  8. Regulating compassion: an overview of Canada's federal medical cannabis policy and practice

    PubMed Central

    Lucas, Philippe G

    2008-01-01

    Background In response to a number of court challenges brought forth by Canadian patients who demonstrated that they benefited from the use of medicinal cannabis but remained vulnerable to arrest and persecution as a result of its status as a controlled substance, in 1999 Canada became the second nation in the world to initiate a centralized medicinal cannabis program. Over its six years of existence, this controversial program has been found unconstitutional by a number of courts, and has faced criticism from the medical establishment, law enforcement, as well as the patient/participants themselves. Methods This critical policy analysis is an evidence-based review of court decisions, government records, relevant studies and Access to Information Act data related to the three main facets of Health Canada's medicinal cannabis policy – the Marihuana Medical Access Division (MMAD); the Canadians Institute of Health Research Medical Marijuana Research Program; and the federal cannabis production and distribution program. This analysis also examines Canada's network of unregulated community-based dispensaries. Results There is a growing body of evidence that Health Canada's program is not meeting the needs of the nation's medical cannabis patient community and that the policies of the Marihuana Medical Access Division may be significantly limiting the potential individual and public health benefits achievable though the therapeutic use of cannabis. Canada's community-based dispensaries supply medical cannabis to a far greater number of patients than the MMAD, but their work is currently unregulated by any level of government, leaving these organizations and their clients vulnerable to arrest and prosecution. Conclusion Any future success will depend on the government's ability to better assess and address the needs and legitimate concerns of end-users of this program, to promote and fund an expanded clinical research agenda, and to work in cooperation with community-based medical cannabis dispensaries in order to address the ongoing issue of safe and timely access to this herbal medicine. PMID:18226254

  9. 42 CFR 403.702 - Definitions and terms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... means individuals who are grounded in the religious beliefs of the RNHCI, trained and experienced in the... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions... for religious reasons. Excepted medical care means medical care that is received involuntarily or...

  10. 42 CFR 403.702 - Definitions and terms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... means individuals who are grounded in the religious beliefs of the RNHCI, trained and experienced in the... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions... for religious reasons. Excepted medical care means medical care that is received involuntarily or...

  11. 42 CFR 403.702 - Definitions and terms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... means individuals who are grounded in the religious beliefs of the RNHCI, trained and experienced in the... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions... for religious reasons. Excepted medical care means medical care that is received involuntarily or...

  12. 42 CFR 403.702 - Definitions and terms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... means individuals who are grounded in the religious beliefs of the RNHCI, trained and experienced in the... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions... for religious reasons. Excepted medical care means medical care that is received involuntarily or...

  13. 42 CFR 403.702 - Definitions and terms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... means individuals who are grounded in the religious beliefs of the RNHCI, trained and experienced in the... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions... for religious reasons. Excepted medical care means medical care that is received involuntarily or...

  14. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  15. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  16. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  17. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  18. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  19. Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999-2008.

    PubMed

    Kahende, Jennifer; Malarcher, Ann; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

    2017-01-01

    To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. We used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.

  20. Health Plans Respond to Parity: Managing Behavioral Health Care in the Federal Employees Health Benefits Program

    PubMed Central

    Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D

    2006-01-01

    The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy. PMID:16529573

  1. Health plans respond to parity: managing behavioral health care in the Federal Employees Health Benefits Program.

    PubMed

    Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D

    2006-01-01

    The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy.

  2. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  3. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  4. Cost-outcome analysis in injury prevention and control: eighty-four recent estimates for the United States.

    PubMed

    Miller, T R; Levy, D T

    2000-06-01

    The objectives of this study were to review cost-outcome analyses in injury prevention and control and estimate associated benefit-cost ratios and cost per quality-adjusted life-year. Medline and Internet search, bibliographic review, and federal agency contacts identified published and unpublished studies from 1987 to 1998 for the United States. Studies of low quality and analyses of occupational, air, rail, and water transport safety programs were excluded. Selected results were recomputed to increase discount rate, benefit category, and benefit estimate comparability and to update injury incidence rates. More than half of the 84 injury prevention measures reviewed yielded net societal cost savings. Twelve measures had costs that exceeded benefits. Of 33 road safety measures analyzed, 19 yielded net cost savings. Of 34 violence prevention approaches studied, 19 yielded net cost savings, whereas 8 had costs that exceeded benefits. Interventions with the highest benefit-cost ratios included juvenile delinquent therapy programs, fire-safe cigarettes, federal road and traffic safety program funding, lane markers painted on roads, post-mounted reflectors on hazardous curves, safety belts in front seats, safety belt laws with primary enforcement, child safety seats, child bicycle helmets, enforcement of laws against serving alcohol to the intoxicated, substance abuse treatment, brief medical interventions with heavy drinkers, and a comprehensive safe communities program in a low-income neighborhood. Studies of cost-saving measures do not exist for several injury types. Injury prevention often can reduce medical costs and save lives. Wider implementation of proven measures is warranted.

  5. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services... supplier of portable x-ray services, a nurse practitioner, or a clinical nurse specialist when he or she... electrophysiologic clinical specialist and permitted to provide the service under State law. (b) Supervising...

  6. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services... supplier of portable x-ray services, a nurse practitioner, or a clinical nurse specialist when he or she... electrophysiologic clinical specialist and permitted to provide the service under State law. (b) Supervising...

  7. 42 CFR 410.33 - Independent diagnostic testing facility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services... supplier of portable x-ray services, a nurse practitioner, or a clinical nurse specialist when he or she... electrophysiologic clinical specialist and permitted to provide the service under State law. (b) Supervising...

  8. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  9. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  10. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  11. 42 CFR 410.130 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions. 410.130 Section 410.130 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.130 Definitions. For the purposes...

  12. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ..., Health professions, Health records, Homeless, Mental health programs, Nursing homes, Reporting and... final rule adopts the proposed rule without changes. We received several comments urging VA to expand....009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care...

  13. A university-state-corporation partnership for providing correctional mental health services.

    PubMed

    Appelbaum, Kenneth L; Manning, Thomas D; Noonan, John D

    2002-02-01

    In September 1998 the University of Massachusetts Medical School, in partnership with a private vendor of correctional health care, began providing mental health services and other services to the Massachusetts Department of Correction. The experience with this partnership demonstrates that the involvement of a medical school with a correctional system has advantages for both. The correctional program benefits from enhanced quality of services, assistance with the recruitment and retention of skilled professionals, and expansion of training and continuing education programs. The medical school benefits by building its revenue base while providing a needed public service and through opportunities to extend its research and training activities. Successful collaboration requires that the medical school have an appreciation of security needs, a sensitivity to fiscal issues, and a readiness to work with inmates who have severe mental disorders and disruptive behavior. Correctional administrators, for their part, must support adequate treatment resources and must collaborate in the resolution of tensions between security and health care needs.

  14. 77 FR 39655 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: TRICARE Retail...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... Retail Pharmacy Program AGENCY: Office of the Secretary, Department of Defense (DoD). ACTION: Proposed...: TRICARE Retail Pharmacy Program on Tuesday, June 26, 2012 (77 FR 38019). This rule is being published to... changes to the TRICARE Pharmacy Benefits Program for the present time. DATES: The proposed rule published...

  15. A critical care helicopter system in trauma.

    PubMed Central

    Jacobs, L. M.; Bennett, B.

    1989-01-01

    Civilian helicopters and emergency medical services in the United States have been in existence for approximately 15 years. The rapid growth of this type of health care delivery coupled with an increasing number of accidents has prompted professional and lay scrutiny of these programs. Although they have a demonstrated history of benefit to patients, the type and severity of injuries to patients who are eligible for helicopter transportation need further definition. The composition of the medical crews and the benefits that particular crew members bring to the patients require ongoing evaluation. Significant questions regarding the number of pilots in a helicopter and in a program remain to be answered. This article reviews the role of emergency medical air transport services in providing care to trauma patients, staff training and evaluation, and safety criteria and offers recommendations to minimize risks to patients and crews. PMID:2695653

  16. Head and Neck Anatomy: Effect of Focussed Near-Peer Teaching on Anatomical Confidence in Undergraduate Medical Students.

    PubMed

    Morris, Simon; Osborne, Max Sallis; Bowyer, Duncan

    2018-05-11

    To assess the effect of near-peer head and neck anatomy teaching on undergraduates and to quantify the benefit from a focussed teaching course. Near-peer teaching involves colleagues within close seniority and age proximity teaching one another on a specified topic. Small group teaching sessions were delivered to medical students on 3 key areas of ENT anatomy. Participants were given a precourse and postcourse questionnaire to determine the benefit attained from the course. An undergraduate anatomy course taking place at the University of Birmingham Medical School. A total of 30 medical students: 15 preclinical (years 1-2) and 15 clinical (years 3-5) medical students participated from a single institution. A total of 71% of students expressed inadequate teaching of head and neck anatomy in undergraduate curriculum. All students (n = 30) expressed benefit from the course, however the patterns of learning differed: preclinical students showed a significant improvement in both their ability to name anatomical structures and their application (p < 0.05). Near-peer learning provides benefit to all medical undergraduates in the context of teaching anatomy which may make it a valuable teaching tool for the future of medical education. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. 42 CFR 410.160 - Part B annual deductible.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Part B annual deductible. 410.160 Section 410.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI Benefits § 410.160 Part B annual...

  18. 38 CFR 21.198 - “Discontinued” status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... personal or other problems; or (ii) Inability of the veteran to benefit from rehabilitation services... of entitlement. (4) Medical and related problems. A veteran's case will be discontinued and assigned... program because of a serious physical or emotional problem for an extended period; and (ii) VA medical...

  19. 38 CFR 21.198 - “Discontinued” status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... personal or other problems; or (ii) Inability of the veteran to benefit from rehabilitation services... of entitlement. (4) Medical and related problems. A veteran's case will be discontinued and assigned... program because of a serious physical or emotional problem for an extended period; and (ii) VA medical...

  20. 42 CFR 410.20 - Physicians' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Physicians' services. 410.20 Section 410.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.20 Physicians' services...

  1. 78 FR 78258 - Duty Periods for Establishing Eligibility for Health Care

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...; 64.009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.014, Veterans State Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical Resources; 64...; Health professions; Health records; Homeless; Mental health programs; Nursing homes; Philippines...

  2. Doing well by doing good. The 7 benefits of a meaningful corporate social responsibility program.

    PubMed

    Macdonald, Deborah

    2008-08-01

    You want your medical group to be a good community player--but you need to attract new patients, retain top staff and manage your bottom line. A corporate social responsibility program may be the shrewd solution.

  3. Evaluating the Investment Potential of HSAs in Benefit Programs.

    PubMed

    LaFleur, James; Magner, Liana; Domaszewicz, Sander

    Despite its complexities, the health savings account (HSA) is a powerful and growing element of the U.S. financial landscape. In the future, employers will likely be expected to provide tax-advantaged savings programs for employees' current and future medical expenses. This article discusses investment lineup issues that must be addressed in order to optimize HSAs to help participants achieve successful outcomes. Plan sponsors at the forefront of addressing these issues (and perhaps others) will be in a better position to help their employees maximize both the health benefits and the wealth benefits provided for a secure retirement.

  4. Comparative costs of family planning services and hospital-based maternity care in Turkey.

    PubMed

    Cakir, H V; Fabricant, S J; Kircalioğlu, F N

    1996-01-01

    The costs of running a recently established family planning program in the Turkish social security system were measured and compared with the costs of providing the medical services and nonmedical benefits for pregnant women. The undiscounted cost savings from averting pregnancy were estimated to exceed the program's recurrent costs by 17.6 to 1. Cost savings represent only 1 percent of all of the system's medical expenditures, but the family planning program is in an early stage, and potential savings could influence management decisionmaking regarding investments in specialized maternity hospitals.

  5. Project Salud. Final Report.

    ERIC Educational Resources Information Center

    Reyes, Richard H.

    A bilingual vocational training program was instituted to provide fifty-six Spanish- and Chinese-speaking students with a chance to acquire English language skills and training as medical clerks simultaneously. Community benefits expected and evident need in the area for bilingual medical-clerical employees led to the choice of this field. The…

  6. 29 CFR 825.700 - Interaction with employer's policies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...

  7. 29 CFR 825.700 - Interaction with employer's policies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...

  8. 29 CFR 825.700 - Interaction with employer's policies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...

  9. 29 CFR 825.700 - Interaction with employer's policies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...

  10. 78 FR 48366 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their... uniform within the following groups: dependents of active duty members in [[Page 48367

  11. 42 CFR 410.22 - Limitations on services of an optometrist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of an optometrist. 410.22 Section 410.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services...

  12. 42 CFR 410.25 - Limitations on services of a podiatrist.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of a podiatrist. 410.25 Section 410.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services...

  13. 20 CFR 30.710 - How are payments for inpatient medical services determined?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... services determined? 30.710 Section 30.710 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... services determined? (a) OWCP will pay for inpatient medical services according to pre-determined... discharges will be classified according to the DRGs prescribed by CMS in the form of the DRG Grouper software...

  14. This Good-Health Regimen Keeps Employes Fit--And School Budgets Trim.

    ERIC Educational Resources Information Center

    Collingwood, Thomas R.

    1984-01-01

    The Dallas Independent School District's staff stress reduction and health awareness program is described. The program features medical screening, fitness assessment, goal setting, exercise and nutrition prescriptions, health education, exercise classes, motivation, and feedback. Benefits reported include significantly improved health and attitude…

  15. 20 CFR 30.905 - How may an impairment evaluation be obtained?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How may an impairment evaluation be obtained... UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA Medical Evidence of Impairment § 30.905 How may an impairment evaluation...

  16. 20 CFR 30.906 - Who will pay for an impairment evaluation?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Who will pay for an impairment evaluation? 30... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA Medical Evidence of Impairment § 30.906 Who will pay for an impairment...

  17. 42 CFR 403.724 - Valid election requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... acceptance of nonexcepted medical treatment is inconsistent with his or her sincere religious beliefs. (iii... GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

  18. 42 CFR 403.724 - Valid election requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... acceptance of nonexcepted medical treatment is inconsistent with his or her sincere religious beliefs. (iii... GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

  19. 42 CFR 403.724 - Valid election requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... acceptance of nonexcepted medical treatment is inconsistent with his or her sincere religious beliefs. (iii... GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

  20. 42 CFR 403.724 - Valid election requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... acceptance of nonexcepted medical treatment is inconsistent with his or her sincere religious beliefs. (iii... GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

  1. 42 CFR 403.724 - Valid election requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... acceptance of nonexcepted medical treatment is inconsistent with his or her sincere religious beliefs. (iii... GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

  2. 42 CFR 410.145 - Requirements for entities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.145 Requirements for entities. (a) Deemed entities. (1) Except as...

  3. 42 CFR 410.145 - Requirements for entities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.145 Requirements for entities. (a) Deemed entities. (1) Except as...

  4. 42 CFR 410.145 - Requirements for entities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.145 Requirements for entities. (a) Deemed entities. (1) Except as...

  5. The potential exploitation of research participants in high income countries who lack access to health care

    PubMed Central

    Rid, Annette; Emanuel, Ezekiel; Wendler, David

    2016-01-01

    There are millions of individuals living in North America and the European Union who lack access to healthcare services. When these individuals participate in research, they are at increased risk of being exposed to the risks and burdens of clinical trials without realizing the benefits that result from them. The mechanisms that have been proposed to ensure that research participants in low‐ and middle‐income countries are not exploited are unlikely to protect participants in high‐income countries. The present manuscript argues that one way to address concerns about exploitation in high‐income countries would be to require sponsors to provide targeted benefits such as medical treatment during the trial, or the study drug after the trial. The latter could be achieved through extension studies, expanded access programs, or named‐patient programs. Sponsors also might provide non‐medical benefits, such as education or social support. Ethical and regulatory guidance should be revised to ensure that research participants in high‐income countries who lack access to healthcare services receive sufficient benefits. PMID:26743927

  6. The Tzu Chi Silent Mentor Program: Application of Buddhist Ethics to Teach Student Physicians Empathy, Compassion, and Self-Sacrifice.

    PubMed

    Santibañez, Scott; Boudreaux, Debra; Tseng, Guo-Fang; Konkel, Kimberly

    2016-10-01

    The Buddhist Tzu Chi Silent Mentor Program promotes the donation of one's body to science as a selfless act by appealing to the Buddhist ethics of compassion and self-sacrifice. Together, faculty, families, and donors help medical students to learn the technical, spiritual, emotional, and psychological aspects of medicine. Students assigned to each "Silent Mentor" visit the family to learn about the donor's life. They see photos and hear family members' stories. Afterwards, students write a brief biography of the donor which is posted on the program website, in the medical school, and on the dissection table. In this paper, we: (1) summarize the Silent Mentor Program; (2) describe findings from an assessment of medical students who recently completed a new version of the program in Malaysia; and (3) explore how healthcare settings could benefit from this innovative program.

  7. Description of a medical writing rotation for a postgraduate pharmacy residency program.

    PubMed

    Brown, Jamie N; Tiemann, Kelsey A; Ostroff, Jared L

    2014-04-01

    To provide a description of a pharmacy residency rotation dedicated to medical writing developed at a tertiary care academic medical center. Contribution to the medical literature is an important component of professional pharmacy practice, and there are many benefits seen by practitioners actively involved in scholarly activities. Residency programs have an opportunity to expand beyond the standard roles of postgraduate pharmacist training but rarely is there formal instruction on medical writing skills or are scholarship opportunities provided to residents. In order to address this deficiency, a residency program may consider the implementation of a formal Medical Writing rotation. This rotation is designed to introduce the resident to medical writing through active discussion on medical writing foundational topics, engage the resident in a collaborative review of a manuscript submitted to a peer-reviewed professional journal, and support the resident in the design and composition of manuscript of publishable quality. A structured Medical Writing rotation during a pharmacy resident's training can help develop the skills necessary to promote scholarly activities and foster resident interest in future pursuit of professional medical writing.

  8. Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008

    PubMed Central

    Kahende, Jennifer; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

    2017-01-01

    Objective To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. Methods We used the linked National Health Interview Survey (survey years 1995, 1997–2005) and the Medicaid Analytic eXtract files (1999–2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18–64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. Results In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. Conclusions Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999–2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation. PMID:28207744

  9. Medical students as hospice volunteers: the benefits to a hospice organization.

    PubMed

    Setla, Judith; Watson, Linda

    2006-01-01

    Hospices have regulatory requirements to provide volunteers who can assist families in a variety of ways. Hospices also typically provide large amounts of uncompensated education for students in various life sciences as part of their mission to promote quality care for those at the end-of-life. Separately, there is evidence of the educational benefits of exposing medical students to hospice patients and practices. But little has been published about the costs or benefits such teaching programs incur at the hospices involved. Hospice of Central New York developed a service-learning elective where first-year medical students were trained as volunteers. Despite initial concerns that significant staff time would be required to develop and maintain this elective, it appears to be an efficient way to satisfy the need for volunteers while contributing to the education of the involved students.

