Knowledge Base Category -

Meaningful connections are not just about having someone to chat with, they’re about the transformative potential of community engagement in enhancing mental, physical, and emotional well-being. By recognizing and nurturing the role that connectedness plays, we can mitigate issues like loneliness, ultimately promoting healthy aging for more Americans.

According to the U.S. Surgeon General's Advisory on the Healing Effects of Social Connection and Community:

• Social isolation among older adults alone accounts for an estimated $6.7 billion in excess Medicare spending annually, largely due to increase hospital and nursing facility spending,
• Loneliness and social isolation increase the risk for premature death by 26% to 29% respectively,
• Poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke,
• Loneliness is also associated with an increased risk for anxiety, depression, and dementia, and
• The lack of social connection may increase susceptibility to viruses and respiratory illness.

How can community groups, businesses, and organizations mark OAM?

• Spread the word about the mental, physical, and emotional health benefits of social connection through professional and personal networks.

• Encourage social media followers to share their thoughts and stories of connection using hashtag #PoweredByConnection to inspire and uplift.
• Promote opportunities to engage, like cultural activities, recreational programs, and interactive virtual events.
• Connect older adults with local services, such as counseling, that can help them overcome obstacles to meaningful relationships and access to support systems.
• Host connection-centric events or programs where older adults can serve as mentors to peers, younger adults, or youths.

What can individuals do to connect?

• Invite more connection into your life by finding a new passion, joining a social club, taking a class, or trying new activities in your community. 
• Stay engaged in your community by giving back through volunteering, working, teaching, or mentoring.
• Invest time with people to build new relationships and discover deeper connections with your family, friends, colleagues, or neighbors.

For more information, visit the official OAM website and follow ACL on X, Facebook, and LinkedIn. Join the conversation on social media using the hashtag #OlderAmericansMonth.

May is National Osteoporosis Awareness and Prevention Month.

Did You Know?

Osteoporosis is a “silent” disease because you typically do not have symptoms and may not even know you have the disease until you break a bone.

Despite this being a “silent” disease there are risk factors for developing osteoporosis, including:  

• A family history of broken bones or osteoporosis,
• History of broken bone after age 50,
• Previous surgery to remove the ovaries before menopause,
• Poor dietary habits, including insufficient amounts of calcium and or vitamin D or protein.
• Physical inactivity or prolonged periods of bedrest,
• Smoking cigarettes,
• Heavy use of alcohol,
• Long-term use of certain medications, such as corticosteroids, proton pump inhibitors, and antiepileptic medications,
• Altered level of hormones, such as too much thyroid hormone, too little estrogen in women, or too little testosterone in men, and
• Low body mass index or underweight.

Why it Matters?

According to the National Osteoporosis Foundation (NOF):

• Approximately 54 million Americans have low bone density or osteoporosis.
• Women can lose up to 20% of bone mass in the first 5-7 years post-menopause.
• Men aged 50 years and older are more likely to break a bone due to osteoporosis than they are to get prostate cancer.
• Studies suggest that approximately 1 in 2 women and up to 1 in 4 men 50 and older will break a bone due to osteoporosis in their lifetime.

What Can You Do?

As we celebrate Osteoporosis Awareness and Prevention Month, here are some steps you can take to improve your bone health:

• Eat foods that support bone health. Get enough calcium, vitamin D, and protein each day. Low-fat dairy; leafy green vegetables; fish; and fortified juices, milk, and grains are good sources of calcium. If your vitamin D level is low, talk with your doctor about taking a supplement.
• Get active. Choose weight-bearing exercise, such as strength training, walking, hiking, jogging, climbing stairs, tennis, and dancing. This type of physical activity can help build and strengthen your bones.

• Don’t smoke. Smoking increases your risk of weakened bones. If you do smoke, here are tips for how to quit smoking.
• Limit alcohol consumption. Too much alcohol can harm your bones. Drink in moderation or not at all. Learn more about alcohol and aging.

Resources

National Institute of Health: National Institute on Aging: Osteoporosis: https://www.nia.nih.gov/health/osteoporosis/osteoporosis

National Osteoporosis Foundation (NOF) May 2024 Social Media Toolkit: https://www.bonehealthandosteoporosis.org/wp-content/uploads/2024-OAPM-Social-Media-Toolkit.pdf

National Institute of Health: National Institute of Arthritis and Musculoskeletal and Skin Diseases: Osteoporosis: https://www.niams.nih.gov/health-topics/osteoporosis

Did You Know?

According to the National Cancer Institute, bladder cancer is the fourth most commonly diagnosed malignancy in men in the United States and the incidence of bladder cancer is about four times higher in men than in women.

Bladder Cancer Symptoms

Although symptoms can vary from person to person, the most common symptom is blood in the urine, called hematuria. Although this is the most common presenting symptom, most people experiencing hematuria do not have bladder cancer. Other common symptoms include:

• Frequent urination,
• Pain or burning during urination,
• Feeling as if you need to urinate even if your bladder is not full, and
• Frequent urination during the night.

