ScienceDaily (Aug. 2, 2012) ? Despite the current and rapid melting of the Greenland Ice Sheet, it remains far from certain just when we will have reached a point when scientists will be able to predict its disappearance. Recent research conducted by the University of Copenhagen in conjunction with the Technical University of Denmark (DTU) and the Danish National Survey and Cadastre (KMS) in collaboration with an international team of scientists reports that this is not the first time in recent history that the ice sheet has been in retreat and then stabilised again.
The researchers' results have just been published in Science.
Describing the findings, University of Copenhagen Associate Professor Kurt H. Kj?r at Professor Eske Willerslevs Centre for GeoGenetics at the Natural History Museum of Denmark asserts:
"That air temperatures have increased and melting has intensified is relatively well-understood. On the other hand, the UN's climate panel, the IPCC, has for many years called for greater knowledge in relation to the other major effect on the Greenland Ice Sheet -- the 'thinning of the ice sheet' which is the effect of the largest glaciers in Greenland flowing faster into the ocean than previously measured. Over the past three years a number of scientific articles have addressed the issue and pointed to a sea-level rise of one metre or more. These reports presuppose that the melting will accelerate to the same degree as during the past decade. This is a question to which we have been able to provide a qualified answer. It turns out that the ice sheet, in relation to this point, behaves more dynamically and is able to more quickly stabilise itself in comparison to what many other models and computer calculations otherwise predict."
Denmark under water
No less than 240 billion tons of fresh water escape their solid state within the Greenland Ice Sheet and runoff or discharge as icebergs into the world's oceans each year. This amount corresponds to a 5.6 meter annual rise in water level if distributed over the surface area of Denmark, an area of approximately 43,000 km2.
Current melting attributable to global warming is so great that some experts warn that we are headed towards an irreversible "tipping point" -- a point at which the global climate is permanently transformed, a point at which low-lying cities and coastal zones around the world will be seriously threatened in 100 years time.
As recently as one year ago this scenario was presented in Copenhagen at a scientific conference organised by the Arctic Council, the University of Copenhagen and Aarhus University, a conference involving over 400 climate researchers from 20 countries.
A problem to be taken more than seriously
Among the somber tones and gloomier outlooks, the recent research findings out of the University of Copenhagen and the Technical University of Denmark (DTU) in conjunction with an international team of researchers, show that the Greenland Ice Sheet is more robust than researchers have otherwise been able to predict using models and computer-based calculations.
The new research findings were obtained by combining contemporary satellite data with old aerial photographs of the ice sheet in northwestern Greenland, one of two hotspots for ice sheet thinning and heavy glacial melt runoff.
Senior researcher Shfaqat Abbas Khan of the Technical University of Denmark (DTU) says of the research results: "We've used a combination of old aerial photographs from the 80's to construct a digital elevation map and recent satellite data. In this way we've been able to gain an overview of the thinning of the ice sheet over the last 30 years in northwestern Greenland. We are the first who have been able to show that the Greenland Ice Sheet was on as a dramatic diet at the end of the 80's as it is today. On the positive side our results show that despite a significant thinning in peripheral regions from 1985-1992; the thinning slowed and then died out."
Old photos
Associate Professor Kurt H. Kj?r of the University of Copenhagen had the idea to create new and comparable elevation models of the ice sheet along a 700 km long stretch of the northwestern Greenland coast using the old photos. This provided researchers with a relatively simple way of revealing more of the ice sheet's secrets in comparison to other new methods.
Kurt H. Kj?r says: "Our results show that the thinning of the ice sheet at the end of the 80's and beginning of the 90's eased over a 4-8 year period, after which a period of stability occurred until 2003. Our conclusion is therefore, that if we judged against longer periods of time, the current thinning of the ice sheet is likely to ease within an 8-year period."
"These variations in the amount of thinning that we are able to document since the 80's make it difficult to predict how much the world's oceans will rise over a longer period of time -- a century for instance -- as a result of Greenland glacial melt-water runoff. However, it is certain that many of the present calculations and computer models of ice sheet conditions that built upon a short range of years since 2000 must be reassessed. It is too early to proclaim the 'ice sheet's future doom' and subsequent contribution to serious water problems for the world. In this context it should be mentioned that the Greenland bedrock rises as the ice sheet in the peripheral regions and especially near the coast is in retreat and becoming thinner. This highlights the enormous forces that are at play in Greenland and of how difficult it is to predict what it means for Greenland as well as the rest of the world," says Associate Professor Kurt H. Kj?r of the Natural History Museum of Denmark, University of Copenhagen.