  10. Cost-Benefit Analysis of a Support Program for Nursing Staff.

    PubMed

    Moran, Dane; Wu, Albert W; Connors, Cheryl; Chappidi, Meera R; Sreedhara, Sushama K; Selter, Jessica H; Padula, William V

    2017-04-27

    A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital. Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program. The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

  11. Feasibility of a knowledge translation CME program: Courriels Cochrane.

    PubMed

    Pluye, Pierre; Grad, Roland; Granikov, Vera; Theriault, Guyléne; Frémont, Pierre; Burnand, Bernard; Mercer, Jay; Marlow, Bernard; Arroll, Bruce; Luconi, Francesca; Légaré, France; Labrecque, Michel; Ladouceur, Roger; Bouthillier, France; Sridhar, Soumya Bindiganavile; Moscovici, Jonathan

    2012-01-01

    Systematic literature reviews provide best evidence, but are underused by clinicians. Thus, integrating Cochrane reviews into continuing medical education (CME) is challenging. We designed a pilot CME program where summaries of Cochrane reviews (Courriels Cochrane) were disseminated by e-mail. Program participants automatically received CME credit for each Courriel Cochrane they rated. The feasibility of this program is reported (delivery, participation, and participant evaluation). We recruited French-speaking physicians through the Canadian Medical Association. Program delivery and participation were documented. Participants rated the informational value of Courriels Cochrane using the Information Assessment Method (IAM), which documented their reflective learning (relevance, cognitive impact, use for a patient, expected health benefits). IAM responses were aggregated and analyzed. The program was delivered as planned. Thirty Courriels Cochrane were delivered to 985 physicians, and 127 (12.9%) completed at least one IAM questionnaire. Out of 1109 Courriels Cochrane ratings, 973 (87.7%) conta-ined 1 or more types of positive cognitive impact, while 835 (75.3%) were clinically relevant. Participants reported the use of information for a patient and expected health benefits in 595 (53.7%) and 569 (51.3%) ratings, respectively. Program delivery required partnering with 5 organizations. Participants valued Courriels Cochrane. IAM ratings documented their reflective learning. The aggregation of IAM ratings documented 3 levels of CME outcomes: participation, learning, and performance. This evaluation study demonstrates the feasibility of the Courriels Cochrane as an approach to further disseminate Cochrane systematic literature reviews to clinicians and document self-reported knowledge translation associated with Cochrane reviews. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  12. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Refills of Maintenance Medications Through Military Treatment Facility Pharmacies or National Mail Order Pharmacy Program. Final rule.

    PubMed

    2016-11-02

    This final rule implements section 702 (c) of the Carl Levin and Howard P. "Buck" McKeon National Defense Authorization Act for Fiscal Year 2015 which states that beginning October 1, 2015, the pharmacy benefits program shall require eligible covered beneficiaries generally to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. An interim final rule is in effect. Section 702(c) of the National Defense Authorization Act for Fiscal Year 2015 also terminates the TRICARE For Life Pilot Program on September 30, 2015. The TRICARE For Life Pilot Program described in section 716(f) of the National Defense Authorization Act for Fiscal Year 2013, was a pilot program which began in March 2014 requiring TRICARE For Life beneficiaries to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. TRICARE for Life beneficiaries are those enrolled in the Medicare wraparound coverage option of the TRICARE program. This rule includes procedures to assist beneficiaries in transferring covered prescriptions to the mail order pharmacy program.

  13. Education and cost/benefit ratios in pulmonary patients.

    PubMed

    Folgering, H; Rooyakkers, J; Herwaarden, C

    1994-04-01

    The need for education of pulmonary patients stems from bad symptom perception, problems in using instruments for assessment of the severity of obstruction, problems in understanding and using (inhaled) medications, and lack in insight in the process of the underlying disease. Education of asthma patients usually leads to better management of the disease, less visits to doctors, less hospital admissions, and less days lost at school or at work. The use of medication often increases. Quality of life improves after an education program. The cost-benefit balance usually is favourable. The effects of education in COPD patients is equivocal. The costs usually are high; the benefits are substantially less than in the asthma group.

  14. 78 FR 34292 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Uniform Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their... uniform within the following groups: dependents of active duty members in pay grades of E-4 and below...

  15. 42 CFR 433.147 - Cooperation in establishing paternity and in obtaining medical support and payments and in...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE FISCAL ADMINISTRATION Third Party Liability Assignment of Rights to Benefits § 433.147 Cooperation in... must require the individual who assigns his or her rights to cooperate in— (1) Establishing paternity...

  16. 5 CFR 875.408 - What is the significance of incontestability?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SERVICE REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Coverage § 875.408 What is the... coverage is different from what is shown in your medical records. (2) If your coverage has been in force... is shown in your medical records and pertains to the condition for which benefits are sought. (3...

  17. 5 CFR 875.408 - What is the significance of incontestability?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SERVICE REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Coverage § 875.408 What is the... coverage is different from what is shown in your medical records. (2) If your coverage has been in force... is shown in your medical records and pertains to the condition for which benefits are sought. (3...

  18. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Retired Reserve for members of the Retired Reserve. Interim final rule with comment period.

    PubMed

    2010-08-06

    This interim final rule establishes requirements and procedures for implementation of TRICARE Retired Reserve. This interim final rule addresses provisions of the National Defense Authorization Act for Fiscal Year 2010 (NDAA-10). The purpose of this interim final rule is to establish the TRICARE Retired Reserve program that implements section 705 of the NDAA-10. Section 705 allows members of the Retired Reserve who are qualified for non-regular retirement, but are not yet 60 years of age, to qualify to purchase medical coverage equivalent to the TRICARE Standard (and Extra) benefit unless that member is either enrolled in, or is eligible to enroll in, a health benefit plan under Chapter 89 of Title 5, United States Code, as well as certain survivors. The amount of the premium that qualified members pay to purchase these benefits will represent the full cost as determined on an appropriate actuarial basis for coverage under the TRICARE Standard (and Extra) benefit including the cost of the program administration. There will be one premium for member-only coverage and a separate premium for member and family coverage. The rules and procedures otherwise outlined in Part 199 of 32 CFR relating to the operation and administration of the TRICARE Standard and Extra programs including the required cost-shares, deductibles and catastrophic caps for retired members and their dependents will apply to this program. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates.

  19. Medical benefits from the NASA biomedical applications program

    NASA Technical Reports Server (NTRS)

    Sigmon, J. L.

    1974-01-01

    To achieve its goals the NASA Biomedical Applications Program performs four basic tasks: (1) identification of major medical problems which lend themselves to solution by relevant aerospace technology; (2) identification of relevant aerospace technology which can be applied to those problems; (3) application of that technology to demonstrate the feasibility as real solutions to the identified problems; and, (4) motivation of the industrial community to manufacture and market the identified solution to maximize the utilization of aerospace solutions to the biomedical community.

  20. Comprehensive School Physical Activity Programs. Position Statement

    ERIC Educational Resources Information Center

    National Association for Sport and Physical Education, 2008

    2008-01-01

    The National Association for Sport and Physical Education (NASPE) recommends that all PK-12 schools implement a Comprehensive School Physical Activity Program. Schools play an important role in public health, and the physical, mental, and social benefits of regular physical activity for youth are well documented. Leading public health, medical,…

  1. Economic effect of an expansion of pharmacy benefits on total health care expenditures by a state Medicaid program.

    PubMed

    Jenkins, Tara L; Harrison, Donald L; Jacobs, Elgene W; Neas, Barbara R; Hagemann, Tracy M

    2009-01-01

    To evaluate the economic effect of a pharmacy benefit expansion on a population of Oklahoma Medicaid recipients and to determine whether recipients who routinely maximized their monthly prescription limit (cap) before the benefit expansion benefited more from the expansion than the remainder of the study population. Retrospective study. Oklahoma Medicaid claims data from January 1, 2003, to December 31, 2004. Data from 15,936 Oklahoma Medicaid recipients. Retrospective administrative analysis using the Oklahoma Health Care Authority pharmacy and medical claims databases. Total health care expenditures per recipient per year, total medical expenditures per recipient per year, and total pharmacy expenditures per recipient per year. Total health care expenditures increased 17% after the benefit expansion (P < 0.0001). Of this increase, 65% was attributed to pharmacy expenditures and 35% to medical expenditures. However, a subpopulation of recipients who routinely reached their prescription limit before the expansion had a statistically significant increase in total and pharmacy expenditures; a statistically significant increase in medical expenditures was not observed. Although total health care expenditures increased after a monthly pharmacy benefit in a Medicaid population was expanded, a subpopulation of recipients identified as high pharmacy users before the expansion did not have a statistically significant increase in medical expenditures, whereas those who were non-high users experienced a significant increase. Additionally, this subpopulation experienced a nonsignificant decrease in hospital expenditures. These results could suggest that this subpopulation was affected differently than the overall population by the expansion of the Medicaid pharmacy benefit.

  2. Health and federal budgetary effects of increasing access to antiretroviral medications for HIV by expanding Medicaid.

    PubMed

    Kahn, J G; Haile, B; Kates, J; Chang, S

    2001-09-01

    OBJECTIVES. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10,000, absent or inadequate medication insurance, and annual income less than $10,000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. An estimated 38,000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13,000 AIDS diagnoses and 2600 deaths and add 5,816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs.

  3. The Diabetes Management Education Program in South Texas: An Economic and Clinical Impact Analysis.

    PubMed

    Kash, Bita A; Lin, Szu-Hsuan; Baek, Juha; Ohsfeldt, Robert L

    2017-01-01

    Diabetes is a major chronic disease that can lead to serious health problems and high healthcare costs without appropriate disease management and treatment. In the United States, the number of people diagnosed with diabetes and the cost for diabetes treatment has dramatically increased over time. To improve patients' self-management skills and clinical outcomes, diabetes management education (DME) programs have been developed and operated in various regions. This community case study explores and calculates the economic and clinical impacts of expanding a model DME program into 26 counties located in South Texas. The study sample includes 355 patients with type 2 diabetes and a follow-up hemoglobin A1c level measurement among 1,275 individuals who participated in the DME program between September 2012 and August 2013. We used the Gilmer's cost differentials model and the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine methodology to predict 3-year healthcare cost savings and 10-year clinical benefits of implementing a DME program in the selected 26 Texas counties. Changes in estimated 3-year cost and the estimated treatment effect were based on baseline hemoglobin A1c level. An average 3-year reduction in medical treatment costs per program participant was $2,033 (in 2016 dollars). The total healthcare cost savings for the 26 targeted counties increases as the program participation rate increases. The total projected cost saving ranges from $12 million with 5% participation rate to $185 million with 75% participation rate. A 10-year outlook on additional clinical benefits associated with the implementation and expansion of the DME program at 60% participation is estimated to result in approximately 4,838 avoided coronary heart disease cases and another 392 cases of avoided strokes. The implementation of this model DME program in the selected 26 counties would contribute to substantial healthcare cost savings and clinical benefits. Organizations that provide DME services may benefit from reduction in medical treatment costs and improvement in clinical outcomes for populations with diabetes.

  4. 41 CFR 101-4.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 101-4.440 Health and insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or...

  5. Cuba's international cooperation in health: an overview.

    PubMed

    De Vos, Pol; De Ceukelaire, Wim; Bonet, Mariano; Van der Stuyft, Patrick

    2007-01-01

    In the first years after Cuba's 1959 revolution, the island's new government provided international medical assistance to countries affected by natural disasters or armed conflicts. Step by step, a more structural complementary program for international collaboration was put in place. The relief operations after Hurricane Mitch, which struck Central America in 1998, were pivotal. From November 1998 onward, the "Integrated Health Program" was the cornerstone of Cuba's international cooperation. The intense cooperation with Hugo Chávez's Venezuela became another cornerstone. Complementary to the health programs abroad, Cuba also set up international programs at home, benefiting tens of thousands of foreign patients and disaster victims. In a parallel program, medical training is offered to international students in the Latin American Medical School in Cuba and, increasingly, also in their home countries. The importance and impact of these initiatives, however, cannot and should not be analyzed solely in public health terms.

  6. What Do Final Year Medical Students Understand by the Concept of Recovery? A Descriptive Qualitative Study.

    PubMed

    Newton-Howes, Giles; Beverley, Georgia; Ellis, Pete M; Gordon, Sarah; Levack, William

    2018-06-01

    Traditional teaching in psychiatry does little to address recovery concepts. The aim of this study was to evaluate the incorporation of a recovery-focused teaching program for medical students in psychiatry. Recovery, as understood by medical students who had participated in a recovery-focused teaching program, was assessed by thematic analysis of recovery-focused assessment reflections. Six major themes emerged from the recovery reflections from final year medical students are as follows: (1) recovery as a person-centered approach, (2) the need for social integration, (3) non-diagnostic framing of mental illness, (4) tensions between the medical model and personal recovery, (5) a patient's willingness to engage with mental health services, and (6) the development of a positive sense of self. A recovery teaching program was associated with students expressing knowledge of recovery principles and positive attitudes towards people with experience of mental illness. Psychiatric placements for medical students may benefit from a recovery focus.

  7. Perspectives of female medical faculty in Ethiopia on a leadership fellowship program.

    PubMed

    Kvach, Elizabeth; Yesehak, Bethlehem; Abebaw, Hiwot; Conniff, James; Busse, Heidi; Haq, Cynthia

    2017-09-01

    This study aims to evaluate a leadership fellowship program through perspectives of Ethiopian women medical faculty participants. An intensive two-week leadership development fellowship was designed for women faculty from Ethiopian medical schools and conducted from 2011-2015 at the University of Wisconsin-School of Medicine and Public Health in Madison, Wisconsin. Nine Ethiopian women working in early- or mid-level academic positions were selected. Semi-structured interviews were conducted with the fellows. Transcripts were reviewed through qualitative analysis to assess the perceived impact of the training on their careers. Three male academic leaders were interviewed to solicit feedback on the program. Eight of 9 fellows were interviewed. Themes describing the benefits of the fellowship included: increased awareness of gender inequities; enhanced motivation for career advancement; increased personal confidence; and improved leadership skills. Fellows provided suggestions for future training and scaling up efforts to promote gender equity. Male leaders described the benefits of men promoting gender equity within academic health centers. This paper provides evidence that targeted brief training programs can enhance women's motivation and skills to become effective leaders in academic medicine in Ethiopia. Promoting gender equity in academic medicine is an important strategy to address health workforce shortages and to provide professional role models for female students in the health professions.

  8. Workplace injuries and the take-up of Social Security disability benefits.

    PubMed

    O'Leary, Paul; Boden, Leslie I; Seabury, Seth A; Ozonoff, Al; Scherer, Ethan

    2012-01-01

    Workplace injuries and illnesses are an important cause of disability. State workers' compensation programs provide almost $60 billion per year in cash and medical-care benefits for those injuries and illnesses. Social Security Disability Insurance (DI) is the largest disability insurance program in the United States, with annual cash payments to disabled workers of $95 billion in 2008. Because injured workers may also receive DI benefits, it is important to understand how those two systems interact to provide benefits. This article uses matched state workers' compensation and Social Security data to study the relationship between workplace injuries and illnesses and DI benefit receipt. We find that having a lost-time injury substantially increases the probability of DI receipt, and, for people who become DI beneficiaries, those with injuries receive DI benefits at younger ages. This relationship remains robust even after we account for important personal and work characteristics.

  9. Advanced ultrasound training for fourth-year medical students: a novel training program at The Ohio State University College of Medicine.

    PubMed

    Bahner, David P; Royall, Nelson A

    2013-02-01

    Ultrasound training and education in medical schools is rare, and the foci of current ultrasound curricula are limited. There is a significant need for advanced ultrasound training models in medical school curricula to reduce educational burdens for physician residency programs and improve overall physician competency.The authors describe and evaluate the advanced ultrasound training program developed at The Ohio State University College of Medicine (OSU COM). The OSU COM program is a longitudinal advanced ultrasound curriculum for fourth-year medical students pursuing specialties that require frequent use of focused ultrasound. One hundred fifty student participants have completed the yearlong program to date. Participants engage in didactic lectures, journal club sessions, hands-on training, teaching and patient-modeling activities, and complete a final project. Experienced Ohio State University Medical Center faculty are recruited from specialties that frequently use ultrasound (e.g., emergency medicine, internal medicine, obstetrics-gynecology). A multimodal instructional assessment approach ensures that ultrasound training yields experience with cognitive, behavioral, and constructive learning components. The authors discuss the benefits of the program as well as its challenges and future directions.The advanced ultrasound training program at OSU COM demonstrates a novel approach to providing ultrasound training for medical students, offering a feasible model for meeting training guidelines without increasing the educational requirements for residency programs.

  10. [MD PhD programs: Providing basic science education for ophthalmologists].

    PubMed

    Spaniol, K; Geerling, G

    2015-06-01

    Enrollment in MD PhD programs offers the opportunity of a basic science education for medical students and doctors. These programs originated in the USA where structured programs have been offered for many years, but now German universities also run MD PhD programs. The MD PhD programs provided by German universities were investigated regarding entrance requirements, structure and financing modalities. An internet and telephone-based search was carried out. Out of 34 German universities 22 offered MD PhD programs. At 15 of the 22 universities a successfully completed course of studies in medicine was required for enrollment, 7 programs admitted medical students in training and 7 programs required a medical doctoral thesis, which had to be completed with at least a grade of magna cum laude in 3 cases. Financing required scholarships in many cases. Several German universities currently offer MD PhD programs; however, these differ considerably regarding entrance requirements, structure and financing. A detailed analysis investigating the success rates of these programs (e.g. successful completion and career paths of graduates) would be of benefit.

  11. Association of learning styles with research self-efficacy: study of short-term research training program for medical students.

    PubMed

    Dumbauld, Jill; Black, Michelle; Depp, Colin A; Daly, Rebecca; Curran, Maureen A; Winegarden, Babbi; Jeste, Dilip V

    2014-12-01

    With a growing need for developing future physician scientists, identifying characteristics of medical students who are likely to benefit from research training programs is important. This study assessed if specific learning styles of medical students, participating in federally funded short-term research training programs, were associated with research self-efficacy, a potential predictor of research career success. Seventy-five first-year medical students from 28 medical schools, selected to participate in two competitive NIH-supported summer programs for research training in aging, completed rating scales to evaluate learning styles at baseline, and research self-efficacy before and after training. We examined associations of individual learning styles (visual-verbal, sequential-global, sensing-intuitive, and active-reflective) with students' gender, ranking of medical school, and research self-efficacy. Research self-efficacy improved significantly following the training programs. Students with a verbal learning style reported significantly greater research self-efficacy at baseline, while visual, sequential, and intuitive learners demonstrated significantly greater increases in research self-efficacy from baseline to posttraining. No significant relationships were found between learning styles and students' gender or ranking of their medical school. Assessments of learning styles may provide useful information to guide future training endeavors aimed at developing the next generation of physician-scientists. © 2014 Wiley Periodicals, Inc.

  12. Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees.

    PubMed

    Stearns, Sally C; Rozier, R Gary; Kranz, Ashley M; Pahel, Bhavna T; Quiñonez, Rocio B

    2012-10-01

    To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB). Observational study using Medicaid claims data (2000-2006). Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals. A total of 209 285 children enrolled in Medicaid at age 6 months. Into the Mouths of Babes visits included screening, parental counseling, topical fluoride application, and referral to dentists, if needed. The cost-effectiveness analysis used the Medicaid program perspective and a propensity score-matched sample with regression analysis to compare children with 4 or more vs 0 IMB visits. Dental treatments and Medicaid payments for children up to age 6 years enabled assessment of the likelihood of whether IMB was cost-saving and, if not, the additional payments per hospital episode avoided. Into the Mouths of Babes is 32% likely to be cost-saving, with discounting of benefits and payments. On average, IMB visits cost $11 more than reduced dental treatment payments per person. The program almost breaks even if future benefits from prevention are not discounted, and it would be cost-saving with certainty if IMB services could be provided at $34 instead of $55 per visit. The program is cost-effective with 95% certainty if Medicaid is willing to pay $2331 per hospital episode avoided. Into the Mouths of Babes improves dental health for additional payments that can be weighed against unmeasured hospitalization costs.

