Wednesday, January 25, 2017

Population Based Payment - for medical care Midnight Special

Twitter today led me to an article from Harvard Medical School News   "Alternative payment model boosts quality of care for low-income patients."

Population-based payment is a new concept for me, and so is the name BCBS of Massachusetts uses "Alternative Quality Contract (AQC).  But the program itself is not new.  Lump-sum payments to healthcare providers are intended to assure us of getting all the way to "well."

But detractors have seen possible problems down the line, and this article intends to show us that the criticism may be exaggerated.

I found the article easy to read.  And I think we may all need some good $ news about getting care in the future.

I just Googled Harvard News raising quality, and the title popped up right away.

Thursday, January 19, 2017


You probably know I loved my PT in Texas.  The most important thing I learned is still what my mechanic used to say:

We're not 29 any more

Even if you are 29, I still suggest caution with most moves. Extra caution with new moves.

That said, I'm a fan of Mayo Clinic, often go there first for health questions.  But regretfully must say, the balance exercises I got today in email are not, not for beginners.  

My PTs and one podiatrist insisted:  anything like standing on one foot, and maybe leaning from side to side, even stepping left to right/right to left quickly...First, do it all at a counter so you can grab on instantly if balance isn't ballerina-perfect.  

(For those of us who are really impatient, you can do those at-the-counter things while you're waiting in the doctor's treatment/consult room in front of the mirror.)

 Trust me.   

If you're still impatient, say "balance" to your MD and maybe you'll get more PT from somebody good.  Someone like the super coach who took away my fear of going down stairs.

I wish you health.

Wednesday, January 4, 2017


Twitter led me to the STAT news article: 

 In a Byzantine health system, navigators help at-risk patients find their way

Interesting article with many good stories of extreme help some navigators may provide, and times they seem to go beyond business as usual.  Also a bit about widely varied training for this position (the training part was a little uncomfortable for me since I've had a social worker or two who only seemed to be working on hours for their senior year college internship.)

This field can have many different definitions, and the navigators may have wide functions.  Headlines don't always tell it all:  I haven't interviewed the local navigator, but she did introduce herself at the lumpectomy surgeon's office and invite us to some educational lunch meetings for breast cancer patients and perhaps some 'survivors' still in treatment or with issues like lymph problems after surgery.

I loved the stories about navigators helping patients with little or no English.  However, facile English speaker patients are mentioned.  We who speak English can be permanently lost in giant hospitals with lousy signage if any.

ONe danger of the system was mentioned, and it's a va.lid  one:  patients, because of the wide varieyty of navigator duties may (easily) gget the ideea that the navigator is a medical professional (often not so.)  

Even our own doctor may be unaware of our hospital's navigator, if there is one, or the navigator's duties or expertise.

I suggest, if you ask for a navigator, be clear on what you want.  If one approaches you, or the hospital sends one, we can ask politely "Is she a cancer nurse?  What will she plan to do for me?"

As I read the article, I learned a lot of things the navigators sometimes do.  

Any way, it's a good read.  And worth knowing about - Even a friend may sometime ask us about them.  

PS  My wonderful NP Carol Hennessey was a perfect navigator for me when she helped me plot which doctor visit first, second, third.  And since I still use the great cream she prescribed.