Ohio KePRO Motion November 2004

                                  For millions of older
                                  Americans, falls present
                                  a serious health risk.
                                  In the United States,
                                  one of ever y three
                                  persons age 65 and
                                  older falls each year.
                                  Among older adults,
falls are the leading cause of injur y deaths
and the most common cause of injuries and
hospital admissions for injuries. In 1997,
about 9,000 seniors died of fall-related
injuries. The total direct cost of fall injuries
in 1994 among people 65 and older was
$20.2 billion. In Ohio, between 2000 and
2020 the number of people age 60 and
over is expected to increase by 44 percent,
according to researchers at Miami University.

Fractures are the most serious health
consequence of falls. Eighty-seven percent
of all fractures among older adults are due
to falls. About 250,000 hip fractures, the
most serious fracture, occur each year among
people over age 65. Half of all older people
hospitalized for hip fractures cannot return
home or live independently after their injur y.

Many of these falls and resulting injuries
can be prevented. Strategies to prevent
falls among older adults include exercises
to improve strength, balance, and flexibility;
reviews of medications that may affect
balance; and home modifications that reduce
fall hazards such as installing grab bars,
improving lighting, and removing items that
may cause tripping.

The Centers for Disease Control and
Prevention (CDC) offers a free tool kit on
ways to prevent falls. The Tool Kit to Prevent
Senior Falls is available through Ohio
KePRO, the Medicare Quality Improvement
Organization for Ohio, on its Web site at
http://www.ohiokepro.com/bene/resources.
asp. For those without access to a
computer, please call the CDC directly
at 1-800-311-3435. I

Creating an Environment for
Healthcare Quality in Ohio
through Public Reporting

By Alice Stollenwerk Petrulis, MD, FACP, Medical Director

oday, or sometime in the future,
you or your family may face the
responsibility of selecting a healthcare
facility for someone you love. The
reasons for healthcare decisions are
varied it may be a progressive decline
in physical, mental or emotional well-
being, or an unexpected accident or
injur y. Regardless of the reason, your
decision may be dif ficult due to related
emotional stress, inexperience, or a
need to act quickly. If you live a distance
from the one in need, the pressure
may be greater. What factors should
you consider and where should you
turn for reliable infor mation?

Compare and Home Health Compare.
They can help you make decisions and
are both quick and easy. You can log
onto www.medicare.gov and follow
simple, step-by-step instr uctions.

For nursing home residents, quality
measures address issues such as
treatment and prevention of bedsores
and pain management. Indicators for
home health agency care include patient
improvement in walking or getting
around, mental health improvements,
and ability to per for m activities of daily
living, such as bathing, taking medicine,
and getting dressed. State and national
averages on the Web sites make it
easier to compare results.

For tunately for patients and their
caregivers, the Centers for Medicare
& Medicaid Ser vices (CMS), an agency
of the U.S. Depar tment of Health and
Human Ser vices, has launched the
national Quality Initiative. The Nursing
Home and Home Health Quality Initiatives
already provide public repor ting and
accountability for the quality of care
provided by nursing homes and home
health agencies across the nation and
in Ohio. The Hospital Quality Initiative
will begin repor ting on hospital quality
of care in 2005.

The Nursing Home Compare Web site
logged more than 70,000 visits to
view Ohio nursing home infor mation
during its first year of operation. Ohio
continues to rank at or near the top
among all states in searches on
www.medicare.gov for nursing home
infor mation. Home Health Compare,
launched in November 2003, has also
been used frequently by Ohio residents
in its first year.

Infor mation on the Nursing Home
Compare and Home Health Compare
Web sites may prove invaluable to the
family selecting long-term care options.
However, the quality measures should
be used in conjunction with other
resources. You should visit the nursing
home or home health agency, meet
staf f and ask questions to help ensure
the care meets your needs.

Publicly repor ting infor mation is a
valuable resource for consumers; it also
guides healthcare professionals in their
ongoing ef for ts to monitor and improve
the quality of care they provide. Ohio
KePRO, Medicare's Quality Improvement
Or ganization for Ohio, implements the
quality initiatives in Ohio.