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The above story is reprinted from materials provided by University of Copenhagen.
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People who lose the most weight may be those who can overcome urges when they see, smell or dream about something tasty, researchers said this week. And their study adds to a growing body of evidence that another key to success is keeping a food diary.
Five Steps To Wealth Through Real Estate Investing:
Filed under: Real Estate,Real Estate Investment ? admin August 2, 2012@ 10:53 am
Not only can you become quite wealthy by investing in real estate (even if the value of the property never goes up)?.you should be able to.
The five step formula to wealth through real estate investing is:
1)??? Purchase income producing real estate at below market value prices
2)??? Buy (leverage) and hold additional properties over time
3)??? Have your real estate professionally managed
4)??? Properly direct the cash flow from your investment properties
5)??? Become financially secure and wealthy over time
It?s that simple because?
Investing in real estate provides a vehicle and opportunity which really has no peers. It?s in its own category. Real estate provides leveraging opportunities, financing and tax benefits that other investments (stocks, bonds, CD?s, etc.), by law, aren?t allowed to offer.
And investing in real estate offers something else that the others don?t typically provide: a predictable cash flow that commences immediately following a property purchase.
___
This form of investing has existed for many years. When executed properly, it?s reliable, predictable and lucrative. It may appear complex initially but is actually quite a simple and straightforward process once familiar. After the correct resources are in place and purchases completed, there are very few ?moving parts.? It functions much like it?s on an auto pilot with good property management.
A certain perspective and understanding is certainly necessary. How much property a person owns isn?t the primary aim or focus. What?s most important is how much cash flow the properties generate which is determined by factors such as: purchase price, renovation expenses, fees, rents, property management costs, mortgage pay down rate, etc. Naturally, it?s important to become familiar with the variables as being knowledgeable encourages effectiveness which can then be replicated again and again. It becomes a system, which in many ways, functions like franchising fast food restaurants.
NOTE: There are a few other necessary ingredients related to this investment model: 1) to have a genuine desire to become wealthy which helps to develop your 2) vision and investment goals, 3) a level of patience and 4) discipline which enables your 5) long term plan for success by managing your cash flow properly?
Here?s a very general example of a long term goal and how it works:
Consider if you were able to purchase one rental property per year for fifteen years (think leveraging). If your fifteen properties were producing an average of $700 per month each in rental income, at the end of the fifteenth year, you?d be receiving a collective cash flow of $10,500 per month. Now that you?ve been doing this for a little while and had been disciplined, that cash could now be directed towards your own living expenses (retirement perhaps) or for reinvesting purposes.
Also remember, that if you purchased the homes with fifteen year mortgages (which we suggest), the homes purchased in the earlier years are beginning to be paid off. So not only are you receiving the average $700 per month from each property, you?re also becoming the owner of a growing number of homes that no longer have mortgages if you obtained financing. They?re beginning to become yours outright.
Plus, yet, another possible benefit: there?s a very strong likelihood that your properties have also appreciated in value over the years.
So now you, the focused, patient, disciplined real estate investor, have received:
-???????? Built-in equity immediately due to an under market value purchase
-???????? Positive monthly cash flow throughout
-???????? Mortgage principle pay down through the years
-???????? Outright property ownership once mortgages paid
-???????? Highly likely property value appreciation over time
Certainly, this isn?t enough information to equip you to immediately begin investing in real estate. The intention is to share highlights of the income producing real estate investment model to you and generate some awareness of its possibilities.
Only about 5% of our country?s population becomes wealthy or financially independent within their lifetimes. We?d like everyone to be able to live their lives within that 5% and to enjoy what it has to offer. It is available.
All that?s required is knowledge and an understanding of the steps. Just add goals (vision), desire, patience, discipline and enjoy the feeling of your impending financial security? OCG Properties LLC, specializes in helping clients purchase investment properties which provide a positive monthly cash flow after all expenses are paid. We deliver secure, turnkey real estate investments with built in equity and in-house property management?