  13. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Coinsurance for durable medical equipment (DME) furnished as a home health service. 409.50 Section 409.50 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health...

  14. 20 CFR 30.702 - How should an employee prepare and submit requests for reimbursement for medical expenses...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... expenses? 30.702 Section 30.702 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... expenses? (a) If an employee has paid bills for medical, surgical or other services, supplies or appliances... of such service shall state each diagnosed condition and furnish the applicable ICD-9-CM code and...

  15. 75 FR 47452 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Retired Reserve...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... the Retired Reserve who are qualified for non-regular retirement, but are not yet 60 years of age, to qualify to purchase medical coverage equivalent to the TRICARE Standard (and Extra) benefit unless that... Code. Section 1076e allows members of the Retired Reserve who are qualified for non-regular retirement...

  16. Military Retirement: Background and Recent Developments

    DTIC Science & Technology

    2017-01-06

    nonmonetary benefits including exchange and commissary privileges, medical care through TRICARE, and access to Morale , Welfare and Recreation (MWR...include exchange and commissary privileges, medical care through TRICARE, and access to Morale , Welfare and Recreation facilities and programs...over the past decade. Congress grapples with constituent concerns as well as budgetary constraints in considering military retirement issues . In the

  17. Patterns of use for brand-name versus generic oral bisphosphonate drugs in Ontario over a 13-year period: a descriptive study.

    PubMed

    Fraser, Lisa-Ann; Albaum, Jordan M; Tadrous, Mina; Burden, Andrea M; Shariff, Salimah Z; Cadarette, Suzanne M

    2015-01-01

    Bisphosphonates are the first-line therapy for the treatment of osteoporosis. In the province of Ontario, the Ontario Drug Benefit Program funds medications for patients aged 65 years and older. The Ontario Drug Benefit Program has a generic substitution policy that requires lower-cost generic drugs to be dispensed when they are available. However, there is controversy surrounding the efficacy and tolerability of generic bisphosphonates. The objective of this study was to describe patterns in the use of brand-name versus generic formulations when dispensing oral bisphosphonate over a 13-year period. We identified all osteoporotic preparations for alendronate and risedronate that were dispensed through the Ontario Drug Benefit Program from 2001 to 2014. We stratified our sample into community-dwelling residents and residents in long-term care facilities. The number of prescriptions dispensed per month were plotted to illustrate trends over time. We found a rapid switch from brand-name to generic bisphosphonate equivalents immediately after the generic became available on the Ontario Drug Benefit formulary, with generics accounting for > 88% of dispensed drug within 2 months. We also observed a reduction in the number of generic drugs dispensed each time a new brand-name alternative (e.g., monthly risedronate, weekly alendronate plus vitamin D) was introduced to the formulary. The dispensing trends were similar in the community and long-term care settings. The Ontario Drug Benefit Program generic substitution policy resulted in rapid uptake of generic oral bisphosphonates among seniors in Ontario. However, there was a switch away from generic medications to new brand-name alternatives whenever they were introduced to the formulary. Therefore, some patients continued to use brand-name bisphosphonate despite the availability of generic options.

  18. Process and impact evaluation of a legal assistance and health care community partnership.

    PubMed

    Teufel, James A; Brown, Stephen L; Thorne, Woody; Goffinet, Diane M; Clemons, Latesha

    2009-07-01

    Community health partnerships have increased in popularity, but their effectiveness is often not evaluated. Through secondary data analysis, this study evaluates a program that offered access to legal services to address health-related issues, such as Medicaid reimbursement, Social Security benefits, medication coverage, and divorce. Based on the analysis reimbursements to expenditures, the health and law program appears to be cost-effective and thereby economically sustainable. The cost-effectiveness of this program increases the likelihood that it will be institutionalized and/or expanded. This program evaluation is used to exemplify how community stakeholders could partner to leverage resources to establish a sustainable community health and law program to address the needs of people living in medically underserved areas.

  19. An Excel Spreadsheet Model for States and Districts to Assess the Cost-Benefit of School Nursing Services.

    PubMed

    Wang, Li Yan; O'Brien, Mary Jane; Maughan, Erin D

    2016-11-01

    This paper describes a user-friendly, Excel spreadsheet model and two data collection instruments constructed by the authors to help states and districts perform cost-benefit analyses of school nursing services delivered by full-time school nurses. Prior to applying the model, states or districts need to collect data using two forms: "Daily Nurse Data Collection Form" and the "Teacher Survey." The former is used to record daily nursing activities, including number of student health encounters, number of medications administered, number of student early dismissals, and number of medical procedures performed. The latter is used to obtain estimates for the time teachers spend addressing student health issues. Once inputs are entered in the model, outputs are automatically calculated, including program costs, total benefits, net benefits, and benefit-cost ratio. The spreadsheet model, data collection tools, and instructions are available at the NASN website ( http://www.nasn.org/The/CostBenefitAnalysis ).

  20. Prescription copay reduction program for diabetic employees: impact on medication compliance and healthcare costs and utilization.

    PubMed

    Nair, Kavita V; Miller, Kerri; Saseen, Joseph; Wolfe, Pamela; Allen, Richard Read; Park, Jinhee

    2009-01-01

    To examine the impact of a value-based benefit design on utilization and expenditures. This benefit design involved all diabetes-related drugs and testing supplies placed on the lowest copay tier for 1 employer group. The sample of diabetic members were enrolled from a 9-month preperiod and for 2 years after the benefit design was implemented. Measured outcomes included prescription drug utilization for diabetes and medical utilization. Generalized measures were used to estimate differences between years 1 and 2 and the preperiod adjusting for age, gender, and comorbidity risk. Diabetes prescription drug use increased by 9.5% in year 1 and by 5.5% in year 2, and mean adherence increased by 7% to 8% in year 1 and fell slightly in year 2 compared with the preperiod. Pharmacy expenditures increased by 47% and 53% and expenditures for diabetes services increased by 16% and 32% in years 1 and 2, respectively. Increases in adherence and use of diabetes medications were observed. There were no compensatory cost-savings for the employer through lower utilization of medical expenditures in the first 2 years. Adherent patients had fewer emergency department visits than nonadherent patients after the implementation of this benefit design.

  1. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES... records, death certificates, x-rays, magnetic resonance images or reports, computer axial tomography or...

  2. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL... certificates, x-rays, magnetic resonance images or reports, computer axial tomography or other imaging reports...

  3. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL... certificates, x-rays, magnetic resonance images or reports, computer axial tomography or other imaging reports...

  4. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES... records, death certificates, x-rays, magnetic resonance images or reports, computer axial tomography or...

  5. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES... records, death certificates, x-rays, magnetic resonance images or reports, computer axial tomography or...

  6. Outcomes and lessons learned from evaluating TRICARE's disease management programs.

    PubMed

    Dall, Timothy M; Askarinam Wagner, Rachel C; Zhang, Yiduo; Yang, Wenya; Arday, David R; Gantt, Cynthia J

    2010-06-01

    To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients. Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program. Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services. Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services. Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

  7. Tactical emergency medical support programs: a comprehensive statewide survey.

    PubMed

    Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

    2012-01-01

    Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

  8. 42 CFR 436.610 - Assignment of rights to benefits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS... assignment of rights must be applied uniformly for all groups covered under the plan. (c) The requirements of...

  9. Exercise, sports participation, and musculoskeletal disorders of pregnancy and postpartum.

    PubMed

    Borg-Stein, Joanne P; Fogelman, David J; Ackerman, Kathryn E

    2011-09-01

    The benefits of rigorous physical activity have long been proclaimed by the medical community. However, consensus regarding exercise duration and intensity in pregnancy has been more difficult to achieve. Conservative exercise guidelines for pregnant women were issued broadly in the 1980s due to limited evidence regarding safety. More recent evidence has failed to demonstrate ill effects of physical activity during pregnancy, as any effects on the mother and the fetus have thus far shown to be positive. The physical discomfort experienced by virtually all women during pregnancy, nearly 25% of whom experience at least temporarily disabling symptoms, is often a barrier to participation in an exercise program. An approach to developing an exercise program during pregnancy will be discussed in this article, as well as the potential benefits of such a program for the maternal-fetal unit, and common pregnancy-related musculoskeletal conditions, including a discussion of the anatomy, physiology, diagnosis, and treatment of such disorders. © Thieme Medical Publishers.

  10. Transfer of financial risk and alternative financing solutions.

    PubMed

    Levitt, Jeffrey C

    2004-01-01

    The high cost of health care in the United States has created a number of alarming economic and social problems. It has contributed to a greater number of underinsured and uninsured individuals living in the United States, and forced people to either ration or not purchase the care they need. Accumulated medical debt is grossly disproportionate to the US median AGI, and accounted for at least 25 percent of all personal bankruptcies. For patients, a guaranteed loan program specifically for medical procedures and treatments with below market interest rates would help alleviate bankruptcies related to medical debt by lowering payments and extending the loan maturities. A guaranteed loan program would also improve the debt charge-off rate for medical providers that carry patient receivables and reduce the risk of their balance sheets. This might hold or reduce the rate at which health care inflation grows. The health care loan program could model the current student loan programs and produce significant economic and societal benefits.

  11. 20 CFR 30.907 - Can an impairment evaluation obtained by OWCP be challenged prior to issuance of the recommended...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Can an impairment evaluation obtained by OWCP... ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA Medical Evidence of Impairment § 30.907 Can an impairment evaluation obtained by OWCP be challenged prior to...

  12. Medical education in Israel 2016: five medical schools in a period of transition.

    PubMed

    Reis, Shmuel; Urkin, Jacob; Nave, Rachel; Ber, Rosalie; Ziv, Amitai; Karnieli-Miller, Orit; Meitar, Dafna; Gilbey, Peter; Mevorach, Dror

    2016-01-01

    We reviewed the existing programs for basic medical education (BME) in Israel as well as their output, since they are in a phase of reassessment and transition. The transition has been informed, in part, by evaluation in 2014 by an International Review Committee (IRC). The review is followed by an analysis of its implications as well as the emergent roadmap for the future. The review documents a trend of modernizing, humanizing, and professionalizing Israeli medical education in general, and BME in particular, independently in each of the medical schools. Suggested improvements include an increased emphasis on interactive learner-centered rather than frontal teaching formats, clinical simulation, interprofessional training, and establishment of a national medical training forum for faculty development. In addition, collaboration should be enhanced between medical educators and health care providers, and among the medical schools themselves. The five schools admitted about 730 Israeli students in 2015, doubling admissions from 2000. In 2014, the number of new licenses, including those awarded to Israeli international medical graduates (IMGs), surpassed for the first time in more than a decade the estimated need for 1100 new physicians annually. About 60 % of the licenses awarded in 2015 were to IMGs. Israeli BME is undergoing continuous positive changes, was supplied with a roadmap for even further improvement by the IRC, and has doubled its output of graduates. The numbers of both Israeli graduates and IMGs are higher than estimated previously and may address the historically projected physician shortage. However, it is not clear whether the majority of newly licensed physicians, who were trained abroad, have benefited from similar recent improvements in medical education similar to those benefiting graduates of the Israeli medical schools, nor is it certain that they will benefit from the further improvements that have recently been recommended for the Israeli medical schools. Inspired by the IRC report, this overview of programs and the updated physician manpower data, we hope the synergy between all stakeholders is enhanced to address the combined medical education quality enhancement and output challenge.

  13. Integrating Collaborative Learning and Competition in a Hematology/Oncology Training Program.

    PubMed

    Makhoul, Issam; Motwani, Pooja; Schafer, Liudmila; Arnaoutakis, Konstantinos; Mahmoud, Fade; Safar, Mazin; Graves, Dorothy; Mehta, Paulette; Govindarajan, Rang; Hutchins, Laura; Thrush, Carol

    2018-02-01

    New educational methods and structures to improve medical education are needed to face the challenge of an exponential increase and complexity of medical knowledge. Collaborative learning has been increasingly used in education, but its use in medical training programs is in its infancy, and its impact is still unknown; the role of competition in education is more controversial. We introduced these pedagogical methods to the hematology/oncology fellowship program at the University of Arkansas for Medical Sciences to improve attendance and performance at didactic activities and different educational outcomes. One year after the adoption of these methods, the fellowship program has reached many of the expected goals from this intervention without the negative consequences of competition observed in younger learners. The most important conclusion of this project is that collaboration and cross-generational team work provide a healthy and effective learning environment and competition may not add further benefit. Analysis, interpretation, and discussion of our experience are provided. This study was approved by the University of Arkansas for Medical Sciences IRB as a low risk educational intervention not requiring a consent form.

  14. 77 FR 73117 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ...This proposed rule provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for a Federally- facilitated Exchange; advance payments of the premium tax credit; a Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. The cost-sharing reductions and advanced payments of the premium tax credit, combined with new insurance market reforms, will significantly increase the number of individuals with health insurance coverage, particularly in the individual market. The premium stabilization programs--risk adjustment, reinsurance, and risk corridors--will protect against adverse selection in the newly enrolled population. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) protections and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance.

  15. 78 FR 15409 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ...This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally-facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs--risk adjustment, reinsurance, and risk corridors--to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance.

  16. A national clinician–educator program: a model of an effective community of practice

    PubMed Central

    Sherbino, Jonathan; Snell, Linda; Dath, Deepak; Dojeiji, Sue; Abbott, Cynthia; Frank, Jason R.

    2010-01-01

    Background The increasing complexity of medical training often requires faculty members with educational expertise to address issues of curriculum design, instructional methods, assessment, program evaluation, faculty development, and educational scholarship, among others. Discussion In 2007, The Royal College of Physicians & Surgeons of Canada responded to this need by establishing the first national clinician–educator program. We define a clinician–educator and describe the development of the program. Adopting a construct from the business community, we use a community of practice framework to describe the benefits (with examples) of this program and challenges in developing it. The benefits of the clinician–educator program include: improved educational problem solving, recognition of educational needs and development of new projects, enhanced personal educational expertise, maintenance of professional satisfaction and retention of group members, a positive influence within the Royal College, and a positive influence within other Canadian academic institutions. Summary Our described experience of a social reorganization – a community of practice – suggests that the organizational and educational benefits of a national clinician–educator program are not theoretical, but real. PMID:21151594

  17. Cross-cultural undergraduate medical education in North America: theoretical concepts and educational approaches.

    PubMed

    Reitmanova, Sylvia

    2011-04-01

    Cross-cultural undergraduate medical education in North America lacks conceptual clarity. Consequently, school curricula are unsystematic, nonuniform, and fragmented. This article provides a literature review about available conceptual models of cross-cultural medical education. The clarification of these models may inform the development of effective educational programs to enable students to provide better quality care to patients from diverse sociocultural backgrounds. The approaches to cross-cultural health education can be organized under the rubric of two specific conceptual models: cultural competence and critical culturalism. The variation in the conception of culture adopted in these two models results in differences in all curricular components: learning outcomes, content, educational strategies, teaching methods, student assessment, and program evaluation. Medical schools could benefit from more theoretical guidance on the learning outcomes, content, and educational strategies provided to them by governing and licensing bodies. More student assessments and program evaluations are needed in order to appraise the effectiveness of cross-cultural undergraduate medical education.

  18. The Ethics Liaison Program: building a moral community.

    PubMed

    Bates, Sarah R; McHugh, Wendy J; Carbo, Alexander R; O'Neill, Stephen F; Forrow, Lachlan

    2017-09-01

    Ethicists often struggle to maintain institution-wide awareness of and commitment to medical ethics. At Beth Israel Deaconess Medical Center (BIDMC), we created the Ethics Liaison Program to address that challenge by making ethics part of the moral culture of the institution. Liaisons represent clinical and non-clinical areas throughout the medical centre. The liaison has a four-part role: to spread awareness and understanding of Ethics Programs among their coworkers; share information regarding ethical dilemmas in their work area with the members of the Ethics Support Service; review ethics activities and needs within their area; and undertake ethics-related projects. This paper lists the notable attributes of the Ethics Liaison Program, and describes the purpose and structure of the programme, its advantages and the challenges to implementing it. The Ethics Liaison Program has helped to make ethics part of the everyday culture at BIDMC, and other medical centres might benefit from the establishment of similar programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Benefits for Children with Disabilities

    MedlinePlus

    ... with disabilities 10 Medicaid and Medicare 12 Children’ s Health Insurance Program 12 Other health care services 13 Introduction ... a child is in a medical facility, and health insurance pays for his or her care. SSI rules ...

  20. The Quantitative Evaluation of the Clinical and Translational Science Awards (CTSA) Program Based on Science Mapping and Scientometric Analysis

    PubMed Central

    Zhang, Yin; Wang, Lei

    2013-01-01

    Abstract The Clinical and Translational Science Awards (CTSA) program is one of the most important initiatives in translational medical funding. The quantitative evaluation of the efficiency and performance of the CTSA program has a significant referential meaning for the decision making of global translational medical funding. Using science mapping and scientometric analytic tools, this study quantitatively analyzed the scientific articles funded by the CTSA program. The results of the study showed that the quantitative productivities of the CTSA program had a stable increase since 2008. In addition, the emerging trends of the research funded by the CTSA program covered clinical and basic medical research fields. The academic benefits from the CTSA program were assisting its members to build a robust academic home for the Clinical and Translational Science and to attract other financial support. This study provided a quantitative evaluation of the CTSA program based on science mapping and scientometric analysis. Further research is required to compare and optimize other quantitative methods and to integrate various research results. PMID:24330689

  1. The quantitative evaluation of the Clinical and Translational Science Awards (CTSA) program based on science mapping and scientometric analysis.

    PubMed

    Zhang, Yin; Wang, Lei; Diao, Tianxi

    2013-12-01

    The Clinical and Translational Science Awards (CTSA) program is one of the most important initiatives in translational medical funding. The quantitative evaluation of the efficiency and performance of the CTSA program has a significant referential meaning for the decision making of global translational medical funding. Using science mapping and scientometric analytic tools, this study quantitatively analyzed the scientific articles funded by the CTSA program. The results of the study showed that the quantitative productivities of the CTSA program had a stable increase since 2008. In addition, the emerging trends of the research funded by the CTSA program covered clinical and basic medical research fields. The academic benefits from the CTSA program were assisting its members to build a robust academic home for the Clinical and Translational Science and to attract other financial support. This study provided a quantitative evaluation of the CTSA program based on science mapping and scientometric analysis. Further research is required to compare and optimize other quantitative methods and to integrate various research results. © 2013 Wiley Periodicals, Inc.

  2. 20 CFR 10.802 - How should an employee prepare and submit requests for reimbursement for medical expenses...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... expenses? 10.802 Section 10.802 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... services, supplies or appliances due to an injury sustained in the performance of duty, he or she may... medical report as provided in § 10.800, to OWCP for consideration. (1) The provider of such service shall...

  3. Benefits of Teaching Medical Students How to Communicate with Patients Having Serious Illness

    PubMed Central

    Ellman, Matthew S.; Fortin, Auguste H.

    2012-01-01

    Innovative approaches are needed to teach medical students effective and compassionate communication with seriously ill patients. We describe two such educational experiences in the Yale Medical School curriculum for third-year medical students: 1) Communicating Difficult News Workshop and 2) Ward-Based End-of-Life Care Assignment. These two programs address educational needs to teach important clinical communication and assessment skills to medical students that previously were not consistently or explicitly addressed in the curriculum. The two learning programs share a number of educational approaches driven by the learning objectives, the students’ development, and clinical realities. Common educational features include: experiential learning, the Biopsychosocial Model, patient-centered communication, integration into clinical clerkships, structured skill-based learning, self-reflection, and self-care. These shared features ― as well as some differences ― are explored in this paper in order to illustrate key issues in designing and implementing medical student education in these areas. PMID:22737055

  4. Linking Engineering and Medical Training: A USC program seeks to introduce medical and engineering students to medical device development.