Online Tools Provide Impor tant
Consumer Information
The national Quality Initiative has two
tools cur rently available on the
Internet for consumers, Nursing Home

Hospital Quality Initiative Coming
Already in the planning stage is a CMS
initiative that will track quality per for m-
ance among Ohio's Medicare-approved

Public Repor ting (cont.)

hospitals. Like the other initiatives, the
Hospital Quality Initiative will help improve
healthcare for Medicare and Medicaid
beneficiaries. Ohio KePRO is working with
key par tners such as the Ohio Hospital
Association to assist hospitals and imple-
ment the Hospital Quality Initiative in Ohio.

Ninety-eight percent of Ohio hospitals have
signed on for public repor ting and their
data will eventually appear on the Hospital
Compare Web site in 2005.

Quality Improvement Successes
In addition to providing your family with key
per for mance repor ts, the national Quality
Initiative helps providers recognize oppor tu-
nities for enhancing their care and ser vices.
Many nursing homes and home health
agencies in Ohio have already made significant
improvements in care by taking advantage
of resources available from Ohio KePRO.

Other Resources
If you do not have a computer or Internet
access, infor mation about Nursing Home
Compare and Home Health Compare is
available by calling the Medicare toll-free
help line at 1-800-MEDICARE (1-800-633-
4227). Staf f at Ohio KePRO can be
reached through the Medicare Beneficiar y
Help Line at 1-800-589-7337 to answer
questions about quality of care issues. I

All items in this newsletter are available in
PDF and HTML formats at www.ohiokepro.com
under Media Publications. You can also
subscribe online to Ohio KePROmotion at
www.ohiokepro.com/publications/
subscribe.asp. I

November is American Diabetes Month Take Control!

What is diabetes?
Diabetes is a disorder characterized by high
levels of glucose in the blood or urine. It is a
chronic illness that should be measured and
monitored by the individual and a qualified
healthcare team.

What ser vices related to diabetes does
Medicare cover?
Glucose monitors, test strips, lancets, and
self-management training are all covered for
Medicare beneficiaries diagnosed with dia-
betes. An individual with diabetes is required
to pay 20% of the Medicare approved amount
after the annual Par t B deductible is paid.

What are the risk factors for diabetes?
90-95% of diabetes cases are non-insulin-
dependent diabetes (Type 2). Risk factors for
this type of diabetes include:
  I Older age
  I Obesity
  I Family histor y of diabetes
  I Prior histor y with gestational diabetes
  I Impaired glucose tolerance
  I Physical inactivity

What should I do to take control of my
diabetes?
Treatment of diabetes can include diet control,
exercise, home blood glucose testing, and in
some cases, oral medication and/or insulin.
Visit your doctor at least once a year for eye
and foot exams as well as a blood pressure
test. Regular and proper glycemic control and
lipid management can delay or prevent
complications from diabetes including hear t
disease, blindness, kidney failure, and lower-
extremity amputations.

Is diabetes a significant public health problem?
Diabetes is the sixth leading cause of death
here in Ohio, with the majority of deaths related
to diabetes occurring after the age of 65.
Individuals with diabetes are dispropor tionately
affected by disability, and the financial costs
to patients and to society are staggering.

Ohio KePRO is the Medicare Quality
Improvement Organization (QIO) for Ohio.
Beneficiaries or anyone acting on their behalf
can call its Help Line toll-free at
1-800-589-7337 for more information. I

Need A Guest For Your News Program?

Whether your media outlet reaches Medicare
beneficiaries, their families or their caregivers,
healthcare is a dynamic and relevant issue for listeners
and viewers. We invite you to contact Ohio KePRO's
media specialist at 216.447.9604 x2219 or via
Online Media Inquiry at http://www.ohiokepro.com/
publications/mediainquiries.asp to access professionals
who can address the healthcare information needs of
your audience from a qualified perspective.

Executive Editor : Suzana C. Iveljic, MBA

Editor : Daniel B. Moss, BSBA

e-mail: dmoss@ohqio.sdps.org

T H E N OV E M B E R E D I T I O N O F O H I O Ke P RO M O T I O N H A S A R R I V E D !
Your News Source for Health & Rights Information for Ohio's Medicare Beneficiaries

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Publication No. 4123-OH-009-11/2004. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with
the Centers for Medicare & Medicaid Ser vices (CMS), an agency of the U. S. Depar tment of Health and Human Ser vices. The contents presented do not
necessarily reflect CMS policy. For more information, please call 1-800-MEDICARE (1-800-633-4227), or visit the CMS Web site at www.medicare.gov.