Health care organizations find risks and opportunities in the quest for reduced costs and improved quality
Rochester, MN, August 2, 2012 Many health care systems across the US have declined to participate in the Centers for Medicare and Medicaid Services' (CMMS) Accountable Care Organization (ACO) program, developed under the Patient Protection and Affordable Care Act (PPACA), to improve efficiency and quality of health care delivery. In a groundbreaking collection of commentaries in the current issue of Mayo Clinic Proceedings, representatives of six leading health care organizations write about the challenges of reducing health care costs while improving health care quality. They further explain why they did or did not choose to participate in one of the two models now operational at CMMS.
"The US Supreme Court's decision upholding the constitutionality of the Patient Protection and Affordable Care Act provides some security for the fates of the Medicare ACO programs and the private sector's parallel initiatives although political rally cries for repeal of the Act continue to be raised in the build-up to the 2012 election," comments David Ballard, MD, MSPH, PhD, Baylor Health Care System, Dallas, TX, Health Care Policy Section Editor for the journal. "Regardless of the ultimate outcome, we should not ignore the current opportunity to learn from these activities and health care organizations' experiences implementing (or not implementing) them. Such study can inform future national and global economic initiatives aimed at lessening health care costs and waste and improving health care value."
The debate over the PPACA has focused primarily on individual coverage, but experts believe that the most critical issue in health care is delivery system reform. "To put it simply, effective access for tens of millions of Americans is at risk not to mention most other public priorities and middle class jobs in a global economy if we fail to improve the efficiency with which high-quality care is delivered," says Len M. Nichols, PhD, of the Center for Health Policy Research and Ethics, George M. Mason University, Fairfax, VA, a contributor to the special report.
ACOs are groups of physicians, hospitals, and other health care providers that are willing to assume responsibility for the care of a clearly defined population of Medicare beneficiaries. If an ACO succeeds in improving care and reducing costs, they receive a share in the savings achieved for Medicare. The CMMS created two ACO programs, the Pioneer Model, with 32 registered organizations, and the Medicare Shared Savings Program (MSSP), with 27 registered organizations. The basic difference is that the Pioneer program has a greater degree of financial risk and reward. "Many highly regarded health systems developed concerns after initial enthusiasm about the MSSP ACO model as a mechanism for accelerating their efforts to reduce costs while improving health care quality," notes Dr. Ballard.
Robert G. Porter, JD, MBA, and Amanda P. Tosto, RN, MS, of St. Louis-based SSM Health Care, consider the lack of beneficiary engagement in the CMMS ACO models to be a serious design flaw in the program. "The rule provides for invisible enrollment, meaning each beneficiary is enrolled on the basis of their claims history without regard for their actual preferences. This type of enrollment isn't consistent with SSMSL's transition to a patient-centered model of care that is based on the development of a transparent partnership among health care professionals, patients, and their families to ensure that decisions respect the patient's wants, needs, and preferences," they say.
Baylor Health Care System would like to file for Medicare Shared Savings ACO designation, but cannot. The program requires patient attribution via the tax identification number of the physician. Many of Baylor's physicians practice in groups that include non-Baylor physicians, with the entire group sharing a single tax ID. Therefore, Baylor would become financially responsible for the patients of physicians who are not part of the ACO. Health Choice, LLC, in Memphis, TN, had concerns about retrospective patient attribution and administrative complexity.
In contrast, the Atlantic Health System has already begun to see benefits from the formation of its ACO. Author David J. Shulkin, MD, of the Morristown Medical Center and Atlantic Health System ACO, Morristown, NJ, explains that in New Jersey's fragmented health system, patients have a 25% greater chance of staying in an intensive care unit and 75% greater use of specialists than the national average. "New Jersey needed a catalyst for change," Dr. Shulkin notes, "and the MSSP presented us with just that option."
The Atlantic Health ACO consists of four geographically based pods, each consisting of a hospital, physicians, and other community-based organizations in the region. Clinical navigators collaborate with primary care physicians to identify patients with short- and long-term care needs and guide them through planned pathways of care. Sixteen "Centers of Excellence" incorporate multidisciplinary approaches to care management. The Cardiac Success program has achieved 4% to 6% 30-day all-cause readmission rates, compared to the national average of 20-25%, by incorporating protocol-based approaches. "Little by little, New Jersey's fragmented health care system is being replaced with coordination and integration," Dr. Shulkin says.