    PubMed

    Tolomiczenko, George; Sanger, Terry

    2015-01-01

    Medical students are attracted by the prospect of a meaningful addition to their clinical work. Engineering students are excited by a unique opportunity to learn directly alongside their medical student peers. For both, as well as the scientific community at large, the boutique program at the University of Southern California (USC) linking engineering and medical training at the graduate level is instructive of a new way of approaching engineering education that can potentially provide benefits to both students and society. Students who have grown up in an era of ?mass customization? in the retail and service industries can enjoy that same degree of flexibility also in the realm of education. At the same time, society gains engineers who have developed an increased empathy and awareness of the clinical contexts in which their innovations will be implemented.

  5. A cost-benefit analysis of the outpatient smoking cessation services in Taiwan from a societal viewpoint.

    PubMed

    Chen, Pei-Ching; Lee, Yue-Chune; Tsai, Shih-Tzu; Lai, Chih-Kuan

    2012-05-01

    This study applied a cost-benefit analysis from a societal viewpoint to evaluate the Outpatient Smoking Cessation Services (OSCS) program. The costs measured in this study include the cost to the health sector, non-health sectors, the patients and their family, as well as the loss of productivity as a result of smoking. The benefits measured the medical costs savings and the earnings due to the increased life expectancy of a person that has stopped smoking for 15 years. Data were obtained from the primary data of a telephone survey, the literatures and reports from the Outpatient Smoking Cessation Management Center and government. Sensitivity analyses were conducted to verify the robustness of the results. There were 169,761 cases that participated in the outpatient smoking cessation program in the years 2007 and 2008, of those cases, 8,282 successfully stopped smoking. The total cost of the OSCS program was 18 million USD. The total benefits of the program were 215 million USD with a 3% discount rate; the net benefit to society was 196 million USD. After conducting sensitivity analyses on the different abstinence, relapse, and discount rates, from a societal perspective, the benefits still far exceeded the costs, while from a health care perspective, there was only a net benefit when the respondent's abstinence rate was used. From a societal perspective, the OSCS program in Taiwan is cost-beneficial. This study provides partial support for the policy makers to increase the budget and expand the OSCS program.

  6. Technology complementing military psychology programs and services in the Pacific Regional Medical Command.

    PubMed

    Stetz, Melba C; Folen, Raymond A; Van Horn, Sandra; Ruseborn, Daniel; Samuel, Kevin M

    2013-08-01

    The Tripler Army Medical Center is the only federal tertiary care hospital serving the Pacific Regional Medical Command. Due to Tripler's large area of responsibility, many behavioral health professionals are starting to employ more technology during their sessions. As explained in this article, virtual reality and telepsychology efforts are proving to benefit military service members and their families in the Pacific Rim. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  7. It's Hard to Get from Here to There: Early Intervention for Rural Young Children in Arkansas

    ERIC Educational Resources Information Center

    Marsh, Carolyn; Casey, Patrick H.

    2006-01-01

    The Kids First program at the University of Arkansas Medical School (UAMS) is an outgrowth of the Infant Health and Development Program, a randomized trial of an early intervention approach for premature, low birth weight children, which showed that intensive intervention had significant initial benefits in the cognitive development and behavior…

  8. 77 FR 22792 - Non-Competitive Program Expansion Supplement To Revise, Update, and Disseminate Educational...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... Medical Center UB4HP19192 Kansas 429,472.00 42,222 Research Institute. University of Kentucky Research....00 42,222 West Virginia University Research UB4HP19050 West Virginia 428,800.00 42,222 Corp... benefits for program evaluative purposes since the GEC grantees already have evaluation requirements with...

  9. 38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT... rehabilitation services or CWT program cannot cause the continuance or natural progress of a disease or injury... CWT program proximately caused a veteran's additional disability or death, it must be shown that the...

  10. 38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT... rehabilitation services or CWT program cannot cause the continuance or natural progress of a disease or injury... CWT program proximately caused a veteran's additional disability or death, it must be shown that the...

  11. 38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT... rehabilitation services or CWT program cannot cause the continuance or natural progress of a disease or injury... CWT program proximately caused a veteran's additional disability or death, it must be shown that the...

  12. 38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT... rehabilitation services or CWT program cannot cause the continuance or natural progress of a disease or injury... CWT program proximately caused a veteran's additional disability or death, it must be shown that the...

  13. The prevalence and practice of academies of medical educators: a survey of U.S. medical schools.

    PubMed

    Searle, Nancy S; Thompson, Britta M; Friedland, Joan A; Lomax, James W; Drutz, Jan E; Coburn, Michael; Nelson, Elizabeth A

    2010-01-01

    Academies of medical educators can be defined as formal organizations of academic teaching faculty recognized for excellence in their contributions to their school's education mission and who, as a group, serve specific needs of the institution. The authors studied the characteristics of academies, including the processes for admission, selection, and retention of academy members; the types of faculty who are academy members; program goals; benefits offered by academies to the individual and to the institution; funding sources and amounts; and the rapid increase in academies since 2003. In 2008, the authors sent an online questionnaire to 127 U.S. medical schools. Responses were analyzed using descriptive statistics. To determine differences between groups, multivariate analysis of variance was performed. Correlation analysis (Pearson r) was used to identify association between variables. Effect size was determined using eta squared (eta2). Thirty-six of the 122 responding schools (96% response rate) reported having academies; 21 schools had initiated academies since 2003, and 33 schools were planning or considering academies. There was a statistically significant difference between academies established before 2004 and in 2004 regarding benefits offered to individuals, membership terms and maintenance requirements, and goals. Rogers' theory of the diffusion of innovation may explain the recent spread of academies. When beginning or reexamining existing academy programs, institutions should consider goals, application process, benefits offered to members as well as the institution, expendable resources, and means of support, because the final product depends on the choices made at the beginning.

  14. Perspectives of female medical faculty in Ethiopia on a leadership fellowship program

    PubMed Central

    Yesehak, Bethlehem; Abebaw, Hiwot; Conniff, James; Busse, Heidi; Haq, Cynthia

    2017-01-01

    Objectives This study aims to evaluate a leadership fellowship program through perspectives of Ethiopian women medical faculty participants. Methods An intensive two-week leadership development fellowship was designed for women faculty from Ethiopian medical schools and conducted from 2011-2015 at the University of Wisconsin-School of Medicine and Public Health in Madison, Wisconsin. Nine Ethiopian women working in early- or mid-level academic positions were selected. Semi-structured interviews were conducted with the fellows. Transcripts were reviewed through qualitative analysis to assess the perceived impact of the training on their careers. Three male academic leaders were interviewed to solicit feedback on the program. Results Eight of 9 fellows were interviewed. Themes describing the benefits of the fellowship included: increased awareness of gender inequities; enhanced motivation for career advancement; increased personal confidence; and improved leadership skills. Fellows provided suggestions for future training and scaling up efforts to promote gender equity. Male leaders described the benefits of men promoting gender equity within academic health centers. Conclusions This paper provides evidence that targeted brief training programs can enhance women’s motivation and skills to become effective leaders in academic medicine in Ethiopia. Promoting gender equity in academic medicine is an important strategy to address health workforce shortages and to provide professional role models for female students in the health professions. PMID:28869749

  15. Peer learning in the UNSW Medicine program.

    PubMed

    Scicluna, Helen A; O'Sullivan, Anthony J; Boyle, Patrick; Jones, Philip D; McNeil, H Patrick

    2015-10-02

    The UNSW Australia Medicine program explicitly structures peer learning in program wide mixing of students where students from two adjoining cohorts complete the same course together, including all learning activities and assessment. The purpose of this evaluation is to explore the student experience of peer learning and determine benefits and concerns for junior and senior students. All medical students at UNSW Australia in 2012 (n = 1608) were invited to complete the Peer Learning Questionnaire consisting of 26 fixed-response items and 2 open-ended items exploring vertical integration and near-peer teaching. Assessment data from vertically integrated and non-vertically integrated courses were compared for the period 2011-2013. We received valid responses from 20 % of medical students (n = 328). Eighty percent of respondents were positive about their experience of vertical integration. Year 1 students reported that second year students provided guidance and reassurance (87.8 %), whilst year 2 students reported that the senior role helped them to improve their own understanding, communication and confidence (84 %). Vertical integration had little effect on examination performance and failure rates. This evaluation demonstrates that vertical integration of students who are one year apart and completing the same course leads to positive outcomes for the student experience of learning. Students benefit through deeper learning and the development of leadership qualities within teams. These results are relevant not only for medical education, but also for other professional higher education programs.

  16. Mass and Volume Optimization of Space Flight Medical Kits

    NASA Technical Reports Server (NTRS)

    Keenan, A. B.; Foy, Millennia Hope; Myers, Jerry

    2014-01-01

    Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success parameters.

  17. Healthcare resource utilisation by patients with coronary heart disease receiving a lifestyle-focused text message support program: an analysis from the TEXT ME study.

    PubMed

    Thakkar, Jay; Redfern, Julie; Khan, Ehsan; Atkins, Emily; Ha, Jeffrey; Vo, Kha; Thiagalingam, Aravinda; Chow, Clara K

    2018-05-23

    The 'Tobacco, Exercise and Diet Messages' (TEXT ME) study was a 6-month, single-centre randomised clinical trial (RCT) that found a text message support program improved levels of cardiovascular risk factors in patients with coronary heart disease (CHD). The current analyses examined whether receipt of text messages influenced participants' engagement with conventional healthcare resources. The TEXT ME study database (N=710) was linked with routinely collected health department databases. Number of doctor consultations, investigations and cardiac medication prescriptions in the two study groups were compared. The most frequently accessed health service was consultations with a General Practitioner (mean 7.1, s.d. 5.4). The numbers of medical consultations, biochemical tests or cardiac-specific investigations were similar between the study groups. There was at least one prescription registered for statin, ACEI/ARBs and β-blockers in 79, 66 and 50% of patients respectively, with similar refill rates in both the study groups. The study identified TEXT ME text messaging program did not increase use of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) captured healthcare services. The observed benefits of TEXT ME reflect direct effects of intervention independent of conventional healthcare resource engagement.

  18. 42 CFR 410.14 - Special requirements for services furnished outside the United States.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS... States if the services meet the applicable conditions of § 410.12 and are furnished in connection with...

  19. 42 CFR 410.14 - Special requirements for services furnished outside the United States.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS... States if the services meet the applicable conditions of § 410.12 and are furnished in connection with...

  20. The implementation of Prime Vendor Europe and its successful impact on an overseas naval medical treatment facility.

    PubMed

    Koerner, S D; Anaya, M A

    1996-10-01

    Prime Vendor Europe (PVE) is the commercial pharmaceutical ordering and delivery program that is revolutionizing overseas health care delivery at military health care treatment facilities located in the European theater. Mirroring civilian programs already available and replacing the Federal Supply System, PVE offers many benefits never before realized at overseas military health care treatment facilities, including: diminished order turnaround times with resultant decreased Operating Target requirements; rapid order confirmation after order placement; lower carrying costs and inventory needs; better dating of pharmaceuticals received; redistribution and increased efficiency of the current manhours needed to operate a pharmacy supply system; order tracking capabilities; and enhancement of the present cooperative and constructive dichotomous relationship between medical logistics and pharmacy regarding pharmaceutical purchasing practices. This paper will explore the fundamentals, past performance, continuous quality improvement of logistical functions, frame-work establishment for PVE, implementation of PVE, and subsequent observed command benefits of PVE realization.

  1. Medical mitigation model: quantifying the benefits of the public health response to a chemical terrorism attack.

    PubMed

    Good, Kevin; Winkel, David; VonNiederhausern, Michael; Hawkins, Brian; Cox, Jessica; Gooding, Rachel; Whitmire, Mark

    2013-06-01

    The Chemical Terrorism Risk Assessment (CTRA) and Chemical Infrastructure Risk Assessment (CIRA) are programs that estimate the risk of chemical terrorism attacks to help inform and improve the US defense posture against such events. One aspect of these programs is the development and advancement of a Medical Mitigation Model-a mathematical model that simulates the medical response to a chemical terrorism attack and estimates the resulting number of saved or benefited victims. At the foundation of the CTRA/CIRA Medical Mitigation Model is the concept of stock-and-flow modeling; "stocks" are states that individuals progress through during the event, while "flows" permit and govern movement from one stock to another. Using this approach, the model is able to simulate and track individual victims as they progress from exposure to an end state. Some of the considerations in the model include chemical used, type of attack, route and severity of exposure, response-related delays, detailed treatment regimens with efficacy defined as a function of time, medical system capacity, the influx of worried well individuals, and medical countermeasure availability. As will be demonstrated, the output of the CTRA/CIRA Medical Mitigation Model makes it possible to assess the effectiveness of the existing public health response system and develop and examine potential improvement strategies. Such a modeling and analysis capability can be used to inform first-responder actions/training, guide policy decisions, justify resource allocation, and direct knowledge-gap studies.

  2. Pharmacy Utilization and the Medicare Modernization Act

    PubMed Central

    Maio, Vittorio; Pizzi, Laura; Roumm, Adam R; Clarke, Janice; Goldfarb, Neil I; Nash, David B; Chess, David

    2005-01-01

    To control expenditures and use medications appropriately, the Medicare drug coverage program has established pharmacy utilization management (PUM) measures. This article assesses the effects of these strategies on the care of seniors. The literature suggests that although caps on drug benefits lower pharmaceutical costs, they may also increase the use of other health care services and hurt health outcomes. Our review raises concerns regarding the potential unintended effects of the Medicare drug program's PUM policies for beneficiaries. Therefore, the economic and clinical impact of PUM measures on seniors should be studied further to help policymakers design better drug benefit plans. PMID:15787955

  3. Sharing the Load: Amish Healthcare Financing

    PubMed Central

    Rohrer, Kristyn; Dundes, Lauren

    2016-01-01

    When settling healthcare bills, the Old Order Amish of Lancaster County, Pennsylvania rely on an ethos of mutual aid, independent of the government. Consonant with this philosophy, many Amish do not participate in or receive benefits from Social Security or Medicare. They are also exempted from the Affordable Care Act of 2010. This study expands the limited documentation of Amish Hospital Aid, an Amish health insurance program that covers major medical costs. Interview data from 11 Amish adults in Lancaster County depict how this aid program supplements traditional congregational alms coverage of medical expenses. The interview data delineate the structure of the program, its operation, and how it encourages cost containment and community interdependence. The manner in which the Amish collaborate to pay for medical expenses provides a thought-provoking paradigm for managing health care costs. PMID:27983624

  4. SU-F-E-12: Elective International Rotations in Medical Physics Residency Programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brown, D; Mundt, A; Einck, J

    Purpose: The purpose of this educational program is to motivate talented, intelligent individuals to become stakeholders in the global effort to improve access to radiotherapy. Methods: The need to improve global access to radiotherapy has been clearly established and several organizations are making substantial progress in securing funding and developing plans to achieve this worthwhile goal. The incorporation of elective international rotations in residency programs may provide one possible mechanism to promote and support this future investment. We recently incorporated an elective 1-month international rotation into our CAMPEP accredited Medical Physics residency program, with our first rotation taking place inmore » Vietnam. A unique aspect of this rotation was that it was scheduled collaboratively with our Radiation Oncology residency program such that Radiation Oncology and Medical Physics residents traveled to the same clinic at the same time. Results: We believe the international rotation substantially enhances the educational experience, providing additional benefits to residents by increasing cross-disciplinary learning and offering a shared learning experience. The combined international rotation may also increase benefit to the host institution by modeling positive multidisciplinary working relationships between Radiation Oncologists and Medical Physicists. Our first resident returned with several ideas designed to improve radiotherapy in resource-limited settings – one of which is currently being pursued in collaboration with a vendor. Conclusion: The elective international rotation provides a unique learning experience that has the potential to motivate residents to become stakeholders in the global effort to improve access to radiotherapy. What better way to prepare the next generation of Medical Physicists to meet the challenges of improving global access to radiotherapy than to provide them with training experiences that motivate them to be socially conscious and equip them with the clinical and problem solving skills required to deliver effective treatments in resource limited settings?.« less

  5. Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships.

    PubMed

    Jacobs, Fabian; Stegmann, Karsten; Siebeck, Matthias

    2014-03-04

    Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs' fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky's sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program.

  6. Occupational Medical Trends in the 70's from Industrial View

    NASA Technical Reports Server (NTRS)

    Williamson, S. M.

    1970-01-01

    Industrial health measures to ensure worker productivity constitute physical examinations as well as environmental control systems. Considered are automatic record keeping facilities for case histories, preventive medical and mental counselling, development of safety standards, and health insurance and disability benefit plans. Cooperation of industry health programs with community health aspects is required to eliminate the loss of manpower capability through alcoholism or mental disease.

  7. Measuring Safety: A New Perspective on Outcomes of a Long-Term Intensive Case Management Program

    DTIC Science & Technology

    2005-05-01

    treatment; complex treatment regimen, like electroconvulsive therapy (ECT), or new technologies; discharge against medical advice from inpatient...treatment; refractory to medication interventions; and need for therapy or psychiatric nursing in the home. While patients meeting the high acuity case...outpatient settings; individual, group, and family therapy ; and chemical dependency services. Exceptions to benefit limits were granted as needed, per

  8. 76 FR 72911 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ...: Elan Green, Medical Benefits and Reimbursement Branch, TMA, telephone (303) 676-3907. SUPPLEMENTARY... 1886(b)(3)(B) of the Social Security Act, and (2) a 0.1 percent point adjustment as required by section 1886(b)(3)(B)(xii) of the Act as added and amended by sections 3401 and 10319(a) of the PPACA. These...

  9. Therapeutic horse back riding of a spinal cord injured veteran: a case study.

    PubMed

    Asselin, Glennys; Penning, Julius H; Ramanujam, Savithri; Neri, Rebecca; Ward, Constance

    2012-01-01

    To determine an incomplete spinal cord injured veteran's experience following participation in a therapeutic horseback riding program. Following the establishment of a nationwide therapeutic riding program for America's wounded service veterans in 2007, a Certified Rehabilitation Registered Nurse from the Michael E. DeBakey Veteran Affairs Medical Center worked with an incomplete spinal cord injured veteran who participated in the Horses for Heroes program. This program resulted in many benefits for the veteran, including an increase in balance, muscle strength, and self-esteem. A physical, psychological, and psychosocial benefit of therapeutic horseback riding is shown to have positive results for the spinal cord injured. Therapeutic riding is an emerging field where the horse is used as a tool for physical therapy, emotional growth, and learning. Veterans returning from the Iraq/Afghanistan war with traumatic brain injuries, blast injuries, depression, traumatic amputations, and spinal cord injuries may benefit from this nurse-assisted therapy involving the horse. © 2012 Association of Rehabilitation Nurses.

  10. Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.

