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CHP Medicare Advantage (HMO) Plans Receive 5 Stars

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

 

 

 

 

 

The Center for Medicare and Medicaid Services (CMS) has published the 2010 health plan star ratings for health plans at www.medicare.gov on the Health Plan Finder. Capital Health Plan is the only Medicare Advantage plan in Florida, and one of only three in the nation, to receive 5 stars for the summary rating of health plan quality from CMS.

Stars for each plan show how well the plan performs in that particular category. Star ratings range from 1 star to 5 stars, where 1 star means "poor" quality and a rating of 5 stars means "excellent" quality.

“These rankings are based on clinical performance, member satisfaction and accreditation information. CHP is always finding ways to improve the quality of the health care services we provide, and we are honored to receive this prestigious recognition,” said CHP Chief Medical Officer Dr. Nancy Van Vessem. “It is a reflection of the commitment of our physicians and clinical staff to consistently deliver quality service.”

If you have questions please contact our local Member Services.

 

Ask Dr. Nancy: Osteoarthritis

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

My knees hurt more and more as the years go by. How would I know if I have osteoarthritis?

Osteoarthritis (OA), also called degenerative joint disease, is the most common type of arthritis. It is caused by a breakdown of the cartilage that cushions the ends of bones. As that cushion wears down, the tendons and ligaments around the joint may weaken and the bones may rub together which causes pain, stiffness and swelling.

Because cartilage wears down over time, osteoarthritis is more common in older people and in people who have had a previous injury to a joint. Joints that bear the weight of the body such as knees and hips are affected the most. Finger joints at the middle and ends of your fingers can also be affected. Unlike other types of arthritis, osteoarthritis only leads to joint problems; it does not cause problems with the skin, internal organs or any other part of the body. Often there is a family history, and it appears that some people have cartilage that is more prone to wear-and-tear than others.

A recent panel with osteoarthritis experts from 12 countries found that 3 symptoms and 3 signs lead to the diagnosis of osteoarthritis with 99% accuracy. The 3 symptoms are: pain on use, short-lived morning stiffness, and limitations on how the joint functions such as stiffness. The 3 signs on exam are: crepitus (a grinding noised with bending of the joint), restricted movement, and bony enlargement. The most obvious place that bony enlargement can be seen is in the finger joints. When bony knobs form on the middle joint of the finger they are called Bouchard’s nodes and when they form on the end joints they are called Heberden’s nodes. You might want to think about whether or not these symptoms sound like ones you have and check in with your primary care physician.

Treatment for osteoarthritis has more to do with lifestyle than medical intervention. The Agency for Healthcare Quality and Research (www.ahrq.gov) recently published a guide, “Osteoarthritis of the Knee”, based on available scientific evidence.

There is a lot of good information in that guide about what helps. The top recommendations are to lose weight, keep moving with low impact exercises, and take mild pain relievers. You might also ask your physician about physical therapy. Strengthening the muscles that move the knee, particularly the large thigh muscle in front, the quadriceps, can lead to improved function and support of the knee.

The guide also discusses other treatments that usually do not reduce pain or improve knee movement for people with osteoarthritis: Glucosamine/ chondroitin supplements, joint lubricant shots (not the same as cortisone shots) and arthroscopic knee surgery to smooth out cartilage.

Ultimately knee osteoarthritis can lead to surgery for joint replacement but it is best to put that possibility off into the future by protecting your knees now.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

 

Dr. Nancy Represents CHP at NCQA Press Conference

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

 

On October 22nd the National Committee for Quality Assurance (NCQA) held a news conference in Washington, DC to release “The State of Health Care Quality: 2009.” The report is produced annually to monitor performance trends over time, track variations in patterns of care and provide recommendations for future quality improvement. It also provides an exclusive look at how well the health system performed over the past year in key areas of care and service. Data is drawn from audited data conveyed to NCQA through its Health Care Effectiveness Data and Information Set (HEDIS®) -- the most widely used performance measurement tool in health care -- as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®).

Dr. Nancy Van Vessem represented Capital Health Plan at the press conference, which focused on the achievements of a few notable health plans in the country. She highlighted Capital Health Plan’s achievements in Diabetes and Coronary Heart Disease Relative Resource Use (RRU) measures. NCQA will start publicly reporting HEDIS® RRU measures in 2010. These measures, unlike previous HEDIS® measures, assess the efficiency of care delivered by health plans for certain chronic diseases. In general, CHP members require less “rescue” such as inpatient admission and emergency room visits than members in other health plans.

Dr. Van Vessem emphasized that the long-term success of CHP is rooted in its high member satisfaction, high levels of trust, and low disenrollment. This means members with diabetes and coronary heart disease have been involved with local physicians and disease management programs over many years. They have fewer gaps in care attributed to a consistent approach to chronic disease and stable benefits.

“At Capital Health Plan we encourage every member to have a primary care physician. Our goal is to help the physicians manage the chronic disease of their patients,” said Dr. Van Vessem. One of the newest enhancements is that primary care physician offices can access its patients’ information related to gaps in care for a variety of quality measures via CHPConnect. This collaboration between Capital Health Plan, physicians and members has led to continued success measured by consistently excellent results on quality and member satisfaction scores. Now, that success has continued with notable performance on relative resource use measurements.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

 

Ask Dr. Nancy

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Q: What activities really help in avoiding mental decline as we age?

That’s a great question—for one reason because you assume brain power need not diminish with time. You’re right. As our cover story explains, scientists now know that brain cells and neural pathways can grow throughout life. Yes, the brain does shrink from age (particularly from about the 60s on), but many easy, everyday activities counteract the process and its mental losses.

 

1. Move it or lose it.

You may be surprised at the premier strategy for keeping your brain sharp: physical exercise. The scientific evidence is clear. Just walking 30–60 minutes several times a week has a big impact on the brain’s “executive functions”: planning, focusing, working memory (for example, retaining a phone number as you dial), multitasking, and making good behavior choices. More exercise increases the benefit. Lifelong exercisers show better mental functioning and less incidence of Alzheimer’s than sedentary people. However, even inactive people of 70 years and older improve cognitive performance with regular exercise. Why? Physical activity improves blood vessel health (blood flow to the brain) and releases proteins that grow neurons and their connections. The brain shrinks less.

 

2. Use it or lose it.

Seek out mental stimulation and training, like the coming InSight™ program for CHP seniors (see page 1). Research shows that learning something new (a language, sport, skill) or improving visual and aural acuity leads to overall improvement in brain function. Practicing a specific task (memory of names, for example) has a more limited benefit.

 

3. Get connected.

Social ties keep your brain livelier. In a study of 2,800 people aged 65 or older, those with at least five social ties suffered less cognitive decline than those without ties. Having connections doesn’t mean a social whirl. The ties included church and social groups, regular visits, and phone calls. Walk with a friend. Your brain gets a double boost!

 

4. Eat to think.

Some nutrients, such as antioxidants, appear to protect our brains—and they’re in tasty foods. Many experts recommend diets rich in colorful fruits (berries, raisins, prunes, oranges, red grapes), dark-colored vegetables (spinach, kale, eggplant), and fish with omega-e fatty acids (salmon, trout).

 

So . . . move, learn, socialize, eat well, and stay smart! It’s your choice. Live well.