Ascension Health will use its two Pioneer ACOs, Seton Health Alliance ACO and Genesys Physician Hospital Organization, to teach the rest of its large system about both medical and financial management as well as strategies for engaging physicians around values and shared business goals. Creagh E. Milford, DO, and Timothy G. Ferris, MD, MPH, of Partners HealthCare in Boston, MA, cite key differences from the health care reforms of the 1990s that influenced the decision to participate as a Pioneer ACO, including the preservation of patient choice and improved technology and electronic health records.
Dr. Nichols comments that none of the organizations represented in this special report think that the goals of the PPACA or the ACO experiments are misguided, and in fact there is a groundswell of parallel incentive realignments in the private sector as well. For example, Baylor has formed the Baylor Quality Alliance to develop a clinically integrated delivery organization, and is creating disease-management, population-management care delivery protocols and pathways. The BQA expects to sign an ACO contract with the Baylor Health Center System Employee Benefit Plan, and is in discussions with several Medicare Advantage plans and commercial plans.
In an interview with Dr. Ballard, Carl E. Couch, MD, MMM, of Baylor Health Care System, notes that the recent Supreme Court ruling on the PPACA confirms that the country is headed in this direction. "Regardless of the decision and the potential political implications this fall in terms of sustaining or overthrowing the act, the fundamental problems remain. Health care still costs too much and the trajectory of the costs is unsustainable. And we still have serious quality problems that can be best addressed by physicians and hospitals committing themselves in an accountable way to improve them. We have the same work to do whether the law is here or not."
###
Notes for editors
The articles are published in Mayo Clinic Proceedings, Volume 87, Issue 8 (August 2012), published by Elsevier.
Full text of the articles is available to credentialed journalists upon request. Contact Rachael Zaleski at +1 215 239 3658 or mcpmedia@elsevier.com to obtain copies. See article citations below for contact information for individual authors.
"The Potential of Medicare Accountable Care Organizations to Transform the American Health Care Marketplace: Rhetoric and Reality," D.J. Ballard, MD, MSPH, PhD, FACP. DOI: 10.1016/j.mayocp.2012.06.005.
Author contact: DavidBa@BaylorHealth.edu
"Accountable Care Organization Pathways: Diverse but Ultimately Parallel," Len M. Nichols, PhD. DOI: 10.1016/j.mayocp.2012.06.010.
Author contact: lnichol9@gmu.edu
"Ascension Health Partners With Centers for Medicare and Medicaid Services to Provide Patient-Centered Care Through the Pioneer Accountable Care Organization Model," R.D. Anderson, PhD, E. Aderholdt, N. Chenven, MD et al. DOI: 10.1016/j.mayocp.2012.06.004.
"A Modified "Golden Rule" for Health Care Organizations," by C.E. Milford, DO and T.G. Ferris, MD, MPH. DOI: 10.1016/j.mayocp.2012.06.009
Author contacts: Cmilford1@partners.org or Tferris@partners.org
"Building an Accountable Care Organization for All the Wrong Reasons," D.J. Shulkin, MD. DOI: 10.1016/j.mayocp.2012.06.012.
Author contact: 973 971 5450 or David.Shulkin@atlantichealth.org
"Why Baylor Health Care System Would Like to File for Medicare Shared Savings Accountable Care Organization Designation but Cannot," C.E. Couch, MD, MMM. DOI: 10.1016/j.mayocp.2012.06.011.
Author contact: carlc@BaylorHealth.edu
"A Physician Hospital Organization's Approach to Clinical Integration and Accountable Care," G. Mayzell, MD, MBA. DOI: 10.1016/j.mayocp.2012.06.019.
Author contact: mayzellg@myhealthchoice.com
"The SSM Health Care Approach to Achieving "True North": Improving Health Care Quality While Reducing Costs," R.G. Porter, JD, MBA, A.P. Tosto, RN, MS. DOI: 10.1016/j.mayocp.2012.06.008.
