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Providers Perspectives

Detecting Alzheimer’s disease earlier using … Greebles?

Difficulty distinguishing novel objects is associated with family history of Alzheimer’s disease.

Unique graphic characters called Greebles may prove to be valuable tools in detecting signs of Alzheimer’s disease decades before symptoms become apparent.

In an article published online in the Journal of Alzheimer’s Disease, Emily Mason, Ph.D., a postdoctoral associate in the Department of Neurological Surgery at the University of Louisville, reported research showing that cognitively normal people who have a genetic predisposition for Alzheimer’s disease (AD) have more difficulty distinguishing among novel figures called Greebles than individuals without genetic predisposition.

Alzheimer’s disease (AD) is a progressive, irreversible neurodegenerative disease characterized by declining memory, cognition and behavior. AD is the most prevalent form of dementia, affecting an estimated 5.5 million individuals in the United States and accounting for 60 to 80 percent of dementia cases. The ability to detect the disease earlier may allow researchers to develop treatments to combat the disease.

“Right now, by the time we can detect the disease, it would be very difficult to restore function because so much damage has been done to the brain,” Mason said. “We want to be able to look at really early, really subtle changes that are going on in the brain. One way we can do that is with cognitive testing that is directed at a very specific area of the brain.”

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Providers Perspectives

AMGA welcomes new members to Board of Directors

AMGA an association representing medical groups and integrated systems of care, today announced the addition of three new members to its Board of Directors, beginning their tenure in January 2017. Joining the AMGA Board are the following: Mark DeRubeis, M.B.A., Chief Executive Officer, Premier Medical Associates Mark DeRubeis is the chief executive officer at Premier Medical Associates, the largest multispecialty practice in the Greater Pittsburgh area. As CEO, DeRubeis is responsible for driving the organization’s growth and commitment to preventative care that delivers the highest quality care with the greatest efficiency. Mr. DeRubeis attended Duquesne University for both undergraduate and graduate work, earning a Bachelor of Arts in business and a master’s in business administration.

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Providers, pharma and PBMs: Three things to watch


Greg Rucinski, Chief Executive Officer, TRICAST

Providers and pharma and pharmacy benefit managers (PBMs) – I refer to them as the “three Ps” and they make up what I suppose you could call the Trinity of pharmaceutical benefit delivery in this country, and have been much in the news as of late. And it’s not a stretch to say that the news hasn’t exactly been positive. Here are three things I think all of us need to keep tabs on.

Thing one 

Of course the news of the day is the suit filed by a major carrier – Anthem – against a major PBM – Express Scripts.

Anthem is claiming that Express Scripts is not performing up to the intent of their contract, and that they’re not delivering on promised pricing (which also includes pharmaceutical manufacturer rebates).

It’s going to be very interesting to see where this goes.

Express Scripts actually bought a PBM called NextRx from Anthem a few years ago and was performing under a promise of that purchase, and I believe there are still many years remaining on their contract.

This occurrence bears watching because this could set a precedent for how everyone views their PBM contracts, and how they’re going to really scrutinize performance moving forward.

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CMS publishes Medicare fee-for-service provider and supplier lists

As part of our efforts to improve care delivery, data sharing, and transparency, the Centers for Medicare & Medicaid Services (CMS) is releasing two public data sets regarding the availability and use of services provided to Medicare beneficiaries by ground ambulance suppliers and home health agencies, as well as a list of Medicare fee-for-service (FFS) providers and suppliers currently approved to bill Medicare. The data sets are accessible at https://data.cms.gov.

CMS recently published a Federal Register notice on February 2, 2016 (effective January 29, 2016) extending the temporary enrollment moratoria on new ground ambulance suppliers and home health agencies sub-units, and branch locations in the Medicare, Medicaid, and the Children’s Health Insurance Programs (CHIP) for an additional six months in seven geographic areas.  Such moratoria provisions were authorized by the Affordable Care Act and serve to reduce fraud, waste, and abuse while ensuring that patient access to care is not interrupted.

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