Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Last week I wrote about a pharmacist colleague who contacted me about using long acting insulin on a prn basis. Our discussion led to the idea of starting insulin at diagnosis. Some of you commented positively on using insulin as needed while others felt that would never work. This week we have an article indicating that early insulin in adolescents with type 2 diabetes improves glycemic control and cardiovascular therapeutic goals.
We are keeping up to date on Accountability Care Organizations (ACO’s) and sharing the information with you because they are a major component of the healthcare changes. ACO’s are part of a Medicare plan to pay extra for good healthcare and they allow practices to share in savings in healthcare costs. Now that some Pioneer ACO’s, Medicare’s first and highest-risk test of the payment mode, have had a chance to operate in this new system, some of them have decided that they no longer want to be a Pioneer and are opting to change to Medicare’s lower-risk ACO alternative, the Shared Savings Program.
In the Shared Savings Program, participants may choose an option with no potential for financial penalties for the first three years versus the Pioneers who risk penalties in the second year. Although they are hoping that CMS will reduce the penalties, or expand the time limits this does not appear likely to happen. It will be interesting to see if the changes affect the proliferation of ACO’s.
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Dave Joffe, Editor-in-chief