Author contact: Robert_Porter@ssmhc.com
Videos of Dr. Ballard interviewing contributors about their organizations' decision to enroll in CMMS's ACO program, and the changes in store for physicians and health systems can be found at:
www.youtube.com/watch?v=90HMhC4e0GM (Shulkin)
www.youtube.com/watch?v=hXwp4azHLqI (Couch)
www.youtube.com/watch?v=EgCfzb6I3Bw (Haydar)
About the authors
David J. Ballard, MD, MSPH, PhD, FACP, Baylor Health Care System, Dallas, TX
Len M. Nichols, PhD, Center for Health Policy Research and Ethics, George Mason University, Fairfax, VA
Raymond D. Anderson, PhD, Ascension Health, St. Louis, MO
Elizabeth Aderholdt, Genesys Regional Medical Center, Grand Blanc, MI
Norman Chenven, MD, Austin Regional Clinic, Austin, TX
Meredith Duncan, Seton Health Alliance, Austin, TX
Nancy Haywood, Genesys Regional Medical Center, Grand Blanc, MI
Michael James, Genesys PHO, Grand Blanc, MI
Samson Jesudass, MD, Seton Healthcare Family, Austin, TX
Amy M.H. Johnson, Ascension Health, St. Louis, MO
Gary King, MD, Genesys PHO, Grand Blanc, MI
Greg Sheff, MD, Seton Health Alliance, Austin, TX
Creagh E. Milford, DO, Massachusetts General Hospital, Boston, MA
Timothy G. Ferris, MD, MPH, Massachusetts General Hospital and Partners HealthCare, Boston, MA
David J. Shulkin, MD, Morristown Medical Center and Atlantic Health System Accountable Care Organization, Morristown, NJ
Carl E. Couch, MD, MMM, Baylor Health Care System, Dallas, TX
George Mayzell, MD, MBA, Health Choice, LLC, Memphis, TN
Robert G. Porter, JD, MBA, SSM Health Care, St. Louis, MO
Amanda P. Tosto, RN, MS, ECG Management Consultants, Inc., St. Louis, MO
About Mayo Clinic Proceedings
The flagship journal of Mayo and one of the premier peer-reviewed clinical journals in general medicine, Mayo Clinic Proceedings is among the most widely read and highly cited scientific publications for physicians, with a circulation of approximately 124,000. While the Proceedings is sponsored by Mayo Clinic, it welcomes submissions from authors worldwide, publishing articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal's mission is to promote the best interests of patients by advancing the knowledge and professionalism of the physician community. www.mayoclinicproceedings.org
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader in medical care, research, and education for people from all walks of life. For more information visit www.mayoclinic.org/about / and www.mayoclinic.org/news.
About Elsevier
Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include ScienceDirect, Scopus, Reaxys, ClinicalKey and Mosby's Nursing Suite, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Health care organizations quest for reduced costs and improved qualityPublic release date: 2-Aug-2012 [ | E-mail | Share ]
Health care organizations find risks and opportunities in the quest for reduced costs and improved quality
Rochester, MN, August 2, 2012 Many health care systems across the US have declined to participate in the Centers for Medicare and Medicaid Services' (CMMS) Accountable Care Organization (ACO) program, developed under the Patient Protection and Affordable Care Act (PPACA), to improve efficiency and quality of health care delivery. In a groundbreaking collection of commentaries in the current issue of Mayo Clinic Proceedings, representatives of six leading health care organizations write about the challenges of reducing health care costs while improving health care quality. They further explain why they did or did not choose to participate in one of the two models now operational at CMMS.
"The US Supreme Court's decision upholding the constitutionality of the Patient Protection and Affordable Care Act provides some security for the fates of the Medicare ACO programs and the private sector's parallel initiatives although political rally cries for repeal of the Act continue to be raised in the build-up to the 2012 election," comments David Ballard, MD, MSPH, PhD, Baylor Health Care System, Dallas, TX, Health Care Policy Section Editor for the journal. "Regardless of the ultimate outcome, we should not ignore the current opportunity to learn from these activities and health care organizations' experiences implementing (or not implementing) them. Such study can inform future national and global economic initiatives aimed at lessening health care costs and waste and improving health care value."
The debate over the PPACA has focused primarily on individual coverage, but experts believe that the most critical issue in health care is delivery system reform. "To put it simply, effective access for tens of millions of Americans is at risk not to mention most other public priorities and middle class jobs in a global economy if we fail to improve the efficiency with which high-quality care is delivered," says Len M. Nichols, PhD, of the Center for Health Policy Research and Ethics, George M. Mason University, Fairfax, VA, a contributor to the special report.
