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Posted by  | Aug 14, 2020 | Courtesy of Sleep Review

Cleveland Clinic researchers have developed a risk prediction model for healthcare providers to forecast an individual patient’s likelihood of testing positive for COVID-19 as well as their outcomes from the disease.

According a new study published in CHEST, the risk prediction model (called a nomogram) shows the relevance of age, race, gender, socioeconomic status, vaccination history, and current medications in COVID-19 risk. The risk calculator is a new tool for healthcare providers to aid them in predicting patient risk and tailoring decision-making about care.

“The ability to accurately predict whether or not a patient is likely to test positive for COVID-19, as well as potential outcomes including disease severity and hospitalization, will be paramount in effectively managing our resources and triaging care,” says Lara Jehi, MD, Cleveland Clinic’s chief research information officer and corresponding author on the study, in a release. “As we continue to battle this pandemic and prepare for a potential second wave, understanding a person’s risk is the first step in potential care and treatment planning.”

The nomogram, which has been deployed as a freely available online risk calculator, was developed using data from nearly 12,000 patients enrolled in Cleveland Clinic’s COVID-19 Registry, which includes all individuals tested at Cleveland Clinic for the disease, not just those that test positive. Continue Reading…

Round 2021 raises big question: Where should pricing be?

Monday, November 2, 2020 @ 09:11 AM  posted by jbuytaert

Courtesy of HME News

by:  Theresa Flaherty -  Friday, October 30, 2020\

WASHINGTON – Industry stakeholders hailed CMS’s decision not to move forward with most of Round 2021 as a “watershed” moment, but they also criticized the agency for trying to have it both ways.

CMS on Oct. 27 announced new single payment amounts for off-the-shelf knee and back braces but not for 13 other product categories because they did “not achieve expected savings.”

“You can’t have a one-way bid program,” said Tom Ryan, president and CEO of AAHomecare. “You can’t accept (the bids) when prices go down, and then, when they go up, not accept the reality of that. We need to work through the fog and get to where the pricing would be.”

AAHomecare has a previously scheduled meeting with CMS officials this week and program transparency will be at the top of the agenda, Ryan said.

CMS on Oct. 27 also published a proposed rule in which it proposed continuing to pay higher 50/50 blended reimbursement rates in rural and non-contiguous bid areas but not the 75/25 blended reimbursement rates in non-rural, non-bid areas, which will revert back to 100% of adjusted payment amounts on April 1, 2020, or whenever the public health emergency ends.

“That’s not good, especially if CMS admitted the pricing would have gone up,” said John Gallagher, vice president of government relations for VGM. “It leaves us stagnated with pricing that’s not going to work.”

Additionally, stakeholders would like some clarification on whether CPI increases will be applied in bid areas. The 2020 fee schedule included, for the first time in several years, increases of 1.6% to 2.4% after several years with no increases.

The proposed rule also leaves the door open to future rounds of competitive bidding, says Cara Bachenheimer, chair of the healthcare group at Brown & Fortunato. CMS says in the rule that for the 13 product categories left out of Round 2021 it’s considering whether to simply extend the current fee schedule adjustments until “new single payment amounts are calculated for the items once competitive bidding of the items has resumed.”

“They could do bidding in three years and might propose additional changes to the program, but those would go through regulatory processes,” she said. “They could do it the same way and reach the same conclusion. The leeway is in how they are establishing the payment rate.”

Whatever CMS decides to do next, it’s clearer than ever that competitive bidding is “fatally flawed,” say stakeholders, who plan to hold up recent developments as further proof of that when they talk to Congress, particularly when it comes to pushing H.R. 2771 over the finish line, says Jay Witter, senior vice president of public policy for AAHomecare.

“The Hill is very interested in this as it appears there are a number of issues that need to be addressed,” he said. “Now that we have brought some stability to the program, we can focus on reimbursement and we’ll be talking to Congress about the non-rural and non-bid areas.”

Life in COVID-19: Managing Asthma

Friday, October 9, 2020 @ 07:10 AM  posted by jbuytaert

Courtesy of the American Association for Respiratory Care – Oct 8, 2020

COVID-19 has taken the world by storm and it doesn’t seem to be leaving anytime soon. So, as  the coming months bring winter and cool crisp weather, you as a respiratory therapist may begin to worry about your patients living with asthma. With no vaccine for COVID-19 and asthma triggering weather on the horizon, it is important to make sure your patients are extra careful this winter season.

That’s why we asked for some help from AARC member Joyce Baker, RRT, RRT-NPS, AE-C, who currently serves as the asthma clinical program coordinator for Children’s Hospital Colorado. The following is a list of frequently asked questions regarding asthma and COVID-19 compiled by Joyce. Read them over and share them with your asthma patients—

Asthma – COVID-19 FAQ

Q: Is asthma “at risk” for COVID-19?

A: People with asthma are more likely to be hospitalized than someone without asthma, mostly because viral illnesses can trigger asthma exacerbations. We cannot say whether asthma attacks from COVID-19 are any different than asthma attacks from any other viral infection. Good ways to decrease risk of an asthma attack from a viral illness is to:

  • Take daily controller medications.
  • Take inhaled corticosteroid medication, which MAY decrease susceptibility of infection
  • Make sure asthma medications are refilled.
  • Call your health care provider if the quick reliever does not resolve asthma symptoms.

Q: Should a child with asthma return to in person classrooms?

A: The American Academy of Pediatrics (AAP) released guidelines saying that it “strongly advocates” the goal of having students “physically present in school.” The AAP based their recommendations on the following emerging evidence:

  • Children are much less likely than adults to get very sick from the virus. Children 10 years old and younger are also less likely to transmit the virus to others.
  • No more risk than flu season.
  • School closures resulted in significant ‘harms’ to children. These harms included a lack of socialization, learning deficits, a decreased ability for schools to monitor problems like depression and abuse, and less access for students to physical activity and to affordable or free food.
  • If a family chooses not to have a child return to in person classroom it is important to respect this decision.

Q: Are there different precautions for a person with asthma who is returning to in person classroom or work?

A: No, people with asthma can return to an in-person classroom or work. All children two and older should wear a mask to prevent the spread, there is no exemption for asthma. Continue Reading…

Proven way to disinfect N95 masks!

Thursday, October 1, 2020 @ 09:10 AM  posted by jbuytaert