In The News

Another Aspect of Grief That I Didn’t Know Until Now

By Barbara Karnes

Being in a relationship is about sharing and compromise. It is “let US do this, what do YOU think?” When a person is alone, not in a relationship, they can do what they want; there is no sharing or compromise.

I hadn’t thought of that before because I didn’t have to. Now that I am only responsible for myself, I only have to figure out “what do I want?” The interesting thing for me is I’m not used to knowing or doing exactly what I want even though I thought I was.

This is another aspect of grief I didn’t know until now that I am living it. Who am I if I am only one? What have I wanted to do but haven’t?  How do I fill my days by myself? 

Yes, there are family and friends, but not 24/7. There are empty spaces that only I can fill. This new turn now requires different thoughts, directions, and new habits.

What do I want to do when no-one is looking? Dance like no one can see me. I can do that now. I can eat what I like. I can decide what I want to eat without taking another into consideration. Should I eat at 4:00 instead of 6:00? I can do that now. Do I want to watch Love It or List It or get in bed at and read until 11 and then stay in bed until 10 am? I can do either without thinking of another if I want to.

Am I going to do all those things? I don’t know. I do know I’m going to be more aware of myself. Yes, it’s sad there isn’t an US anymore but I am thinking there is a new ME in here somewhere.

What is the story about the optimist and the pessimist ? The pessimist just sees a barn full of manure whereas the optimist thinks there must be a pony in there somewhere - something like that. I think that is where this grief journey is taking me. I miss Jack. I get lonely sometimes, but I am finding a new aspect of myself.

Again, I am sharing my experience because though I know a lot about end of life, I did not know much about grieving. I’m not sure anyone can understand the nuances of grief without experiencing it.

I am sharing this more emotional aspect of grieving so you who wear the same shoes as I am now will see what the new normal looks like and realize you are not the only one.

Something More about Another Aspect of Grief That I Didn’t Know Until Now 

Almost a year ago now I discovered a terrific company called HelpTexts. Those who are grieving recieve support from experts in the grief field straight to their phones. I have given subscriptions to friends who report back that the texts have been incredibly helpful. I have a discount code if you would like to gift a year of grief support to someone you know- HELPTEXTS

 

Medicare Advantage Headwinds Didn't Prevent Payers from Turning a Profit in 2023

Fierce Healthcare / By Paige Minemyer
 
Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023.
 
Leading the way, as per the norm, was UnitedHealth Group, which brought in $22.4 billion in profit for the year. Its closest rival, CVS Health, earned $8.3 billion in 2023 profit, according to a Fierce Healthcare review of quarterly earnings reports.
 
Both of these firms represent major players in Medicare Advantage (MA): UnitedHealthcare and Aetna, respectively. And both felt the impacts of the higher-than-expected care use in the back half of the year, with CVS cutting its outlook for 2024 to compensate.
 
Humana, another of the largest MA plans in the country, was the most acutely effected by the utilization increase, given that the bulk of its insurance business is in the Medicare space. While it was profitable for the year, posting $2.5 billion, it reported a $541 million loss in the fourth quarter and set conservative guidance for 2024 amid "greater inherent uncertainty" in MA.

Read Full Article

 

How to Prescribe Physical Activity in Patients With Obesity

Medscape Medical News: Carla Nieto Martínez

Exercise should no longer be a mere "complement" or a standard recommendation within healthy lifestyle guidelines, say experts. Recent evidence confirms its physiological importance and endorses its beneficial and therapeutic effects on overall health, particularly in the case of obesity and its comorbidities. These findings emphasized the reasons to include exercise prescription in addressing this condition. This conclusion emerged from discussions among experts in Physical Activity and Sports Sciences during the XIX Congress of the Spanish Society for Obesity, where the role of physical exercise as a therapeutic strategy was analyzed from various perspectives.

Javier Butragueño, PhD, coordinator of the Exercise Working Group at the Spanish Society of Obesity, emphasized the need to "reposition" the role of exercise and the message conveyed to the population. "We must move beyond the typical recommendation to 'just walk' and rethink this message. When working with patients with obesity, you realize that, for example, the guideline of 10,000 steps per day makes little sense for those who weigh 140 kg, have been sedentary for a long time, and have not reached 2000 daily steps. Clinically, it becomes evident that current recommendations may not align with the needs of these patients," he said.

Precision Focus

Butragueño highlighted the necessity of shifting the central focus from weight-related variables alone. While weight is crucial, evidence suggests that it should be evaluated along with other strategies, such as nutrition and pharmacology.

"The approach must change to view exercise as a metabolism regulator," said Butragueño. "For specialists, this means educating the population about the need to stay active for overall health. This is a disruptive message because the prevailing idea, almost obsessive, associates exercise primarily with weight loss, a completely incorrect approach that can even be detrimental in some cases."

Butragueño emphasized the supportive role of physical exercise in interventions for these patients. "Data show that it is both an enhancer and a co-adjuvant in strategies that also include psychology and endocrinology. It should be part of the approach to obesity but individualized and phenotyped to give physical activity the necessary dimension in each specific case."

As an example of this adaptability in therapeutic strategy, Butragueño referred to addressing binge eating disorder. "In this case, specialists must acknowledge that sports are a third-line option, always behind the psychologist, who plays a primary role. Exercise is used to enhance the emotions triggered through its practice, considering that many of these patients maintain a very negative relationship with their bodies."

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HHAU x bttn: Medical Supply Platform Webinar

Thursday, February 29 · 2:00 – 3:00 p.m.

Please join HHAC for a webinar with bttn, The Medical Supply Platform. bttn will be showcasing how purchasing is made easy but most importantly how they are lowering costs on your medical supply bill. Come and find out why so many are switching to bttn. 

Google Meet joining info
Video call link: https://meet.google.com/beb-erza-rxm
Or dial: ‪(US) +1 413-340-2463 PIN: ‪596 822 961#
More phone numbers: https://tel.meet/beb-erza-rxm?pin=2106479611043

 

Hospice Comprehensive Assessment Measure Fact Sheet + Hospice Item Set Manual Update

  • The Centers for Medicare & Medicaid Services (CMS) posted a Fact Sheet for the Hospice Comprehensive Assessment Quality measure. The document provides clarification on the measure and guidance on how to calculate the Hospice Comprehensive Assessment Measure for your hospice as well as FAQs for the measure. The Comprehensive Assessment quality measure captures whether seven key care processes were conducted upon a patients’ admission to hospice and was first publicly reported on Care Compare in 2018.
  • The Hospice Item Set (HIS) Manual has been updated to remove COVID-19 public health emergency references, revise the Annual Payment Update (APU) penalty to reflect the current four percent (4%), revise the terminology related to the Consensus Based Entity (CBE) and make some date changes.

A Change Table outlining all the revisions is available here.

 

No changes are necessary for hospice operations relative to the HIS.

 
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