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Monday Memo
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Clinical Accuracy Spoken Here
Spring Pollen and Asthma Management

It is generally accepted that there are allergic (extrinsic) and nonallergic (intrinsic) forms of asthma, and the distinction is usually based on the presence or absence of allergy skin-test reactivity. Extrinsic asthma appears to be the predominant form of the disease among young people and intrinsic asthma is more common among older subjects. The NAEPP recommends health care providers counsel asthma patients about exposures to inhalant allergens, regardless of their level of asthma severity. Once their sensitivities are identified, case managers can help their patients understand the pathogenesis of asthma and the importance of allergen control to asthma management.

Athena Forum, Asthma: Module B www.athenaforum.com

Diabetes and Menopausal Weight Gain

The co-morbid conditions associated with excess weight are many. One of the greatest contemporary concerns is the weight-related epidemic of diabetes. Weight gain, obesity, and physical inactivity are risk factors for diabetes. Caloric intake in adults has increased by approximately 20% and some 75% of adult women do not meet the physical exercise recommendations. On a more positive note, the majority of cases of diabetes in women can be prevented with behavior modification alone. High fiber, low fat diet, BMI >25%, 30 minutes of daily exercise, moderate alcohol consumption and smoking cessation are modifiable, achievable lifestyle factors.

Athena Forum, Women's Health: Module B
Excellence in Case Mgmnt
HCM Obligation: Ethical Behavior

Case Managers have three professional obligations. The third is Ethical Behavior. Ethics is the branch of philosophy that explores questions about duty, obligations, responsibility, and individual rights... . "What should I do in this situation?" Professional ethics involves rules or standards concerned with actions that can be considered right or wrong, appropriate or inappropriate. Ethical dilemmas occur when ethical values are conflicting in a right vs. right scenario, such as truth vs. loyalty or justice vs. mercy. Most facilities have teams assigned to assist staff including the HCM to resolve ethical dilemmas.

[Reference: Athena Forum, Principles of Case Management: Module A.]

In the Headlines . . .
ACOs Accountable for Shared Savings or Losses

The new ACO delivery and payment model could serve 5 million Medicare beneficiaries through participating providers, and potentially save Medicare as much as $960 million over three years. CMS would continue to pay providers as it does under Medicare, and also develop a performance benchmark for each ACO to measure if the ACO qualifies to receive shared savings or be held accountable for losses. Quality in an ACO will be measured in five essential areas: patient/caregiver care experience, care coordination, patient safety, preventive health, and at-risk population health. The ACOs must define care coordination processes.

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The look of confidence
  CM Excellence® Series: 
  » Principles of Case
  » Patient Advocacy
  » Utilization Management
  » Discharge Planning
  » Hospital Revenue Cycle

  Clinical Series: 
  » Asthma
  » Behavioral Health
  » Colorectal Cancer
  » COPD
  » CV Risk: Stroke & MI
  » Diabetes
  » EOL & Palliative
  » GI Disorders
  » Heart Failure
  » Multiple Sclerosis
  » Obesity Management
  » Pain Management
  » Rheumatoid Arthritis
  » Women’s Health



Cathy Wright Cathy Wright, BSN, RN
Clinical Editor
Athena Forum


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