ACOs are groups of physicians, hospitals, and other health care providers that are willing to assume responsibility for the care of a clearly defined population of Medicare beneficiaries. If an ACO succeeds in improving care and reducing costs, they receive a share in the savings achieved for Medicare. The CMMS created two ACO programs, the Pioneer Model, with 32 registered organizations, and the Medicare Shared Savings Program (MSSP), with 27 registered organizations. The basic difference is that the Pioneer program has a greater degree of financial risk and reward. "Many highly regarded health systems developed concerns after initial enthusiasm about the MSSP ACO model as a mechanism for accelerating their efforts to reduce costs while improving health care quality," notes Dr. Ballard.
Robert G. Porter, JD, MBA, and Amanda P. Tosto, RN, MS, of St. Louis-based SSM Health Care, consider the lack of beneficiary engagement in the CMMS ACO models to be a serious design flaw in the program. "The rule provides for invisible enrollment, meaning each beneficiary is enrolled on the basis of their claims history without regard for their actual preferences. This type of enrollment isn't consistent with SSMSL's transition to a patient-centered model of care that is based on the development of a transparent partnership among health care professionals, patients, and their families to ensure that decisions respect the patient's wants, needs, and preferences," they say.
Baylor Health Care System would like to file for Medicare Shared Savings ACO designation, but cannot. The program requires patient attribution via the tax identification number of the physician. Many of Baylor's physicians practice in groups that include non-Baylor physicians, with the entire group sharing a single tax ID. Therefore, Baylor would become financially responsible for the patients of physicians who are not part of the ACO. Health Choice, LLC, in Memphis, TN, had concerns about retrospective patient attribution and administrative complexity.
In contrast, the Atlantic Health System has already begun to see benefits from the formation of its ACO. Author David J. Shulkin, MD, of the Morristown Medical Center and Atlantic Health System ACO, Morristown, NJ, explains that in New Jersey's fragmented health system, patients have a 25% greater chance of staying in an intensive care unit and 75% greater use of specialists than the national average. "New Jersey needed a catalyst for change," Dr. Shulkin notes, "and the MSSP presented us with just that option."
The Atlantic Health ACO consists of four geographically based pods, each consisting of a hospital, physicians, and other community-based organizations in the region. Clinical navigators collaborate with primary care physicians to identify patients with short- and long-term care needs and guide them through planned pathways of care. Sixteen "Centers of Excellence" incorporate multidisciplinary approaches to care management. The Cardiac Success program has achieved 4% to 6% 30-day all-cause readmission rates, compared to the national average of 20-25%, by incorporating protocol-based approaches. "Little by little, New Jersey's fragmented health care system is being replaced with coordination and integration," Dr. Shulkin says.
Ascension Health will use its two Pioneer ACOs, Seton Health Alliance ACO and Genesys Physician Hospital Organization, to teach the rest of its large system about both medical and financial management as well as strategies for engaging physicians around values and shared business goals. Creagh E. Milford, DO, and Timothy G. Ferris, MD, MPH, of Partners HealthCare in Boston, MA, cite key differences from the health care reforms of the 1990s that influenced the decision to participate as a Pioneer ACO, including the preservation of patient choice and improved technology and electronic health records.
Dr. Nichols comments that none of the organizations represented in this special report think that the goals of the PPACA or the ACO experiments are misguided, and in fact there is a groundswell of parallel incentive realignments in the private sector as well. For example, Baylor has formed the Baylor Quality Alliance to develop a clinically integrated delivery organization, and is creating disease-management, population-management care delivery protocols and pathways. The BQA expects to sign an ACO contract with the Baylor Health Center System Employee Benefit Plan, and is in discussions with several Medicare Advantage plans and commercial plans.
In an interview with Dr. Ballard, Carl E. Couch, MD, MMM, of Baylor Health Care System, notes that the recent Supreme Court ruling on the PPACA confirms that the country is headed in this direction. "Regardless of the decision and the potential political implications this fall in terms of sustaining or overthrowing the act, the fundamental problems remain. Health care still costs too much and the trajectory of the costs is unsustainable. And we still have serious quality problems that can be best addressed by physicians and hospitals committing themselves in an accountable way to improve them. We have the same work to do whether the law is here or not."
###
Notes for editors
The articles are published in Mayo Clinic Proceedings, Volume 87, Issue 8 (August 2012), published by Elsevier.