    PubMed

    Wan, Eric L; Xie, Li; Barrett, Miceile; Baltodano, Pablo A; Rivadeneira, Andres F; Noboa, Jonathan; Silver, Maya; Zhou, Richard; Cho, Suzy; Tam, Tammie; Yurter, Alp; Gentry, Carol; Palacios, Jorge; Rosson, Gedge D; Redett, Richard J

    2015-01-01

    In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. We established a recovery and donation program to collect clean and unused supplies for healthcare institutions in developing nations. We analyzed items donated over a 3-year period (September 2010-November 2013) by quantity and weight, and estimated the projected value of the program under potential nationwide participation. To capture the health benefits attributable to the donated supplies at recipient institutions, we partnered with two tertiary-care centers in Guayaquil, Ecuador and conducted a pilot study on the utility of the donated supplies at the recipient institutions (October 2013). We determined the disability-adjusted life years (DALY) averted for all patients undergoing procedures involving donated items and estimated the annual attributable DALY as well as the cost per DALY averted both by supply and by procedure. Approximately, 2 million lbs (907,185 kg) per year of medical supplies are recoverable from large non-rural US academic medical centers. Of these supplies, 19 common categories represent a potential for donation worth US $15 million per year, at a cost-utility of US $2.14 per DALY averted. Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.

  11. Economic Evaluation of a Worksite Obesity Prevention and Intervention Trial among Hotel Workers in Hawaii

    PubMed Central

    Meenan, Richard T.; Vogt, Thomas M.; Williams, Andrew E.; Stevens, Victor J.; Albright, Cheryl L.; Nigg, Claudio

    2010-01-01

    Objective Economic evaluation of Work, Weight, and Wellness (3W), a two-year randomized trial of a weight loss program delivered through Hawaii hotel worksites. Methods Business case analysis from hotel perspective. Program resources were micro-costed (2008 dollars). Program benefits were reduced medical costs, fewer absences, and higher productivity. Primary outcome was discounted 24-month net present value (NPV). Results Control program cost $222K to implement over 24 months ($61 per participant), intervention program cost $1.12M ($334). Including overweight participants (body mass index > 25), discounted control NPV was −$217K; −$1.1M for intervention program. Presenteeism improvement of 50% combined with baseline 10% productivity shortfall required to generate positive 24-month intervention NPV. Conclusions 3W’s positive clinical outcomes did not translate into immediate economic benefit for participating hotels, although modest cost savings were observed in the trial’s second year. PMID:20061889

  12. Hospital safeguards capital program through private sector partnership.

    PubMed

    Thomas, J; Lungo, A; Bobrow, M

    1984-02-01

    As access to capital tightens, more hospitals are exploring the benefits of partnerships with private companies. A California hospital, burdened by the long-term debt it incurred for a medical office building, worked together with its medical staff and an outside real estate developer. By selling the building to the developer, not only was the hospital able to finance a much-needed expansion and reconstruction project, but the hospital's medical staff had an opportunity to become limited partners in the ownership of the building.

  13. Medication therapy management and condition care services in a community-based employer setting.

    PubMed

    Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

    2010-08-15

    A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical outcomes. A business model in which health-system pharmacists provide MTM and condition care services for company employees has demonstrated successful outcomes in terms of patient satisfaction, cost savings, and clinical benefits.

  14. UCSF partnership to enrich science teaching for sixth graders in San Francisco's schools.

    PubMed

    Doyle, H J

    1999-04-01

    Increasing the diversity of students entering the health professions is a challenging goal for medical schools. One approach to this goal is to share the enthusiasm and energy of medical students with younger students, who may pursue medical education in the future. The MedTeach program, established in 1989 and coordinated by the Science & Health Education Partnership of the University of California, San Francisco (UCSF), does so by partnering volunteer medical students from UCSF with sixth-grade classes studying the human body. In 1997-98, around 350 sixth-graders in the San Francisco Schools benefitted from the program. Each team of medical student's visits its class ten to 12 times a year to present engaging, hands-on lessons on body systems and health. The medical students are also role models for the middle-school students. In addition, the diverse student population of San Francisco public schools provides a rich environment for the medical students to improve their communication and teaching skills.

  15. The benefits of international rotations to resource-limited settings for U.S. surgery residents.

    PubMed

    Henry, Jaymie A; Groen, Reinou S; Price, Raymond R; Nwomeh, Benedict C; Kingham, T Peter; Hardy, Mark A; Kushner, Adam L

    2013-04-01

    U.S. surgery residents increasingly are interested in international experiences. Recently, the Residency Review Committee approved international surgery rotations for credit toward graduation. Despite this growing interest, few U.S. surgery residency programs offer formal international rotations. We aimed to present the benefits of international surgery rotations and how these rotations contribute to the attainment of the 6 Accreditation Council for Graduate Medical Education (ACGME) competencies. An e-mail-based survey was sent in November 2011 to the 188 members of Surgeons OverSeas, a group of surgeons, residents, fellows, and medical students with experience working in resource-limited settings. They were asked to list 5 benefits of international rotations for surgery residents. The frequency of benefits was qualitatively grouped into 4 major categories: educational, personal, benefits to the foreign institution/Global Surgery, and benefits to the home institution. The themes were correlated with the 6 ACGME competencies. The 58 respondents (31% response rate) provided a total of 295 responses. Fifty themes were identified. Top benefits included learning to optimally function with limited resources, exposure to a wide variety of operative pathology, exposure to a foreign culture, and forming relationships with local counterparts. All ACGME competencies were covered by the themes. International surgery rotations to locations in which resources are constrained, operative diseases vary, and patient diversity abound provide unique opportunities for surgery residents to attain the 6 ACGME competencies. General surgery residency programs should be encouraged to establish formal international rotations as part of surgery training to promote resident education and assist with necessary oversight. Copyright © 2013 Mosby, Inc. All rights reserved.

  16. 20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

  17. 20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

  18. 20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

  19. 20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

  20. 20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

  1. 42 CFR 435.134 - Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336 (July 1, 1972). 435.134 Section 435.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES,...

  2. 42 CFR 435.134 - Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336 (July 1, 1972). 435.134 Section 435.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES,...

  3. Is It Time for Entrustable Professional Activities for Residency Program Directors?

    PubMed

    Bing-You, Robert G; Holmboe, Eric; Varaklis, Kalli; Linder, Jo

    2017-06-01

    Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.

  4. The effect of a bidirectional exchange on faculty and institutional development in a global health collaboration.

    PubMed

    Bodnar, Benjamin E; Claassen, Cassidy W; Solomon, Julie; Mayanja-Kizza, Harriet; Rastegar, Asghar

    2015-01-01

    The MUYU Collaboration is a partnership between Mulago Hospital-Makerere University College of Health Sciences (M-MakCHS), in Kampala, Uganda, and the Yale University School of Medicine. The program allows Ugandan junior faculty to receive up to 1 year of subspecialty training within the Yale hospital system. The authors performed a qualitative study to assess the effects of this program on participants, as well as on M-MakCHS as an institution. Data was collected via semi-structured interviews with exchange participants. Eight participants (67% of those eligible as of 4/2012) completed interviews. Study authors performed data analysis using standard qualitative data analysis techniques. Analysis revealed themes addressing the benefits, difficulties, and opportunities for improvement of the program. Interviewees described the main benefit of the program as its effect on their fund of knowledge. Participants also described positive effects on their clinical practice and on medical education at M-MakCHS. Most respondents cited financial issues as the primary difficulty of participation. Post-participation difficulties included resource limitations and confronting longstanding institutional and cultural habits. Suggestions for programmatic improvement included expansion of the program, ensuring appropriate management of pre-departure expectations, and refinement of program mentoring structures. Participants also voiced interest in expanding post-exchange programming to ensure both the use of and the maintenance of new capacity. The MUYU Collaboration has benefitted both program participants and M-MakCHS, though these benefits remain difficult to quantify. This study supports the assertion that resource-poor to resource-rich exchanges have the potential to provide significant benefits to the resource-poor partner.

  5. Exploring the role of social capital in supporting a regional medical education campus.

    PubMed

    Toomey, Patricia; Hanlon, Neil; Bates, Joanna; Poole, Gary; Lovato, Chris Y

    2011-01-01

    To help address physician shortages in the underserved community of Prince George, Canada, the University of British Columbia (UBC) and various partners created the Northern Medical Program (NMP), a regional distributed site of UBC's medical doctor undergraduate program. Early research on the impacts of the NMP revealed a high degree of social connectedness. The objective of the present study was to explore the role of social capital in supporting the regional training site and the benefits accrued to a broad range of stakeholders and network partners. In this qualitative study, 23 semi-structured interviews were conducted with community leaders in 2007. A descriptive content analysis based on analytic induction technique was employed. Carpiano's Bourdieu-based framework of 'neighbourhood' social capital was adapted to empirically describe how social capital was produced and mobilized within and among networks during the planning and implementation of the NMP. Results from this study reveal that the operation of social capital and the related concept of social cohesion are multifaceted, and that benefits extend in many directions, resulting in somewhat unanticipated benefits for other key stakeholders and network partners of this medical education program. Participants described four aspects of social capital: (i) social cohesion; (ii) social capital resources; (iii) access to social capital; and (iv) outcomes of social capital. The findings of this study suggest that the partnerships and networks formed in the NMP planning and implementation phases were the foundation for social capital mobilization. The use of Carpiano's spatially-bounded model of social capital was useful in this context because it permitted the characterization of relations and networks of a tight-knit community body. The students, faculty and administrators of the NMP have benefitted greatly from access to the social capital mobilized to make the NMP operational. Taking account of the dynamic and multifaceted operation of social capital helps one move beyond a view of geographic communities as simply containers or sinks of capital investment, and to appreciate the degree to which they may act as a platform for productive network formation and expansion.

  6. Smoke alarm giveaway and installation programs: an economic evaluation.

    PubMed

    Liu, Ying; Mack, Karin A; Diekman, Shane T

    2012-10-01

    The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. Published by Elsevier Inc.

  7. An examination of Eyal & Hurst’s (2008) framework for promoting retention in resource-poor settings through locally-relevant training: A case study for the University of Guyana Surgical Training Program

    PubMed Central

    Prashad, Anupa J.; Cameron, Brian H.; McConnell, Meghan; Rambaran, Madan; Grierson, Lawrence E. M.

    2017-01-01

    Background Eyal and Hurst proposed that locally relevant medical education can offset the prevalence of physician “brain drain” in resource-poor regions of the world, and presented a framework of the ethical and pragmatic benefits and concerns posed by these initiatives. The present study explored the framework’s utility through a case study of the University of Guyana Diploma in Surgery (UGDS) program Methods The framework’s utility was evaluated using a case study design that included review and analysis of documents and semi-structured interviews with graduates, trainees, faculty members, and policy makers associated with the UGDS program. Data were analyzed from constructivist and interpretivist perspectives, and compared against the benefits and concerns described by Eyal and Hurst. Results The framework is a useful template for capturing the breadth of experience of locally relevant training in the Guyanese setting. However, the results suggest that delineating the framework factors as either beneficial or concerning may constrict its applicability. The case study design also provided specific insights about the UGDS program, which indicate that the Program has promoted the retention of graduates and a sustainable culture of postgraduate medical education in Guyana. Conclusion It is suggested that the framework be modified so as to represent the benefits and concerns of locally relevant training along a continuum of advantage. These approaches may help us understand retention within a resource-poor country, but also within particularly remote areas and public health care systems generally. PMID:29114344

  8. Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships

    PubMed Central

    2014-01-01

    Background Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs’ fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Methods Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. Results The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Conclusion Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky’s sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program. PMID:24589133

  9. Medical students as peer tutors: a systematic review

    PubMed Central

    2014-01-01

    Background While Peer Assisted Learning (PAL) has long occurred informally in medical education, in the past ten years, there has been increasing international interest in formally organised PAL, with many benefits for both the students and institutions. We conducted a systematic review of the literature to establish why and how PAL has been implemented, focussing on the recruitment and training process for peer tutors, the benefits for peer tutors, and the competency of peer tutors. Method A literature search was conducted in three electronic databases. Selection of titles and abstracts were made based on pre-determined eligibility criteria. We utilized the ‘AMEE Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30’ to assist us in establishing the review aims in a systematic review of the literature between 2002 and 2012. Six key questions were developed and used in our analysis of particular aspects of PAL programs within medical degree programs. Results We found nineteen articles that satisfied our inclusion criteria. The PAL activities fell into three broad categories of teacher training, peer teaching and peer assessment. Variability was found in the reporting of tutor recruitment and training processes, tutor outcomes, and tutor competencies. Conclusion Results from this review suggest that there are many perceived learning benefits for student tutors. However, there were mixed results regarding the accuracy of peer assessment and feedback, and no substantial evidence to conclude that participation as a peer tutor improves one’s own examination performance. Further research into PAL in medicine is required if we are to better understand the relative impact and benefits for student tutors. PMID:24912500

  10. A pilot study of a weight management program with food provision in schizophrenia.

    PubMed

    Jean-Baptiste, Michel; Tek, Cenk; Liskov, Ellen; Chakunta, Umesh Rao; Nicholls, Sarah; Hassan, Akm Q; Brownell, Kelly D; Wexler, Bruce E

    2007-11-01

    Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

  11. Consultation and referral between physicians in new medical practice environments.

    PubMed

    Schaffer, W A; Holloman, F C

    1985-10-01

    The traditional exchange of medical expertise between physicians for patient benefit has been accomplished by referral. Physicians have traditionally decided when and to whom to refer patients. Health care "systems" now dominate medical practice, and their formats can alter spontaneous collegial interaction in referral. Institutional programs now pursue patient referrals as part of a marketing strategy to attract new patients who then become attached to the institution, rather than to a physician. Referral behavior can affect a physician's personal income in prepaid insurance programs where referrals are discouraged. The referring physician may bear legal liability for actions of the consultant. New practice arrangements and affiliations may place physicians in financial conflict-of-interest situations, challenge ethical commitments, and add new moral responsibility.

  12. Medicare and You

    MedlinePlus

    ... 800-829-4833 va. gov Office of Personnel Management Get information about the Federal Employee Health Benefits (FEHB) Program ... in health plans, including Medicare ■ Medical and case management records (except ... Any other records that contain information that doctors or health plans use to make ...

  13. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  14. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  15. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  16. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  17. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section 410... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  18. Medicaid program; deduction of incurred medical expenses (spenddown)--HCFA. Final rule with comment period.

    PubMed

    1994-01-12

    This final rule with comment period permits States flexibility to revise the process by which incurred medical expenses are considered to reduce an individual's or family's income to become Medicaid eligible. This process is commonly referred to as "spenddown." Only States which cover the medically needy, and States which use more restrictive criteria to determine eligibility of the aged, blind, and disabled, than the criteria used to determine eligibility for Supplemental Security Income (SSI) benefits (section 1902(f) States) have a spenddown. These revisions permit States to: Consider as incurred medical expenses projected institutional expenses at the Medicaid reimbursement rate, and deduct those projected expenses from income in determining eligibility; combine the retroactive and prospective medically needy budget periods; either include or exclude medical expenses incurred earlier than the third month before the month of application (States must, however, deduct current payments on old bills not previously deducted in any budget period); and deduct incurred medical expenses from income in the order in which the services were provided, in the order each bill is submitted to the agency, by type of service. All States with medically needy programs using the criteria of the SS program may implement any of the provisions. States using more restrict criteria than the SSI program under section 1902(f) of the Social Security Act may implement all of these provisions except for the option to exclude medical expenses incurred earlier than the third month before the month of application.

  19. How Medicaid and Other Public Policies Affect Use of Tobacco Cessation Therapy, United States, 2010–2014

    PubMed Central

    Brantley, Erin; Bysshe, Tyler; Steinmetz, Erika; Bruen, Brian K.

    2016-01-01

    Introduction State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers. Methods We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014. Results Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels. Conclusions States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs. PMID:27788063

  20. Pilates program design and health benefits for pregnant women: A practitioners' survey.

    PubMed

    Mazzarino, Melissa; Kerr, Debra; Morris, Meg E

    2018-04-01

    Little is known about recommendations for safe and appropriate instruction of Pilates exercises to women during pregnancy. The aim of this study was to examine Pilates practitioners' perspectives regarding Pilates program design for pregnant women. We also sought to elucidate their views on the potential benefits, restrictions and contraindications on Pilates in pregnancy. A cross-sectional survey was performed. Pilates practitioners were invited to participate via email. Participants were surveyed about their experience and views on: screening processes in alignment with The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines; (ii) optimal exercise program features and (iii) physical and mental health benefits of Pilates for pregnant women. The survey was completed by 192 Pilates practitioners from a range of settings. Practitioners reported conducting formal screening (84%) for safety in pregnant women prior to commencing Pilates classes. Most did not routinely seek medical approval from the woman's general practitioner. Divergent views emerged regarding the safety and benefits of Pilates exercises in the supine position. Mixed opinions were also generated regarding the effects of spinal flexion exercises, single-leg stance exercises and breathing manoeuvres. There was little agreement on the optimal frequency or dosage of exercises. Views regarding absolute contraindications to exercise differed from The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines which cautioned about the dangers of persistent bleeding, premature labour, pre-eclampsia, placental praevia and incompetent cervix. The most frequent reported physical and psychological benefit of Pilates was improving pelvic floor strength (12%) and improved social wellbeing (23%). The study highlighted wide variations in practice for Pilates exercises with pregnant woman as well as low adherence to clinical practice guidelines. Further evidence is required to advise on appropriate screening and individualized Pilates programming, particularly for women with medical conditions during pregnancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Medical Team Training Improves Team Performance: AOA Critical Issues.

    PubMed

    Carpenter, James E; Bagian, James P; Snider, Rebecca G; Jeray, Kyle J

    2017-09-20

    Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case. This training program led to measured improvements in job satisfaction and compliance with checklist tasks, and identified opportunities to improve training sessions. MTT provides the potential for sustainable change and a positive impact on the environment of the operating room.

  2. [Medical support on human resources and clinical laboratory in Myanmar].

    PubMed

    Koide, Norio

    2012-03-01

    I have been involved in medical cooperation programs between Myanmar and Japan for over 10 years. The purpose of the first visit to Myanmar was the investigation of hepatitis C spreading among thalassemia patients. I learned that the medical system was underdeveloped in this country, and have initiated several cooperation programs together with Professor Shigeru Okada, such as the "Protection against hepatitis C in Myanmar", "Scientist exchange between the Ministry of Health, Myanmar and Okayama University", and "Various activities sponsored by a Non-Profit Organization". As for clinical laboratories, the laboratory system itself is pre-constructed and the benefit of a clinical laboratory in modern medicine is not given to patients in Myanmar. The donation of drugs and reagents for laboratory tests is helpful, but it will be more helpful to assist the future leaders to learn modern medicine and develop their own various systems to support modern medicine. Our activity in the cooperation program is described.

  3. Health Benefits Mandates and Their Potential Impacts on Racial/Ethnic Group Disparities in Insurance Markets.

    PubMed

    Charles, Shana Alex; Ponce, Ninez; Ritley, Dominique; Guendelman, Sylvia; Kempster, Jennifer; Lewis, John; Melnikow, Joy

    2017-08-01

    Addressing racial/ethnic group disparities in health insurance benefits through legislative mandates requires attention to the different proportions of racial/ethnic groups among insurance markets. This necessary baseline data, however, has proven difficult to measure. We applied racial/ethnic data from the 2009 California Health Interview Survey to the 2012 California Health Benefits Review Program Cost and Coverage Model to determine the racial/ethnic composition of ten health insurance market segments. We found disproportional representation of racial/ethnic groups by segment, thus affecting the health insurance impacts of benefit mandates. California's Medicaid program is disproportionately Latino (60 % in Medi-Cal, compared to 39 % for the entire population), and the individual insurance market is disproportionately non-Latino white. Gender differences also exist. Mandates could unintentionally increase insurance coverage racial/ethnic disparities. Policymakers should consider the distribution of existing racial/ethnic disparities as criteria for legislative action on benefit mandates across health insurance markets.