   

  If the cancer has grown large or spread beyond the bladder, symptoms may include:

• Being unable to urinate
• Lower back pain on one side of the body
• Pain in the abdomen
• Bone pain or tenderness
• Unintended weight loss and loss of appetite
• Swelling in the feet, and
• Feeling tired.

   

  Why it Matters?

  There are risk factors related to developing bladder cancer, most common being tobacco use, especially smoking cigarettes. Examples of additional risk factors includes:

• Having a family history of bladder cancer,
• Having certain changes in the genes that are linked to bladder cancer,
• Being exposed to paints, dyes, metals, or petroleum products in the workplace,
• Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, such as cyclophosphamide or ifosfamide,
• Taking Aristolochia fangchi, a Chinese herb,
• Drinking water from a well that has high levels of arsenic,
• Drinking water that has been treated with chlorine,
• Having a history of bladder infections, and
• Using urinary catheters for a long time.

What Can I Do?

First, if you smoke, quit! If you think you may be at risk for bladder cancer and/or are experiencing symptoms common for bladder cancer, discuss this with your physician. Time matters. The earlier bladder cancer is identified, the better chance a person has of surviving five years after diagnosis.

Resources:

PDQ® Screening and Prevention Editorial Board. PDQ Bladder and Other Urothelial Cancer Screening. Bethesda, MD: National Cancer Institute. Updated 03/15/2024. Available at https://www.cancer.gov/types/bladder/hp/bladder-screening-pdq. Accessed 04/30/2024. [PMID:26389217]

National Cancer Institute – Bladder Cancer Symptoms. Updated 01/16/2023. Available at https://www.cancer.gov/types/bladder/symptoms. Accessed 04/30/2024.

Compliance Education Updates

March 2024: MLN8659122: MLN Fact Sheet Original Medicare vs. Medicare Advantage Updated

CMS updated the payment rules for patients enrolled in Medicare Advantage Organizations. https://www.cms.gov/files/document/mln8659122-original-medicare-vs-medicare-advantage.pdf

April 2024: MLN Educational Tool Medicare Preventive Services Revised

CMS has revised this tool to clarify social determinants of health information, add a link to the most current and comprehensive list of ICD-10 codes for bone mass measurement and colorectal cancer screening, add coding, coverage, and payment information for COVID-19 vaccine and administration, and replace Hepatis B information with a link to the Hepatitis B screening service. https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html

Other Updates

March 26, 2024: GAO Improper Payments: Information on Agencies’ Fiscal Year 2023 Estimates

In this report the Government Accountability Office (GAO) indicates the importance of this information due to the fact that “improper payments – those that should not have been made or were made in the incorrect amount – have consistently been a government-wide issue. Since fiscal year 2003, cumulative improper payment estimated by executive branch agencies have totaled about $2.7 trillion. Reducing improper payments is critical to safeguarding federal funds.” With an estimated $51 billion in estimated improper payments HHC’s Medicare (Medicare Fee-for-Service (Parts A and B), Medicare Advantage (Part C), and Medicare Prescription Drug (Part D)) had the highest estimated improper payments across 14 government agencies.

https://www.gao.gov/assets/d24106927.pdf?emci=4185bdfa-36ed-ee11-aaf0-002248223794&emdi=645794fb-40ed-ee11-aaf0-002248223794&ceid=7931774

March 27, 2024: CMS Releases FY 2025 Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule (CMS-1804-P)

CMS is proposing to update payment rates by 2.8 percent. This proposed rule includes annual updates to the prospective payment rates, the outlier threshold, the case-mix-group relative weights and average length of stay values, the wage index, associated impact analysis, and IRF Quality Reporting Program (QRP). Also included are two requests for information (RFIs) (1) Future Measure Concepts for the IRF QRP, and (2) Creating and IRF QRP Star Rating System.

CMS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2025-inpatient-rehabilitation-facility-prospective-payment-system-proposed-rule-cms-1804

CMS Proposed Rule: https://www.cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation/rules-related-files/cms-1804-p

IRF QRP webpage: https://www.cms.gov/medicare/quality/inpatient-rehabilitation-facility

March 28, 2024: CMS Issues 3 FY 2025 Proposed Rules: SNF, Inpatient Psych and Hospice

FY 2025 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1802-P) CMS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/fy-25-skilled-nursing-facility-prospective-payment-system-proposed-rule-cms-1802-p

FY 2025 Medicare Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Quality Reporting (IPFQR) Updates Proposed Rule (CMS-1806-P) CMS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2025-medicare-inpatient-psychiatric-facilities-prospective-payment-system-ipf-pps-and

• Of note, CMS has proposed to increase the per treatment amount for electroconvulsive therapy (ECT) from the current FY 2024 payment per treatment of $385.58 to $660.30. CMS believes this increase would help ensure that patients who need ECT are more able to access it. (ECT CPT 90870)

Did You Know?