Full text of the articles is available to credentialed journalists upon request. Contact Rachael Zaleski at +1 215 239 3658 or mcpmedia@elsevier.com to obtain copies. See article citations below for contact information for individual authors.
"The Potential of Medicare Accountable Care Organizations to Transform the American Health Care Marketplace: Rhetoric and Reality," D.J. Ballard, MD, MSPH, PhD, FACP. DOI: 10.1016/j.mayocp.2012.06.005.
Author contact: DavidBa@BaylorHealth.edu
"Accountable Care Organization Pathways: Diverse but Ultimately Parallel," Len M. Nichols, PhD. DOI: 10.1016/j.mayocp.2012.06.010.
Author contact: lnichol9@gmu.edu
"Ascension Health Partners With Centers for Medicare and Medicaid Services to Provide Patient-Centered Care Through the Pioneer Accountable Care Organization Model," R.D. Anderson, PhD, E. Aderholdt, N. Chenven, MD et al. DOI: 10.1016/j.mayocp.2012.06.004.
"A Modified "Golden Rule" for Health Care Organizations," by C.E. Milford, DO and T.G. Ferris, MD, MPH. DOI: 10.1016/j.mayocp.2012.06.009
Author contacts: Cmilford1@partners.org or Tferris@partners.org
"Building an Accountable Care Organization for All the Wrong Reasons," D.J. Shulkin, MD. DOI: 10.1016/j.mayocp.2012.06.012.
Author contact: 973 971 5450 or David.Shulkin@atlantichealth.org
"Why Baylor Health Care System Would Like to File for Medicare Shared Savings Accountable Care Organization Designation but Cannot," C.E. Couch, MD, MMM. DOI: 10.1016/j.mayocp.2012.06.011.
Author contact: carlc@BaylorHealth.edu
"A Physician Hospital Organization's Approach to Clinical Integration and Accountable Care," G. Mayzell, MD, MBA. DOI: 10.1016/j.mayocp.2012.06.019.
Author contact: mayzellg@myhealthchoice.com
"The SSM Health Care Approach to Achieving "True North": Improving Health Care Quality While Reducing Costs," R.G. Porter, JD, MBA, A.P. Tosto, RN, MS. DOI: 10.1016/j.mayocp.2012.06.008.
Author contact: Robert_Porter@ssmhc.com
Videos of Dr. Ballard interviewing contributors about their organizations' decision to enroll in CMMS's ACO program, and the changes in store for physicians and health systems can be found at:
www.youtube.com/watch?v=90HMhC4e0GM (Shulkin)
www.youtube.com/watch?v=hXwp4azHLqI (Couch)
www.youtube.com/watch?v=EgCfzb6I3Bw (Haydar)
About the authors
David J. Ballard, MD, MSPH, PhD, FACP, Baylor Health Care System, Dallas, TX
Len M. Nichols, PhD, Center for Health Policy Research and Ethics, George Mason University, Fairfax, VA
Raymond D. Anderson, PhD, Ascension Health, St. Louis, MO
Elizabeth Aderholdt, Genesys Regional Medical Center, Grand Blanc, MI
Norman Chenven, MD, Austin Regional Clinic, Austin, TX
Meredith Duncan, Seton Health Alliance, Austin, TX
Nancy Haywood, Genesys Regional Medical Center, Grand Blanc, MI
Michael James, Genesys PHO, Grand Blanc, MI
Samson Jesudass, MD, Seton Healthcare Family, Austin, TX
Amy M.H. Johnson, Ascension Health, St. Louis, MO
Gary King, MD, Genesys PHO, Grand Blanc, MI
Greg Sheff, MD, Seton Health Alliance, Austin, TX
Creagh E. Milford, DO, Massachusetts General Hospital, Boston, MA
Timothy G. Ferris, MD, MPH, Massachusetts General Hospital and Partners HealthCare, Boston, MA
David J. Shulkin, MD, Morristown Medical Center and Atlantic Health System Accountable Care Organization, Morristown, NJ
Carl E. Couch, MD, MMM, Baylor Health Care System, Dallas, TX
George Mayzell, MD, MBA, Health Choice, LLC, Memphis, TN
Robert G. Porter, JD, MBA, SSM Health Care, St. Louis, MO
Amanda P. Tosto, RN, MS, ECG Management Consultants, Inc., St. Louis, MO
About Mayo Clinic Proceedings
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Home | Health and Food | Food Recipes | Recipes by Points | 5 Point | Butternut Squash and Spinach Pasta Casserole Recipe with Caramelized Onions ? 5 Points +
If you are up to putting in some elbow grease in the kitchen and making an incredibly delicious and healthy pasta casserole recipe, well then this Butternut Squash and Spinach Pasta Casserole Recipe with Caramelized Onions is for you. Loaded with delicious veggies and a fabulous creamy bechamel sauce, each serving is just 5 Points +. It does require lots of separate pots and pans for cooking various components of the casserole, but it is oh so worth it. The garlic sauteed spinach, the onions caramelized in butter, and the roasted butternut squash all combine perfectly in this vegetarian pasta casserole recipe. I used a fresh, whole milk buffalo mozzarella to top it with and it was amazing! It?s a big recipe, so we had lots of leftovers, and it re-heated very nicely as well. This is definitely a Weight Watchers casserole recipe that will impress. And though I made it in the middle of a high temp summer, I?d ideally make this tomato-free pasta recipe in the fall, as the sage and nutmeg give it a fall-like flavor.