  4. Pharmacy Benefits Management in the Veterans Health Administration Revisited: A Decade of Advancements, 2004-2014.

    PubMed

    Aspinall, Sherrie L; Sales, Mariscelle M; Good, Chester B; Calabrese, Vincent; Glassman, Peter A; Burk, Muriel; Moore, Von R; Neuhauser, Melinda M; Golterman, Lori; Ourth, Heather; Valentino, Michael A; Cunningham, Francesca E

    2016-09-01

    Over the past decade, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services (PBM) has enhanced its formulary management activities and added programs to ensure that the national drug plan continues to meet the pharmacy needs of veterans and to promote safe and appropriate drug therapy in the face of rising medication expenditures. This article describes the broad range of services provided by the VA PBM that work in partnership to deliver a high-quality and sustainable pharmacy benefit for veterans. In support of formulary management, VA PBM pharmacists prepare extensive clinical guidance documents (e.g., drug monographs and criteria for use) that are used by physicians and pharmacists with operational and clinical oversight of the VA national formulary. The VA PBM has utilized various contracting techniques and continually evaluates drug utilization data to identify opportunities for potential savings. Remarkably, since before 2004, the average acquisition cost for a 1-month supply of medication has remained fairly stable at approximately $13-$15. Two new VA PBM programs are the VA Center for Medication Safety (VA MedSAFE) and the Clinical Pharmacy Practice Office (CPPO). VA MedSAFE is a comprehensive pharmacovigilance program focused on the detection, assessment, and prevention of adverse drug events, and CPPO is dedicated to improving safe and appropriate medication use by supporting and expanding clinical pharmacy practice. Moving forward, the VA PBM will consider new initiatives to stay at the forefront of providing quality care while maintaining economic viability. No outside funding supported this research. This work was supported by VA Pharmacy Benefits Management Services (VA PBM), Hines, Illinois, and VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Glassman is co-director of the VA Center for Medication Safety, which is part of the VA PBM. He is also part of the Medical Advisory Panel for the VA PMB. All other authors are employed by the VA PBM. The views expressed in this article are those of the authors, and no official endorsement by the U.S. Department of Veteran Affairs or the U.S. government is intended or should be inferred. Study concept and design were contributed by Valentino, Cunningham, Good, Aspinall, and Sales. Calabrese and Ourth took the lead in data collection, along with Good, Cunningham, Aspinall, Sales, Burk, Moore, Neuhauser, and Golterman. Data interpretation was performed by Burk, Newhauser, and Golterman, along with Glassman, Calabrese, Moore, and Ourth. The manuscript was written by Aspinall and Sales, along with Burk, Newhauser, Golterman, Ourth, and Cunningham. Good, Glassman, and Moore revised the manuscript, along with Calabrese, Valentino, and Aspinall.

  5. Intimate examination teaching with volunteers: implementation and assessment at the University of Antwerp.

    PubMed

    Hendrickx, Kristin; De Winter, Benedicte Y; Wyndaele, Jean-Jacques; Tjalma, Wiebren A A; Debaene, Luc; Selleslags, Bert; Mast, Frieda; Buytaert, Philippe; Bossaert, Leo

    2006-10-01

    Teaching intimate physical examinations in medical schools generates practical, didactical and ethical problems. At the University of Antwerp, a unique program with intimate examination assistants (IEA) was implemented for fifth year's undergraduate students. They learn gynaecological and urological skills in healthy volunteers. Technical, communicative and attitude aspects are taken into account. Description of the implementation of the project. Assessment of the project by questionnaires, written reflections and round table conferences. The results provide detailed information about the student's perceptions of each component of the program as well as the perceptions of the IEA's and the teachers. The multilevel evaluation of the program supports the surplus value of working with IEA's in medical education. The eye-catcher in this program is the integration of clinical skills with communicative skills and attention for students' attitude. Working with IEA's for intimate examinations represents a benefit in medical education by lowering the student's threshold to perform the intimate physical examination on both men and women during their fulltime clerkships.

  6. Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew.

    PubMed

    Rizal, Rachel E; Mediratta, Rishi P; Xie, James; Kambhampati, Swetha; Hills-Evans, Kelsey; Montacute, Tamara; Zhang, Michael; Zaw, Catherine; He, Jimmy; Sanchez, Magali; Pischel, Lauren

    2015-01-01

    Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful servicelearning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program's outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians.

  7. Medical school deans' perceptions of organizational climate: useful indicators for advancement of women faculty and evaluation of a leadership program's impact.

    PubMed

    Dannels, Sharon; McLaughlin, Jean; Gleason, Katharine A; McDade, Sharon A; Richman, Rosalyn; Morahan, Page S

    2009-01-01

    The authors surveyed U.S. and Canadian medical school deans regarding organizational climate for faculty, policies affecting faculty, processes deans use for developing faculty leadership, and the impact of the Executive Leadership in Academic Medicine (ELAM) Program for Women. The usable response rate was 58% (n = 83/142). Deans perceived gender equity in organizational climate as neutral, improving, or attained on most items and deficient on four. Only three family-friendly policies/benefits were available at more than 68% of medical schools; several policies specifically designed to increase gender equity were available at fewer than 14%. Women deans reported significantly more frequent use than men (P = .032) of practices used to develop faculty leadership. Deans' impressions regarding the impact of ELAM alumnae on their schools was positive (M = 5.62 out of 7), with those having more fellows reporting greater benefit (P = .01). The deans felt the ELAM program had a very positive influence on its alumnae (M = 6.27) and increased their eligibility for promotion (M = 5.7). This study provides a unique window into the perceptions of medical school deans, important policy leaders at their institutions. Their opinion adds to previous studies of organizational climate focused on faculty perceptions. Deans perceive the organizational climate for women to be improving, but they believe that certain interventions are still needed. Women deans seem more proactive in their use of practices to develop leadership. Finally, deans provide an important third-party judgment for program evaluation of the ELAM leadership intervention, reporting a positive impact on its alumnae and their schools.

  8. Benefits of teaching medical students how to communicate with patients having serious illness: comparison of two approaches to experiential, skill-based, and self-reflective learning.

    PubMed

    Ellman, Matthew S; Fortin, Auguste H

    2012-06-01

    Innovative approaches are needed to teach medical students effective and compassionate communication with seriously ill patients. We describe two such educational experiences in the Yale Medical School curriculum for third-year medical students: 1) Communicating Difficult News Workshop and 2) Ward-Based End-of-Life Care Assignment. These two programs address educational needs to teach important clinical communication and assessment skills to medical students that previously were not consistently or explicitly addressed in the curriculum. The two learning programs share a number of educational approaches driven by the learning objectives, the students' development, and clinical realities. Common educational features include: experiential learning, the Biopsychosocial Model, patient-centered communication, integration into clinical clerkships, structured skill-based learning, self-reflection, and self-care. These shared features - as well as some differences - are explored in this paper in order to illustrate key issues in designing and implementing medical student education in these areas.

  9. How we launched a developmental student-as-teacher (SAT) program for all medical students.

    PubMed

    Blanco, Maria A; Maderer, Ann; Oriel, Amanda; Epstein, Scott K

    2014-05-01

    Teaching is a necessary skill for medical trainees and physicians. We designed and launched a developmental Student-as-Teacher program for all students, beginning with the class of 2016. A task force of faculty and students designed the program. The goal is to enable all students to acquire basic principles of teaching and learning at different stages in their four-year medical school career. Upon completion, students will achieve twenty-eight learning objectives grouped within four competency domains: (1) Adult and Practice-Based Learning; (2) Learning Environment; (3) Instructional Design and Performance; and, (4) Learner's Assessment and Evaluation. The program combines online learning modules and a field teaching experience. The entire class of 2016 (N = 200) completed the first online module. Students found the module effective, and 70% reported an increase in their level of knowledge. Although most students are expected to complete their field teaching experience in fourth year, twelve students completed their field experience in first year. Reported strengths of these experiences include reinforcement of their medical knowledge and improvement of their adult teaching skills. The program was successfully launched, and students are already experiencing the benefits of training in basic teaching skills in the first year of the program.

  10. Identifying clinical net benefit of psychotropic medication use with latent variable techniques: Evidence from Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).

    PubMed

    Bareis, Natalie; Lu, Juan; Kirkwood, Cynthia K; Kornstein, Susan G; Wu, Elwin; Mezuk, Briana

    2018-05-29

    Poor medication adherence is common among individuals with Bipolar Disorder (BD). Understanding the sources of heterogeneity in clinical net benefit (CNB) and how it is related to psychotropic medications can provide new insight into ways to improve adherence. Data come from the baseline assessments of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB, and validity of this construct was assessed using the SF-36. Adherence was defined as taking 75% or more of medications as prescribed. Associations between CNB and adherence were tested using multiple logistic regression adjusting for sociodemographic characteristics. Five classes of CNB were identified: High (24%), Moderately high (12%), Moderate (26%), Moderately low (27%) and Low (12%). Adherence to psychotropic medications did not differ across classes (71% to 75%, χ 2   = 3.43, p = 0.488). Medication regimens differed by class: 57% of the High CNB were taking ≤2 medications, whereas 49% of the Low CNB were taking ≥4. CNB classes had good concordance with the SF-36. Missing data limited measures used to define CNB. Participants' perceptions of their illness and treatment were not assessed. This novel operationalization of CNB has construct validity as indicated by the SF-36. Although CNB and polypharmacy regimens are heterogeneous in this sample, adherence is similar across CNB. Studying adherent individuals, despite suboptimal CNB, may provide novel insights into aspects influencing adherence. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Right-to-try laws and individual patient "compassionate use" of experimental oncology medications: A call for improved provider-patient communication.

    PubMed

    Hoerger, Michael

    2016-01-01

    The U.S. Food and Drug Administration's Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, "Compassionate Use"). Sixteen U.S. states recently passed "right-to-try" legislation aimed at promoting Expanded Access. Acknowledging popular support, Expanded Access could undermine clinical trials that benefit public health. Moreover, existing norms in oncologic care, for example, often lead patients to pursue intense treatments near the end of life, at the expense of palliation, and improved communication about the risks and benefits of Expanded Access would more often discourage its use.

  12. Family medical leave--management strategies.

    PubMed

    Morris, Judy A; Strasser, Patricia B

    2004-12-01

    Employers are recognizing the impact of lost productivity on total benefit costs. In a recent report based on 2002 benefit data, lost productivity represented 71% of the full cost of health/absence benefits (Integrated Benefits Institute, 2004). Occupational health nurse managers can develop FMLA leave management policies and programs to assure that leave is provided when appropriate, to help curb FMLA abuse and fraud, and to assist employers in defending adverse employment actions based on attendance. A review of employer policies and FMLA implementation also assesses compliance with the Act and provides the basis for appropriate responses in the case of legal actions and employee complaints to the U.S. Department of Labor.

  13. 42 CFR 438.420 - Continuation of benefits while the MCO or PIHP appeal and the State fair hearing are pending.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED... fair hearing are pending. (a) Terminology. As used in this section, “timely” filing means filing on or...

  14. 42 CFR 438.420 - Continuation of benefits while the MCO or PIHP appeal and the State fair hearing are pending.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED... fair hearing are pending. (a) Terminology. As used in this section, “timely” filing means filing on or...

  15. 42 CFR 438.420 - Continuation of benefits while the MCO or PIHP appeal and the State fair hearing are pending.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED... fair hearing are pending. (a) Terminology. As used in this section, “timely” filing means filing on or...

  16. 42 CFR 438.420 - Continuation of benefits while the MCO or PIHP appeal and the State fair hearing are pending.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED... fair hearing are pending. (a) Terminology. As used in this section, “timely” filing means filing on or...

  17. 32 CFR 199.21 - Pharmacy benefits program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... information may include but are not limited to: (A) Medical and pharmaceutical textbooks and reference books... Book) published by the Food and Drug Administration, or any successor to such reference. Generics are...) Cross-sectional or retrospective economic evaluations; (F) Pharmacoeconomic models; (G) Patent...

  18. The Benefits of Health Maintenance.

    ERIC Educational Resources Information Center

    Rosenstein, Alan H.

    1987-01-01

    The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

  19. 42 CFR 410.143 - Requirements for approved accreditation organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Requirements for approved accreditation organizations. 410.143 Section 410.143 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient...

  20. 42 CFR 410.143 - Requirements for approved accreditation organizations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Requirements for approved accreditation organizations. 410.143 Section 410.143 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient...

  1. 42 CFR 410.100 - Included services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Included services. 410.100 Section 410.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient Rehabilitation Facility (CORF) Services...

  2. 42 CFR 410.102 - Excluded services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Excluded services. 410.102 Section 410.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient Rehabilitation Facility (CORF) Services...

  3. 42 CFR 438.420 - Continuation of benefits while the MCO or PIHP appeal and the State fair hearing are pending.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED... fair hearing are pending. (a) Terminology. As used in this section, “timely” filing means filing on or...

  4. Subjective evaluation of a peer support program by women with breast cancer: A qualitative study.

    PubMed

    Ono, Miho; Tsuyumu, Yuko; Ota, Hiroko; Okamoto, Reiko

    2017-01-01

    The aim of this study was to determine the subjective evaluation of a breast cancer peer support program based on a survey of the participants who completed the program. Semistructured interviews were held with 10 women with breast cancer. The responses were subject to a qualitative inductive analysis. Women with breast cancer who participated in the breast cancer peer support program evaluated the features of the program and cited benefits, such as "Receiving individual peer support tailored to your needs," "Easily consulted trained peer supporters," and "Excellent coordination." Also indicated were benefits of the peer support that was received, such as "Receiving peer-specific emotional support," "Obtaining specific experimental information," "Re-examining yourself," and "Making preparations to move forward." The women also spoke of disadvantages, such as "Strict management of personal information" and "Matching limitations." In this study, the subjective evaluation of a peer support program by women with breast cancer was clarified . The women with breast cancer felt that the program had many benefits and some disadvantages. These results suggest that there is potential for peer support-based patient-support programs in medical services that are complementary to the current support that is provided by professionals. © 2016 Japan Academy of Nursing Science.

  5. Health care use and costs for participants in a diabetes disease management program, United States, 2007-2008.

    PubMed

    Dall, Timothy M; Roary, Mary; Yang, Wenya; Zhang, Shiping; Chen, Yaozhu J; Arday, David R; Gantt, Cynthia J; Zhang, Yiduo

    2011-05-01

    The Disease Management Association of America identifies diabetes as one of the chronic conditions with the greatest potential for management. TRICARE Management Activity, which administers health care benefits for US military service personnel, retirees, and their dependents, created a disease management program for beneficiaries with diabetes. The objective of this study was to determine whether participation intensity and prior indication of uncontrolled diabetes were associated with health care use and costs for participants enrolled in TRICARE's diabetes management program. This ongoing, opt-out study used a quasi-experimental approach to assess program impact for beneficiaries (n = 37,370) aged 18 to 64 living in the United States. Inclusion criteria were any diabetes-related emergency department visits or hospitalizations, more than 10 diabetes-related ambulatory visits, or more than twenty 30-day prescriptions for diabetes drugs in the previous year. Beginning in June 2007, all participants received educational mailings. Participants who agreed to receive a baseline telephone assessment and telephone counseling once per month in addition to educational mailings were considered active, and those who did not complete at least the baseline telephone assessment were considered passive. We categorized the diabetes status of each participant as "uncontrolled" or "controlled" on the basis of medical claims containing diagnosis codes for uncontrolled diabetes in the year preceding program eligibility. We compared observed outcomes to outcomes predicted in the absence of diabetes management. Prediction equations were based on regression analysis of medical claims for a historical control group (n = 23,818) that in October 2004 met the eligibility criteria for TRICARE's program implemented June 2007. We conducted regression analysis comparing historical control group patient outcomes after October 2004 with these baseline characteristics. Per-person total annual medical savings for program participants, calculated as the difference between observed and predicted outcomes, averaged $783. Active participants had larger reductions in inpatient days and emergency department visits, larger increases in ambulatory visits, and larger increases in receiving retinal examinations, hemoglobin A1c tests, and urine microalbumin tests compared with passive participants. Participants with prior indication of uncontrolled diabetes had higher per-person total annual medical savings, larger reduction in inpatient days, and larger increases in ambulatory visits than did participants with controlled diabetes. Greater intensity of participation in TRICARE's diabetes management program was associated with lower medical costs and improved receipt of recommended testing. That patients who were categorized as having uncontrolled diabetes realized greater program benefits suggests diabetes management programs should consider indication of uncontrolled diabetes in their program candidate identification criteria.

  6. Value of lifestyle intervention to prevent diabetes and sequelae.

    PubMed

    Dall, Timothy M; Storm, Michael V; Semilla, April P; Wintfeld, Neil; O'Grady, Michael; Narayan, K M Venkat

    2015-03-01

    The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes. To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae. This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease. Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years. Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Smoke Alarm Giveaway and Installation Programs

    PubMed Central

    Liu, Ying; Mack, Karin A.; Diekman, Shane T.

    2015-01-01

    Background The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. Purpose To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Methods Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Results Cost-effectiveness analysis (CEA) resulted in anaverage cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost–benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit–cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Conclusions Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventionsto reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. PMID:22992356

  8. Global Health Values of a Multidirectional Near Peer Training Program in Surgery, Pathology, Anatomy, Research Methodology, and Medical Education for Haitian, Rwandan, and Canadian Medical Students.

    PubMed

    Elharram, Malik; Dinh, Trish; Lalande, Annie; Ge, Susan; Gao, Sophie; Noël, Geoffroy

    As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students. Students from the University of Kigali, Rwanda and Université Quisqueya, Haiti, participated in a 3-week program at McGill University. The students spanned from the first to sixth year of their respective medical training. The program consisted of anatomy dissections, surgical simulations, clinical pathology shadowing, and interactive sessions in research methodology and medical education. To evaluate the program, a survey was administered to students using a mixed methodology approach. Common benefits pointed out by the participants included personal and professional growth. The exchange improved career development, sense of responsibility toward one's own community, teaching skills, and sociocultural awareness. The participants all agreed that the anatomy dissections improved their knowledge of anatomy and would make them more comfortable teaching the material when the returned to their university. The clinical simulation activities and shadowing experiences allowed them to integrate the different disciplines. However, the students all felt the research component had too little time devoted to it and that the knowledge presented was beyond their educational level. The development of an integrated international program in surgery, pathology, anatomy, research methodology, and medical education provided medical students with an opportunity to learn about differences in health care and medical education between the 3 countries. This exchange demonstrated that a crosscultural near-peer teaching environment can be an effective and sustainable method of medical student-centered development in global health. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  9. Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

    PubMed Central

    Paul, Edward; Fullerton, Danya Fortess; Cohen, Ellen; Lawton, Ellen; Ryan, Anne; Sandel, Megan

    2009-01-01

    Background Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. Intervention This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Discussion Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced. PMID:21975996

  10. Outcomes of Kidney Transplantations Under the Philippine Health Insurance Corporation's Type Z Benefit Package at the National Kidney and Transplant Institute, Philippines.

