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HEALTHBEAT SHOW NOTES .... Episode #74 - Recorded December 8, 2006

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and informational Podcast.

In this week’s news:  We’ll Look At –  

• Lumbar Spine Fusion Investigated
• Midlife Risk Factors and Healthy Survival in Men
• CMS posts final pay-cut rule - ACA, ICA urge chiropractic action
• 45% of midlife women use CAM
• Health coaching: An option for DCs?

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #74, recorded December 8, 2006.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

This week’s Episode is sponsored by DaVinci Laboratories.  Please surf to our web site at ChiropracticRadio.com and click on the DaVinci link for your Health and Nutritional needs.

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And Now for some news ….

Lumbar Spine Fusion Investigated

A study in the November 1, 2006 issue of the journal Spine, evaluated the influence of lumbar intervertebral fusion devices on clinical and disability outcomes among Washington State compensated workers with chronic back pain.

The efficacy of lumbar fusion for chronic low back pain remains controversial. Recent randomized controlled trials have shown results of fusion to be equivalent to those of structured exercise and cognitive intervention. Lumbar fusion rates, however, continue to increase nationally, fueled, in part, by introduction of new fusion devices, including intervertebral cages in 1996. It is not known whether these newer devices have improved outcomes, and particularly in compensated workers.

The study concluded that Use of intervertebral fusion devices rose rapidly after their introduction in 1996. This increased use was associated with an increased complication risk without improving disability or reoperation rates.

Surf to our Show Notes for a link to this study's Abstract - http://www.spinejournal.com/pt/re/spine/abstract.00007632-200611010-00013.htm;jsessionid=FjHpTR5s29HK9vq5x61wyNByCxddCFqtvBlRXp4LshJvr43QVZcp!-333421703!-949856144!8091!-1

Midlife Risk Factors and Healthy Survival in Men

A study in the November 15th issue of the Journal of the American Medical Association discussed the fact that healthy survival has no clear phenotypic definition, and little is known about its attributes, particularly in men.

The phenotype of an individual organism is either its total physical appearance and constitution or a specific manifestation of a trait, such as size, eye color, or behavior that varies between individuals.

The study was performed to test whether midlife biological, lifestyle, and sociodemographic risk factors are associated with overall survival and exceptional survival (free of a set of major diseases and impairments).

The study found that high grip strength and avoidance of overweight, hyperglycemia, hypertension, smoking, and excessive alcohol consumption were associated with both overall and exceptional survival.

Exceptional survival was defined as survival to a specified age (75, 80, 85, or 90 years) without incidence of 6 major chronic diseases and without physical and cognitive impairment.

In addition, high education and avoidance of hypertriglyceridemia were associated with exceptional survival, and lack of a marital partner was associated with mortality before age 85 years. Risk factor models based on cumulative risk factors (survival risk score) suggest that the probability of survival to oldest age is as high as 69% with no risk factors and as low as 22% with 6 or more risk factors. The probability of exceptional survival to age 85 years was 55% with no risk factors but decreased to 9% with 6 or more risk factors.

The study's conclusion stated that the data suggest that avoidance of certain risk factors in midlife is associated with the probability of a long and healthy life among men.

For more information, surf to our Show Notes - http://jama.ama-assn.org/cgi/content/abstract/296/19/2343

CMS posts final pay-cut rule - ACA, ICA urge chiropractic action

The Centers for Medicare and Medicaid has posted a final rule outlining a plan to revise the way it calculates “relative value units” (RVUs) for certain services.

According to the American Chiropractic Association (ACA) and the International Chiropractors Association, the rule will result significant cuts in Medicare payments for participating chiropractors beginning in January 2007.

CMS has elected to pay for increased costs related to these revisions by applying an adjustment across the work RVUs for all services. This adjustment alone results in an 8 percent cut for chiropractors, according to ACA.

ACA officials say that changes recently put forth in a final rule issued by the Centers for Medicare and Medicaid Services (CMS) undermine Congress’ goal of preserving patient access and achieving greater quality of care. The association is pressing for a one year delay in implementation of the rule to provide CMS more time to assess the negative impact of the changes.

ACA, along with other physicians groups (including the American Medical Association and the Alliance of Specialty Physicians) is also pressing Congress for action on another possible Medicare cut, which involves a legally mandated formula to control Medicare spending — the Sustainable Growth Rate (SGR).

ACA and ICA estimate that the combination of the two cuts would result in a 13.1 percent total decrease to chiropractic reimbursement rates.

For more information, and to review the CMS Final Rule, surf to our Show Notes - http://www.chiroeco.com/news/2006/November/CMS.php

http://www.cms.hhs.gov/PhysicianFeeSched/

45% of midlife women use CAM

A National Health Interview Survey revealed that 45 percent of women 45 to 57 years of age had used some form of Complementary and Alternative Medicine (CAM) within the last 12 months.

Of the 3,621 female participants, the most cited reason for using CAM involved treatment of pain, with 3 percent mentioning menopause. Approximately 25 percent used biologics such as herbs, or mind-body modalities, such as biofeedback, and 15 percent used body work such as massage and chiropractic medicine.

For more information, surf to - www.menopausejournal.com

Health coaching: An option for DCs?

Chiropractors wishing to participate in the industrial market may have another option available to them — health coaching. An article in the L.A. Times reports that a number of major insurers are offering employers the option of engaging health coaches for their employees.

Programs vary, as do the health coaches, who are often nurses but may be other healthcare professionals. The focus of the health coach is generally the same, however: to help employees manage illnesses and lifestyle issues such as weight loss or smoking cessation.

In some cases, the healthcare professional contacts employees; in others, employees initiate the calls for medical information and assistance.

Watson Wyatt, in conjunction with the National Business Group on Health, surveyed U.S. employers and found that by 2007, 54 percent of the largest companies will offer some version of health coaching to employees.

For more information, surf to - www.latimes.com

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show.

And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

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– Octavio Paz

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

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