Some serious effort in the kitchen goes a long way in this amazing Butternut Squash and Spinach Pasta Casserole Recipe with Caramelized Onions. Delicious and filling, each serving is just 5 Points+ making it a great Weight Watchers dinner recipe idea.
Ingredients
2 cups dry, high fiber pasta (like Ronzoni Smart Taste)
4 cups butternut squash, cut into small cubes
3 large onions, thinly sliced
16 oz fresh spinach leaves
8oz fresh, whole milk mozzarella, sliced
15oz container fat free ricotta
2 tbsp light butter (I used Brummel & Brown)
1/4 cup whole wheat flour
1 ? cups fat free milk
1/2 cup fresh basil, finely chopped
1/4 cup fresh parsley, finely chopped
6 cloves garlic, minced
1/2 tsp nutmeg
1/2 tsp dried sage powder
1 tsp chili flakes
1 tsp olive oil
2 tsp salt
1 tsp black pepper
1/2 cup grated Parmesan
Instructions
To roast the butternut squash, preheat oven to 425F. Lightly spray the butternut squash with an olive oil mister and sprinkle with salt and pepper. Roast the butternut squash for about 30 minutes.
Meanwhile, set a non-stick skillet over medium heat and heat olive oil. Then add cloves of garlic and a pinch of chili flakes.
Heat until garlic begins to soften, about 2 minutes. Add in spinach and saut? until spinach is completely wilted. Set aside on a paper towel to drain.
Prepare pasta according to package directions. Drain and set aside.
To caramelize the onions, melt 1 tablespoon of butter in a large nonstick skillet over medium heat. Add the onions with a tsp of salt and cook down for about 20-30 minutes, until onions turn brown. Set aside.
To make the creamy sauce, bring the milk, nutmeg, sage, ? tsp pepper, and remaining chili flakes to a simmer.
In a separate sauce pan, make the rue by melting the remaining tbsp. of butter and then adding in the flour. Stir until doughy (about one minute).
Whisk the milk into the butter and flour mix (the rue). It should be smooth and velvety, not chunky or too thick. If it is, just add some more milk to thin it out. Add in the Parmesan, and whisk until smooth. Set aside.
In a small bowl, combine ricotta, basil, remaining garlic, salt, pepper and chili flakes.
Now, preheat the oven to 375.
In a large, 5qt casserole dish, place a layer of noodles, spinach, onions, and then dot with a third of ricotta. Then cover with about 1/4 of the cream sauce. Repeat with the remaining ingredients until are used up.
Then top evenly with the sliced mozzarella.
Bake for about 20-25 minutes, or until bubbling.
Turn the broiler on and bake for another 5 minutes, or until browned on top.
Remove from oven and let cool for about 15-20 minutes.
This entry was posted by LaaLoosh on Wednesday, August 1st, 2012 at 7:12 am and is filed under 5 Point, American, Baking, Butternut Squash, Casserole, Dinner, Healthy, Italian, Main Dish, Pasta, Spinach, Vegetarian.
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Public release date: 2-Aug-2012
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