    PubMed

    Pamugas, G E P; Arakama, M-H I; Danguilan, R A; Ledesma, D

    2016-04-01

    Under the Universal Health Care Program of the Department of Health, the Philippine Health Insurance Corporation (PHIC) launched the Case Type Z benefit package for kidney transplantation, providing the largest amount (USD $13,300.00) for any single medical procedure. The objective of this study was to describe under the PHIC Case Type Z Benefit Package for kidney transplantation at the National Kidney and Transplant Institute and kidney transplantation outcomes under this package. Included in the benefit were standard risk recipients between 10 and 70 years of age with at least 1 human leukocyte antigen (HLA) DR match with the donor, panel-reactive antibody (PRA) less than 20%, and absence of donor-specific antibody (DSA). Previous transplantations, malignancy, hepatitis B and C, human immunodeficiency virus (HIV) positivity, cytomegalovirus (CMV) R-/D+, congestive heart failure, and liver cirrhosis were exclusion criteria. Patients were evaluated by a medical social worker according to their family's financial status. Since June 2012, a total of 261 patients have received the benefit, with 44 under service, 37 with fixed co-pay and 180 with variable co-pay. Of the living donor kidney transplants, 98% had immediate graft function, with 2.3% (6/261) acute rejection rates at 1 year. The total cost of hospitalization was within the benefit for living donor kidney transplants (less than USD 8000.00) but exceeded it in all cases of deceased donor kidney transplants. The successful use of and excellent outcomes under the Case Type Z benefit demonstrated how collaboration among government agencies, health care providers, and pharmaceutical companies could result in a program that improved the access to health care for Filipino patients with end-stage renal disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Optimization Routine for Generating Medical Kits for Spaceflight Using the Integrated Medical Model

    NASA Technical Reports Server (NTRS)

    Graham, Kimberli; Myers, Jerry; Goodenow, Deb

    2017-01-01

    The Integrated Medical Model (IMM) is a MATLAB model that provides probabilistic assessment of the medical risk associated with human spaceflight missions.Different simulations or profiles can be run in which input conditions regarding both mission characteristics and crew characteristics may vary. For each simulation, the IMM records the total medical events that occur and “treats” each event with resources drawn from import scripts. IMM outputs include Total Medical Events (TME), Crew Health Index (CHI), probability of Evacuation (pEVAC), and probability of Loss of Crew Life (pLOCL).The Crew Health Index is determined by the amount of quality time lost (QTL). Previously, an optimization code was implemented in order to efficiently generate medical kits. The kits were optimized to have the greatest benefit possible, given amass and/or volume constraint. A 6-crew, 14-day lunar mission was chosen for the simulation and run through the IMM for 100,000 trials. A built-in MATLAB solver, mixed-integer linear programming, was used for the optimization routine. Kits were generated in 10% increments ranging from 10%-100% of the benefit constraints. Conditions wheremass alone was minimized, volume alone was minimized, and where mass and volume were minimizedjointly were tested.

  12. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training...

  13. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training...

  14. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training...

  15. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training...

  16. 42 CFR 410.145 - Requirements for entities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and... documentation and is fully accredited (and periodically reaccredited) by an organization approved by CMS under § 410.142. (ii) The entity is not accredited by an organization that owns or controls the entity. (2...

  17. 42 CFR 410.145 - Requirements for entities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and... documentation and is fully accredited (and periodically reaccredited) by an organization approved by CMS under § 410.142. (ii) The entity is not accredited by an organization that owns or controls the entity. (2...

  18. 45 CFR 5.67 - Exemption six: Clearly unwarranted invasion of personal privacy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... employees; social security numbers; medical information about individuals participating in clinical research studies; names and addresses of individual beneficiaries of our programs, or benefits such individuals receive; earning records, claim files, and other personal information maintained by the Social Security...

  19. 45 CFR 5.67 - Exemption six: Clearly unwarranted invasion of personal privacy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... employees; social security numbers; medical information about individuals participating in clinical research studies; names and addresses of individual beneficiaries of our programs, or benefits such individuals receive; earning records, claim files, and other personal information maintained by the Social Security...

  20. 45 CFR 5.67 - Exemption six: Clearly unwarranted invasion of personal privacy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... employees; social security numbers; medical information about individuals participating in clinical research studies; names and addresses of individual beneficiaries of our programs, or benefits such individuals receive; earning records, claim files, and other personal information maintained by the Social Security...

  1. 45 CFR 5.67 - Exemption six: Clearly unwarranted invasion of personal privacy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... employees; social security numbers; medical information about individuals participating in clinical research studies; names and addresses of individual beneficiaries of our programs, or benefits such individuals receive; earning records, claim files, and other personal information maintained by the Social Security...

  2. 42 CFR 410.141 - Outpatient diabetes self-management training.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient diabetes self-management training. 410... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training...

  3. 42 CFR 417.436 - Rules for enrollees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.436 Rules for enrollees... limited to the following: (1) All benefits provided under the contract, as described in § 417.440. (2) How...

  4. [Parameter of evidence-based medicine in health care economics].

    PubMed

    Wasem, J; Siebert, U

    1999-08-01

    In the view of scarcity of resources, economic evaluations in health care, in which not only effects but also costs related to a medical intervention are examined and a incremental cost-outcome-ratio is build, are an important supplement to the program of evidence based medicine. Outcomes of a medical intervention can be measured by clinical effectiveness, quality-adjusted life years, and monetary evaluation of benefits. As far as costs are concerned, direct medical costs, direct non-medical costs and indirect costs have to be considered in an economic evaluation. Data can be used from primary studies or secondary analysis; metaanalysis for synthesizing of data may be adequate. For calculation of incremental cost-benefit-ratios, models of decision analysis (decision tree models, Markov-models) often are necessary. Methodological and ethical limits for application of the results of economic evaluation in resource allocation decision in health care have to be regarded: Economic evaluations and the calculation of cost-outcome-rations should only support decision making but cannot replace it.

  5. States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.

    PubMed

    Keohane, Laura M; Trivedi, Amal; Mor, Vincent

    2017-10-01

    Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.

  6. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    PubMed Central

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID:26384479

  7. Enhance®Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review.

    PubMed

    Petrescu-Prahova, Miruna G; Eagen, Thomas J; Fishleder, Sarah L; Belza, Basia

    2017-03-01

    Physical activity has many benefits for older adult physical and mental health. Enhance ® Fitness (EF) is an evidence-based group exercise program delivered by community-based organizations. The purpose of this study was to review recent evidence on the dissemination and implementation of EF. A scoping review of qualitative and quantitative studies with EF as main focus was conducted. CINAHL, PubMed, PubMed Central, SCOPUS, Web of Science, PsycINFO, and Google Scholar were searched between October and November 2015 for data-based studies on EF published in 2010-2015. Two team members abstracted each paper independently using a data abstraction tool. Results were summarized using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Seventeen publications met inclusion criteria. EF has reached and is effective across a broad population base, including individuals with low SES and diverse ethnic/racial backgrounds. EF participation may be associated with reduced risk for falls requiring medical care, and is associated with fewer hospital admissions. Analyses of medical cost savings from EF participation and program implementation costs suggest economic benefits of EF implementation for communities. Organization-level maintenance is facilitated by program-specific and organizational factors, such as instructor training and funding. Individual-level maintenance is facilitated by program structure, absence of pain, and increased quality of life. More-rigorous evidence is needed about the association between participation in EF and conditions such as falls. Evaluation of program fidelity, adaptations, and sustainability is limited; more-systematic examination across population groups and types of organizations would help ensure older adults continue to benefit from EF participation. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Reducing oral and maxillofacial surgery resident risk exposure: lessons from graduate medical education reform.

    PubMed

    Buhrow, Suzanne Morse; Buhrow, Jack A

    2013-12-01

    It is estimated that, in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Although numerous studies examine the causes of medical trainee errors and efforts to mitigate patient injuries in this population, little research exists on adverse events experienced by oral and maxillofacial surgery (OMFS) residents or strategies to improve patient safety awareness in OMFS residency programs. The authors conducted a retrospective literature review of contemporary studies on medical trainees' reported risk exposure and the impact of integrating evidence-based patient safety training into residency curricula. A review of the literature suggests that OMFS residents face similar risks as medical trainees in medical, surgical, and anesthesia residency programs and may benefit from integrating competency-based safety training in the OMFS residency curriculum. OMFS trainees face particular challenges when transitioning from dental student to surgical resident, particularly related to their limited clinical exposure to high-reliability organizations, which may place them at higher risk than other medical trainees. OMFS educators should establish resident competence in patient safety principles and system improvement strategies throughout the training period.

  9. Physical activity counseling in medical school education: a systematic review

    PubMed Central

    Dacey, Marie L.; Kennedy, Mary A.; Polak, Rani; Phillips, Edward M.

    2014-01-01

    Background Despite a large evidence base to demonstrate the health benefits of regular physical activity (PA), few physicians incorporate PA counseling into office visits. Inadequate medical training has been cited as a cause for this. This review describes curricular components and assesses the effectiveness of programs that have reported outcomes of PA counseling education in medical schools. Methods The authors systematically searched MEDLINE, EMBASE, PsychINFO, and ERIC databases for articles published in English from 2000 through 2012 that met PICOS inclusion criteria of medical school programs with PA counseling skill development and evaluation of outcomes. An initial search yielded 1944 citations, and 11 studies representing 10 unique programs met criteria for this review. These studies were described and analyzed for study quality. Strength of evidence for six measured outcomes shared by multiple studies was also evaluated, that is, students’ awareness of benefits of PA, change in students’ attitudes toward PA, change in personal PA behaviors, improvements in PA counseling knowledge and skills, self-efficacy to conduct PA counseling, and change in attitude toward PA counseling. Results Considerable heterogeneity of teaching methods, duration, and placement within the curriculum was noted. Weak research designs limited an optimal evaluation of effectiveness, that is, few provided pre-/post-intervention assessments, and/or included control comparisons, or met criteria for intervention transparency and control for risk of bias. The programs with the most evidence of improvement indicated positive changes in students’ attitudes toward PA, their PA counseling knowledge and skills, and their self-efficacy to conduct PA counseling. These programs were most likely to follow previous recommendations to include experiential learning, theoretically based frameworks, and students’ personal PA behaviors. Conclusions Current results provide some support for previous recommendations, and current initiatives are underway that build upon these. However, evidence of improvements in physician practices and patient outcomes is lacking. Recommendations include future directions for curriculum development and more rigorous research designs. PMID:25062944

  10. Automated external defibrillators in National Collegiate Athletic Association Division I Athletics.

    PubMed

    Coris, Eric E; Sahebzamani, Frances; Walz, Steve; Ramirez, Arnold M

    2004-01-01

    Sudden cardiac death is the leading cause of death in athletes. Evidence on current sudden cardiac death prevention through preparticipation history, physicals, and noninvasive cardiovascular diagnostics has demonstrated a low sensitivity for detection of athletes at high risk of sudden cardiac death. Data are lacking on automated external defibrillator programs specifically initiated to respond to rare dysrhythmia in younger, relatively low-risk populations. Surveys were mailed to the head athletic trainers of all National Collegiate Athletic Association Division I athletics programs listed in the National Athletic Trainers' Association directory. In all, 303 surveys were mailed; 186 departments (61%) responded. Seventy-two percent (133) of responding National Collegiate Athletic Association Division I athletics programs have access to automated external defibrillator units; 54% (101) own their units. Proven medical benefit (55%), concern for liability (51%), and affordability (29%) ranked highest in frequency of reasons for automated external defibrillator purchase. Unit cost (odds ratio = 1.01; 95% confidence interval, 1.01-1.0), donated units (odds ratio = 1.92; confidence interval, 3.66-1.01), institution size (odds ratio =.0001; confidence interval, 1.3 E-4 to 2.2E-05), and proven medical benefit of automated external defibrillators (odds ratio = 24; confidence interval, 72-8.1) were the most significant predictors of departmental defibrillator ownership. Emergency medical service response time and sudden cardiac death event history were not significantly predictive of departmental defibrillator ownership. The majority of automated external defibrillator interventions occurred on nonathletes. Many athletics medicine programs are obtaining automated external defibrillators without apparent criteria for determination of need. Usage and maintenance policies vary widely among departments with unit ownership or access. Programs need to approach the issue of unit acquisition and implementation with knowledge of the surrounding emergency medical service system, geography of their individual sports medicine facilities, numbers and relative risk of their athletes, and budgetary constraints.

  11. Lessons learned: a "homeless shelter intervention" by a medical student.

    PubMed

    Owusu, Yasmin; Kunik, Mark; Coverdale, John; Shah, Asim; Primm, Annelle; Harris, Toi

    2012-05-01

    The authors explored the process of implementing a medical student-initiated program designed to provide computerized mental health screening, referral, and education in a homeless shelter. An educational program was designed to teach homeless shelter staff about psychiatric disorders and culturally-informed treatment strategies. Pre- and post-questionnaires were obtained in conjunction with the educational program involving seven volunteer shelter staff. A computerized mental health screening tool, Quick Psycho-Diagnostics Panel (QPD), was utilized to screen for the presence of nine psychiatric disorders in 19 volunteer homeless shelter residents. Shelter staffs' overall fund of knowledge improved by an average of 23% on the basis of pre-/post-questionnaires (p=0.005). Of the individuals who participated in the mental health screening, 68% screened positive for at least one psychiatric disorder and were referred for further mental health care. At the 3-month follow-up of these individuals, 46% of those referred had accessed their referral services as recommended. Medical student-initiated psychiatric outreach programs to the homeless community have the potential to reduce mental health disparities by both increasing access to mental health services and by providing education. The authors discuss educational challenges and benefits for the medical students involved in this project.

  12. Policy analysis for prenatal genetic diagnosis.

    PubMed

    Thompson, M; Milunsky, A

    1979-01-01

    Consideration of the analytic difficulties faced in estimating the benefits and costs of prenatal genetic diagnosis, coupled with a brief review of existing benefit-cost studies, leads to the conclusion that public subsidy of prenatal testing can yield benefits substantially in excess of costs. The practical obstacles to such programs include the attitudes of prospective parents, a lack of knowledge, monetary barriers, inadequately organized medical resources, and the political issue of abortion. Policy analysis can now nevertheless formulate principles and guide immediate actions to improve present utilization of prenatal testing and to facilitate possible future expansion of these diagnostic techniques.

  13. Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

    PubMed

    Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

    2012-09-15

    The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

  14. [The characteristics of allocation of voluntary medical insurance of working population in Russia].

    PubMed

    Ankudinov, A B; Lebedev, O V

    2016-01-01

    The article presents the results of analysis of widespread of prevalence of additional medical services and voluntary medical insurance of working population of Russia. The quantitative values were received concerning widespread of disposal to Russian workers of various industries of social benefits on partial and full payment of treatment, degree of participation of workers in programs of voluntary medical insurance. It is demonstrated that besides sectorial characteristics the determinants of widespread of granting additional medical insurance are positioned as individual characteristics of workers and such obstacles as length of service, education, salary of worker, type of residence settlement, harmful and dangerous conditions of labor, type of property of enterprise (public/non-public).

  15. Policy statement--emergency information forms and emergency preparedness for children with special health care needs.

    PubMed

    2010-04-01

    Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.

  16. COMPARE/Radiology, an interactive Web-based radiology teaching program evaluation of user response.

    PubMed

    Wagner, Matthias; Heckemann, Rolf A; Nömayr, Anton; Greess, Holger; Bautz, Werner A; Grunewald, Markus

    2005-06-01

    The aim of this study is to assess user benefits of COMPARE/Radiology, a highly interactive World Wide Web-based training program for radiology, as perceived by its users. COMPARE/Radiology (http://www.idr.med.uni-erlangen.de/compare.htm), an interactive training program based on 244 teaching cases, was created by the authors and made publicly available on the Internet. An anonymous survey was conducted among users to investigate the composition of the program's user base and assess the acceptance of the training program. In parallel, Web access data were collected and analyzed using descriptive statistics. The group of responding users (n = 1370) consisted of 201 preclinical medical students (14.7%), 314 clinical medical students (22.9%), 359 residents in radiology (26.2%), and 205 users of other professions (14.9%). A majority of respondents (1230; 89%) rated the interactivity of COMPARE/Radiology as good or excellent. Many respondents use COMPARE/Radiology for self-study (971; 70%) and for teaching others (600; 43%). Web access statistics show an increase in number of site visits from 1248 in December 2002 to 4651 in April 2004. Users appreciate the benefits of COMPARE/Radiology. The interactive instructional design was rated positively by responding users. The popularity of the site is growing, evidenced by the number of network accesses during the observation period.

  17. Characteristics of nontrauma scene flights for air medical transport.

    PubMed

    Krebs, Margaret G; Fletcher, Erica N; Werman, Howard; McKenzie, Lara B

    2014-01-01

    Little is known about the use of air medical transport for patients with medical, rather than traumatic, emergencies. This study describes the practices of air transport programs, with respect to nontrauma scene responses, in several areas throughout the United States and Canada. A descriptive, retrospective study was conducted of all nontrauma scene flights from 2008 and 2009. Flight information and patient demographic data were collected from 5 air transport programs. Descriptive statistics were used to examine indications for transport, Glasgow Coma Scale Scores, and loaded miles traveled. A total of 1,785 nontrauma scene flights were evaluated. The percentage of scene flights contributed by nontraumatic emergencies varied between programs, ranging from 0% to 44.3%. The most common indication for transport was cardiac, nonST-segment elevation myocardial infarction (22.9%). Cardiac arrest was the indication for transport in 2.5% of flights. One air transport program reported a high percentage (49.4) of neurologic, stroke, flights. The use of air transport for nontraumatic emergencies varied considerably between various air transport programs and regions. More research is needed to evaluate which nontraumatic emergencies benefit from air transport. National guidelines regarding the use of air transport for nontraumatic emergencies are needed. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  18. 20 CFR 725.708 - Disputes concerning medical benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Disputes concerning medical benefits. 725.708... FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Medical Benefits and Vocational Rehabilitation § 725.708 Disputes concerning medical benefits. (a) Whenever a dispute develops concerning medical services under...

  19. Cost of chronic hepatitis B infection in South Korea.

    PubMed

    Yang, Bong-Min; Kim, Cheol-Hwan; Kim, Ji-Yun

    2004-01-01

    To estimate the direct medical costs of chronic hepatitis B (CHB) infection and its liver disease sequelae in South Korea. Korea is a hepatitis B-endemic area with 5.79% to 10.87% of males and 1.51% to 4.44% of females over 20 years of age carrying the virus. It is estimated that 25% of carriers will develop serious hepatitis B virus (HBV)-related complications. While vaccination programs have reduced the prevalence of hepatitis B in people younger than 20 years, significant CHB-related morbidity will continue to occur for the next 15 to 30 years until the benefits of the vaccination programs take effect. Direct medical costs for six CHB-related disease states, including hepatocellular carcinoma and liver transplant, were estimated for the year 2001. Four data sources were used to gather information: the National Health Insurance Corporation database, patients' medical charts, expert opinion, and patient survey data. In 2001, the total medical costs of six CHB-related diseases were 250 million Korean Won (KRW) (equivalent to U.S. 208.6 million dollars), based on an exchange rate of KRW 1200 = US 1 dollar. Annual treatment costs per patient ranged from KRW297,392 (US 248 dollars) for chronic hepatitis B to KRW 80.6 million (U.S. 67,156 dollars) for liver transplant. The cost of treatment rose continuously with liver disease progression. The main cost driver was inpatient hospitalizations (including surgical costs). CHB-related diseases are a significant cost burden to the South Korean healthcare system. In addition to the obvious clinical benefits, the prevention or delay of chronic hepatitis B liver disease progression in South Korea could result in substantial economic benefits to the whole society.

  20. 76 FR 4703 - Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... regarding medical loss ratio standards and the insurance premium rate review process, and issues premium... Oriented Plan program. Collects, compiles and maintains comparative pricing data for an Internet portal... benefit from the new health insurance system. Collects, compiles and maintains comparative pricing data...

  1. 42 CFR 403.720 - Conditions for coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... healing and for whom the acceptance of medical services would be inconsistent with their religious beliefs... services to inpatients on a 24-hour basis. (6) Does not furnish, on the basis of religious beliefs, through... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  2. 42 CFR 403.720 - Conditions for coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... healing and for whom the acceptance of medical services would be inconsistent with their religious beliefs... services to inpatients on a 24-hour basis. (6) Does not furnish, on the basis of religious beliefs, through... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  3. 42 CFR 403.720 - Conditions for coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... healing and for whom the acceptance of medical services would be inconsistent with their religious beliefs... services to inpatients on a 24-hour basis. (6) Does not furnish, on the basis of religious beliefs, through... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  4. 42 CFR 403.720 - Conditions for coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... healing and for whom the acceptance of medical services would be inconsistent with their religious beliefs... services to inpatients on a 24-hour basis. (6) Does not furnish, on the basis of religious beliefs, through... PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

  5. 42 CFR 435.134 - Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... programs if he were not in a medical institution or intermediate care facility, and the Medicaid plan... institution or intermediate care facility, and the State's Medicaid plan covers this optional group. [43 FR...

  6. 42 CFR 435.134 - Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... programs if he were not in a medical institution or intermediate care facility, and the Medicaid plan... institution or intermediate care facility, and the State's Medicaid plan covers this optional group. [43 FR...

  7. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Exempt individuals. 440.315 Section 440.315 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.315 Exempt individuals....

  8. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Exempt individuals. 440.315 Section 440.315 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.315 Exempt individuals....

  9. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Exempt individuals. 440.315 Section 440.315 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.315 Exempt individuals....

  10. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Exempt individuals. 440.315 Section 440.315 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.315 Exempt individuals....

  11. 42 CFR 440.315 - Exempt individuals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Exempt individuals. 440.315 Section 440.315 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.315 Exempt individuals....

  12. 42 CFR 410.105 - Requirements for coverage of CORF services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for coverage of CORF services. 410.105 Section 410.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Comprehensive Outpatient...

  13. 42 CFR 438.102 - Provider-enrollee communications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... advocating on behalf of an enrollee who is his or her patient, for the following: (i) The enrollee's health.... (iii) The risks, benefits, and consequences of treatment or nontreatment. (iv) The enrollee's right to... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.102...

  14. 42 CFR 438.102 - Provider-enrollee communications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... advocating on behalf of an enrollee who is his or her patient, for the following: (i) The enrollee's health.... (iii) The risks, benefits, and consequences of treatment or nontreatment. (iv) The enrollee's right to... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.102...

  15. 42 CFR 438.102 - Provider-enrollee communications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... advocating on behalf of an enrollee who is his or her patient, for the following: (i) The enrollee's health.... (iii) The risks, benefits, and consequences of treatment or nontreatment. (iv) The enrollee's right to... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.102...

  16. 42 CFR 438.102 - Provider-enrollee communications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... advocating on behalf of an enrollee who is his or her patient, for the following: (i) The enrollee's health.... (iii) The risks, benefits, and consequences of treatment or nontreatment. (iv) The enrollee's right to... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.102...

  17. Eight Years of the Mayo International Health Program: What an International Elective Adds to Resident Education

    PubMed Central

    Sawatsky, Adam P.; Rosenman, David J.; Merry, Stephen P.; McDonald, Furman S.

    2010-01-01

    OBJECTIVE: To examine the educational benefits of international elective rotations during graduate medical education. PARTICIPANTS AND METHODS: We studied Mayo International Health Program (MIHP) participants from April 1, 2001, through July 31, 2008. Data from the 162 resident postrotation reports were reviewed and used to quantitatively and qualitatively analyze MIHP elective experiences. Qualitative analysis of the narrative data was performed using NVivo7 (QRS International, Melbourne, Australia), a qualitative research program, and passages were coded and analyzed for trends and themes. RESULTS: During the study period, 162 residents representing 20 different specialties were awarded scholarships through the MIHP. Residents rotated in 43 countries, serving over 40,000 patients worldwide. Their reports indicated multiple educational and personal benefits, including gaining experience with a wide variety of pathology, learning to work with limited resources, developing clinical and surgical skills, participating in resident education, and experiencing new peoples and cultures. CONCLUSION: The MIHP provides the structure and funding to enable residents from a variety of specialties to participate in international electives and obtain an identifiable set of unique, valuable educational experiences likely to shape them into better physicians. Such international health electives should be encouraged in graduate medical education. PMID:20675512

  18. Provider, veteran, and family perspectives on family education in Veterans Affairs community-based outpatient facilities.

    PubMed

    Sherman, Michelle D; Fischer, Ellen P

    2012-02-01

    The Veterans Affairs (VA) healthcare system is dedicated to providing high-quality mental health services to all veterans, including the nearly 40% of enrolled veterans living in rural areas. Family education programs regarding mental illness and posttraumatic stress disorder, mandated for delivery in all VA medical centers and some community-based outpatient clinics (CBOCs), have been developed and provided primarily in large, urban medical centers. This qualitative investigation involved interviews with CBOC providers and veterans and families who live in rural areas and/or seek care in CBOCs to ascertain their perceptions of the benefits, feasibility, structural and cultural barriers, and logistical preferences regarding family education. The perspectives and concerns that emerged in these interviews were combined with expert knowledge to identify the resources and considerations a VAMC would want to address when translating and implementing similar programming into CBOCs. Although institutional, logistic, and attitudinal challenges were described, all three stakeholder groups endorsed the need for family education, did not see the barriers as insurmountable, and provided creative solutions. Administrators and CBOC clinicians may benefit by anticipating and problem solving around the key issues raised when developing family programming.

  19. The pacific island health care project.

    PubMed

    Person, Donald Ames

    2014-01-01

    US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations. More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990-1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.).

  20. Building Workforce Capacity Abroad While Strengthening Global Health Programs at Home: Participation of Seven Harvard-Affiliated Institutions in a Health Professional Training Initiative in Rwanda.

    PubMed

    Cancedda, Corrado; Riviello, Robert; Wilson, Kim; Scott, Kirstin W; Tuteja, Meenu; Barrow, Jane R; Hedt-Gauthier, Bethany; Bukhman, Gene; Scott, Jennifer; Milner, Danny; Raviola, Giuseppe; Weissman, Barbara; Smith, Stacy; Nuthulaganti, Tej; McClain, Craig D; Bierer, Barbara E; Farmer, Paul E; Becker, Anne E; Binagwaho, Agnes; Rhatigan, Joseph; Golan, David E

    2017-05-01

    A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda. In this Article, the authors describe how U.S. academic institutions (focusing on the seven Harvard-affiliated institutions participating in the HRH Program-Harvard Medical School, Brigham and Women's Hospital, Harvard School of Dental Medicine, Boston Children's Hospital, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Massachusetts Eye and Ear Infirmary) have also benefited: (1) by providing opportunities to their faculty and trainees to engage in global health activities; (2) by establishing long-term, academic partnerships and collaborations with Rwandan academic institutions; and (3) by building the administrative and mentorship capacity to support global health initiatives beyond the HRH Program. In doing this, the authors describe the seven Harvard-affiliated institutions' contributions to the HRH Program, summarize the benefits accrued by these institutions as a result of their participation in the program, describe the challenges they encountered in implementing the program, and outline potential solutions to these challenges that may inform similar future health professional training initiatives.

  1. Right-to-Try Laws and Individual Patient “Compassionate Use” of Experimental Oncology Medications: A Call for Improved Provider-Patient Communication

    PubMed Central

    Hoerger, Michael

    2016-01-01

    The U.S. Food and Drug Administration’s Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, “Compassionate Use”). Sixteen U.S. states recently passed “right-to-try” legislation aimed at promoting Expanded Access. Acknowledging popular support, Expanded Access could undermine clinical trials that benefit public health. Moreover, existing norms in oncologic care, for example, often lead patients to pursue intense treatments near the end of life, at the expense of palliation, and improved communication about the risks and benefits of Expanded Access would more often discourage its use. PMID:26313583

  2. Evaluation of a Computerized Clinical Information System (Micromedex).

    PubMed Central

    Lundsgaarde, H. P.; Moreshead, G. E.

    1991-01-01

    This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database. PMID:1807583

  3. Evaluation of a Computerized Clinical Information System (Micromedex).

    PubMed

    Lundsgaarde, H P; Moreshead, G E

    1991-01-01

    This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database.

  4. Computer-Assisted, Programmed Text, and Lecture Modes of Instruction in Three Medical Training Courses: Comparative Evaluation

    DTIC Science & Technology

    1980-06-01

    I.indslev was peerless in leadership and management support of this project. The in anscriPt benefited from the reviews of several individuals. and...i4 7 Medical L.aboratorv achievement as a function of learner strategy preference for processing information and CAI vs. lecture...characteristics ’were used to assist CAI authors in the initial development of instructional materials and strategies appropriate to the target population in each

  5. Analyses of Military Healthcare Benefit Design and Delivery: Study in Support of the Military Compensation and Retirement Modernization Commission

    DTIC Science & Technology

    2015-01-01

    Health Sciences , and other specialized skill training and professional development education programs; • Base Operations/Communications – DoD medical and... Actuary lowered its estimate of future per capita medical spending for dual-eligible beneficiaries (i.e., beneficiaries eligible for both TRICARE and...of the covered population into account. While advanced actuarial modeling would be required to determine each plan’s actual premiums, here we

  6. A longitudinal study of medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in hospitalizations for cardiovascular disease.

    PubMed

    Land, Thomas; Rigotti, Nancy A; Levy, Douglas E; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Wetherell, Leann; Keithly, Lois

    2010-12-07

    Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%-70%) and 49% (95% confidence interval 6%-72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low-income smokers, removing the barriers to the use of smoking cessation pharmacotherapy has the potential to decrease short-term utilization of hospital services.

  7. A Longitudinal Study of Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Hospitalizations for Cardiovascular Disease

    PubMed Central

    Land, Thomas; Rigotti, Nancy A.; Levy, Douglas E.; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Wetherell, LeAnn; Keithly, Lois

    2010-01-01

    Background Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Methods and Findings Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%–70%) and 49% (95% confidence interval 6%–72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Conclusions Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low-income smokers, removing the barriers to the use of smoking cessation pharmacotherapy has the potential to decrease short-term utilization of hospital services. Please see later in the article for the Editors' Summary PMID:21170313

  8. Learnings From the Pilot Implementation of Mobile Medical Milestones Application.

    PubMed

    Page, Cristen P; Reid, Alfred; Coe, Catherine L; Carlough, Martha; Rosenbaum, Daryl; Beste, Janalynn; Fagan, Blake; Steinbacher, Erika; Jones, Geoffrey; Newton, Warren P

    2016-10-01

    Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool. Residents and faculty completed presurveys and postsurveys about the tool and the evaluation process in their program. Program directors were interviewed individually. Interviews and open-ended survey responses were analyzed and coded using the constant comparative method, and responses were tabulated under themes. Common perceptions included increased data collection, enhanced efficiency, and increased perceived quality of the information gathered with the M3App. Residents appreciated the timely, high-quality feedback they received. Faculty reported becoming more comfortable with the tool over time, and a more favorable evaluation of the tool was associated with higher utilization. Program directors reported improvements in faculty knowledge of the milestones and resident satisfaction with feedback. Faculty and residents credited the M3App with improving the quality and efficiency of resident feedback. Residents appreciated the frequency, proximity, and specificity of feedback, and faculty reported the app improved their familiarity with the milestones. Implementation challenges included lack of a physician champion and competing demands on faculty time.

  9. Migration of a telehealth program to a e-education health program

    NASA Astrophysics Data System (ADS)

    Gomez, A.; Montano, L. F.; Amaro, L.; Aleman, B.

    It's presented the result of the experience of Telehealth in Mexico, inside a National program, in one Public Health Institution, which along nine years of using, has been fulfilled a retrospective and prospective analysis of future application, emphasising on the specification of characteristics of the application sites, with impact measures: Cost/Opportunity , Cost/Benefit , and Cost/Efficiency . Anticipating inversion and reorganization of the net when being convenient, as well as situate the distance medical attention, beyond the institutional technologic platforms. A fanlight of possibilities is already opened to e-education programs that support the preventive medicine, the self-care, and the distance medical education in all medical attention levels, enlarging it covering not only to doctors, paramedical and nurses but also to general population, making it more equable and covering the minorities like rural population, handicaps, and indigene population overall in development ways countries and identifying the impact measurements in the evaluation of the enabling given to; doctors, teachers, students and open population. Also is proposed a Latin American E-Education Net for Health.

  10. Benefits, Costs, and Harms of Osteoporosis Screening in Male Veterans

    DTIC Science & Technology

    2013-10-01

    obtaining text files due to new requirement for real SSN access. However, NLP programming is completed, validated, and ready to run on the dataset...the diagnosis and management of osteoporosis in Canada : summary. CMAJ Canadian Medical Association Journal 2010, 182(17):1864-1873. 13. Qaseem A

  11. 42 CFR 440.370 - Economy and efficiency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Economy and efficiency. 440.370 Section 440.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.370 Economy and efficiency....

  12. 42 CFR 410.172 - Payment for partial hospitalization services in CMHCs: Conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for partial hospitalization services in CMHCs: Conditions. 410.172 Section 410.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS...

  13. 77 FR 10663 - Due Date of Initial Application Requirements for State Home Construction Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... professions; Health records; Homeless; Mental health programs; Nursing homes; Philippines, Reporting and... constructing, remodeling, altering, or expanding State home facilities that will furnish specified types of..., Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.014, Veterans State Domiciliary Care...

  14. LATIS3D: The Goal Standard for Laser-Tissue-Interaction Modeling

    NASA Astrophysics Data System (ADS)

    London, R. A.; Makarewicz, A. M.; Kim, B. M.; Gentile, N. A.; Yang, T. Y. B.

    2000-03-01

    The goal of this LDRD project has been to create LATIS3D-the world's premier computer program for laser-tissue interaction modeling. The development was based on recent experience with the 2D LATIS code and the ASCI code, KULL. With LATIS3D, important applications in laser medical therapy were researched including dynamical calculations of tissue emulsification and ablation, photothermal therapy, and photon transport for photodynamic therapy. This project also enhanced LLNL's core competency in laser-matter interactions and high-energy-density physics by pushing simulation codes into new parameter regimes and by attracting external expertise. This will benefit both existing LLNL programs such as ICF and SBSS and emerging programs in medical technology and other laser applications. The purpose of this project was to develop and apply a computer program for laser-tissue interaction modeling to aid in the development of new instruments and procedures in laser medicine.

  15. Army National Guard Medical Readiness Training Exercises in Southern Command

    DTIC Science & Technology

    1994-06-03

    pulled , the number of people in a health education class, or the number of procedures performed in order to assess the success of the program...the dental set was configured for general dentistry, but the missions often entailed pulling teeth rather than restoration of teeth. The staff...participating units’ level would benefit the academic world and may reveal valuable clues as to how to modify the program. The goali and objectives

  16. Economic analysis of measles elimination program in the Republic of Korea, 2001: a cost benefit analysis study.

    PubMed

    Bae, Geun-Ryang; Choe, Young June; Go, Un Yeong; Kim, Yong-Ik; Lee, Jong-Koo

    2013-05-31

    In this study, we modeled the cost benefit analysis for three different measles vaccination strategies based upon three different measles-containing vaccines in Korea, 2001. We employed an economic analysis model using vaccination coverage data and population-based measles surveillance data, along with available estimates of the costs for the different strategies. In addition, we have included analysis on benefit of reduction of complication by mumps and rubella. We evaluated four different strategies: strategy 1, keep-up program with a second dose measles-mumps-rubella (MMR) vaccine at 4-6 years without catch-up campaign; strategy 2, additional catch-up campaign with measles (M) vaccine; strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4, catch-up campaign with MMR vaccine. The cost of vaccination included cost for vaccines, vaccination practices and other administrative expenses. The direct benefit of estimated using data from National Health Insurance Company, a government-operated system that reimburses all medical costs spent on designated illness in Korea. With the routine one-dose MMR vaccination program, we estimated a baseline of 178,560 measles cases over the 20 years; when the catch-up campaign with M, MR or MMR vaccines was conducted, we estimated the measles cases would decrease to 5936 cases. Among all strategies, the two-dose MMR keep-up program with MR catch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefit of 51.6 billion KRW. Across different vaccination strategies, our finding suggest that MR catch-up campaign in conjunction with two-dose MMR keep-up program was the most appropriate option in terms of economic costs and public health effects associated with measles elimination strategy in Korea. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Beyond Medical "Missions" to Impact-Driven Short-Term Experiences in Global Health (STEGHs): Ethical Principles to Optimize Community Benefit and Learner Experience.

    PubMed

    Melby, Melissa K; Loh, Lawrence C; Evert, Jessica; Prater, Christopher; Lin, Henry; Khan, Omar A

    2016-05-01

    Increasing demand for global health education in medical training has driven the growth of educational programs predicated on a model of short-term medical service abroad. Almost two-thirds of matriculating medical students expect to participate in a global health experience during medical school, continuing into residency and early careers. Despite positive intent, such short-term experiences in global health (STEGHs) may exacerbate global health inequities and even cause harm. Growing out of the "medical missions" tradition, contemporary participation continues to evolve. Ethical concerns and other disciplinary approaches, such as public health and anthropology, can be incorpo rated to increase effectiveness and sustainability, and to shift the culture of STEGHs from focusing on trainees and their home institutions to also considering benefits in host communities and nurtur ing partnerships. The authors propose four core principles to guide ethical development of educational STEGHs: (1) skills building in cross-cultural effective ness and cultural humility, (2) bidirectional participatory relationships, (3) local capacity building, and (4) long-term sustainability. Application of these principles highlights the need for assessment of STEGHs: data collection that allows transparent compar isons, standards of quality, bidirectionality of agreements, defined curricula, and ethics that meet both host and sending countries' standards and needs. To capture the enormous potential of STEGHs, a paradigm shift in the culture of STEGHs is needed to ensure that these experiences balance training level, personal competencies, medical and cross-cultural ethics, and educational objectives to minimize harm and maximize benefits for all involved.

  18. Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.

    PubMed

    Goulet-Stock, Sybil; Rueda, Sergio; Vafaei, Afshin; Ialomiteanu, Anca; Manthey, Jakob; Rehm, Jürgen; Fischer, Benedikt

    2017-01-01

    While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems. © 2017 S. Karger AG, Basel.

  19. Perceived benefits of the hepatitis C peer educators: a qualitative investigation.

    PubMed

    Batchelder, A W; Cockerham-Colas, L; Peyser, D; Reynoso, S P; Soloway, I; Litwin, A H

    2017-09-29

    Although opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment. In addition to HCV treatment-access barriers, substance-using patients may be reluctant to pursue treatment because of wariness of the medical system, lack of knowledge, or stigma related to HCV treatment. Implementation of a formal peer education program is one model of reducing provider- and patient-level barriers to HCV treatment, by enhancing mutual trust and reducing stigma. We used thematic qualitative analysis to explore how 30 HCV patients and peer educators perceived a HCV peer program within an established methadone maintenance program in the USA. Participants unanimously described the program as beneficial. Participants described the peer educators' normalization and dispelling of myths and fears around HCV treatment, and their exemplification of HCV treatment success, and reductions in perceived stigma. Peer educators described personal benefits. These findings indicate that HCV peer educators can enhance HCV treatment initiation and engagement within opioid substitution programs.

  20. 20 CFR 725.701 - Availability of medical benefits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Availability of medical benefits. 725.701... FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED Medical Benefits and Vocational Rehabilitation § 725.701 Availability of medical benefits. (a) A miner who is determined to be eligible for benefits under this part or...

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