• Esophageal cancer is more common in men.
• The two most common types of esophageal cancer are adenocarcinoma (most common in White people) and squamous cell carcinoma (more common in African Americans).

Estimated New Cases and Deaths from Esophageal Cancer in the United States in 2024

• New Cases: 22,370, an increase from the 21,560 estimated new cases in 2023
• Deaths: 16,130, an increase the from 16,120 estimated deaths in 2023

   

  Esophageal Cancer Risk Factors

  Risk Factors for Squamous Cell Esophageal Cancer include the following:

• Tobacco use.
• Heavy alcohol use.
• Being malnourished.
• Being infected with human papillomavirus (HPV).
• Having tylosis:
• Having achalasia:
• Having swallowed lye (a chemical found in some cleaning fluids).
• Drinking very hot liquids on a regular basis.

   

  Risk Factors for Esophageal Adenocarcinoma include the following:

• Having gastroesophageal reflux disease (GERD).
• Having Barret’s esophagus.
• Having a history of using drugs that relax the lower esophageal sphincter (the ring of muscle that opens and closes the opening between the esophagus and stomach).
• Being overweight.

Signs and Symptoms of Esophageal Cancer

• Painful or difficult swallowing.
• Weight loss.
• Pain behind the breastbone.
• Hoarseness and cough.
• Indigestion and heartburn.
• A lump under the skin.

Tests Used to Diagnose Esophageal Cancer

• Physical exam and health history.
• Chest x-ray.
• Esophagoscopy.
• Biopsy.

Why it Matters?

In most cases, esophageal cancer is a treatable but rarely curable disease. The five-year survival rate is 21.76%.

Patients have a better chance of recovery when esophageal cancer is found early. Only 18.1% of patients are diagnosed with esophageal cancer at the localized level. The five-year survival rate for this group of patients is 48.8%.

Signs and symptoms associated with esophageal cancer can also be present with other diseases. If you have any of the signs and symptoms mentioned in this article, discuss them with your doctor.

Resources

PDQ® Adult Treatment Editorial Board. PDQ Esophageal Cancer Treatment (Adult). Bethesda, MD: National Cancer Institute. Updated 2/6/2024. Available at: https://www.cancer.gov/types/esophageal/hp/esophageal-treatment-pdq. Accessed 04/03/2024. [PMID: 26389338]

PDQ® Screening and Prevention Editorial Board. PDQ Esophageal Cancer Prevention. Bethesda, MD: National Cancer Institute. Updated 07/30/2021 Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-prevention-pdq. Accessed 04/03/2024. [PMID: 26389280]

PDQ® Adult Treatment Editorial Board. PDQ Esophageal Center Treatment. Bethesda, MD: National Cancer Institute. Updated 09/21/2023. Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-treatment-pdq. Accesses 04/03/2024. [PMID: 26389463]

March 4, 2024: MLN MM13449: Stay of Enrollment

Make sure your staff knows about a new provider enrollment status called a stay of enrollment and updates to the Medicare Program Integrity Manual, Chapter 10. https://www.cms.gov/files/document/mm13449-stay-enrollment.pdf

March 7, 2024: MLN MM13546: New Waived Tests

Make sure your billing staff is aware of the Clinical Laboratory Improvement Amendment (CLIA) requirements, new CLIA-waived tests approved by the FDA, and use of modifier QW for CLIA-waived tests. https://www.cms.gov/files/document/mm13546-new-waived-tests.pdf

March 14, 2024: MLN MM13548: Medicare Claims Processing Manual Updates – HCPCS Billing Codes & Advance Beneficiary Notice of Non-coverage Requirements

Make sure your staff knows the HCPCS codes to bill and what CPT codes to not bill for an initial preventive physical exam (IPPE) and annual wellness visit (AWV) services. CMS also includes information about providing a patient an Advanced Beneficiary Notice of Non-coverage (ABN) in this article. https://www.cms.gov/files/document/medicare-claims-processing-manual-updates-hcpcs-billing-codes-advance-beneficiary-notice-non.pdf

March 18, 2024: MLN MM13554: Changes to the Laboratory National Coverage Determination Edit Software: July 2024 Update

Make sure your billing staff knows about newly available codes, recent coding changes, and how to find NCD coding information. Relevant laboratory NCD coding with changes July 2024 includes NCD 190.18 (Serum Iron Studies), 190.21B (Glycated Hemoglobin/Glycated Protein), and 190.31 (Prostate Specific Antigen). https://www.cms.gov/files/document/mm13554-changes-laboratory-national-coverage-determination-edit-software-july-2024-update.pdf

March 21, 2024: Transmittal R12552CP: April 2024 Update of the Hospital Outpatient Prospective Payment System (OPPS)

This Recurring Update Notification (RUN) provides instructions on coding changes and policy updates that are effective April 1, 2024, for the Hospital OPPS. Updates include coding and policy changes for new services, pass-through drug, and devices, eleven new Proprietary Lab Analysis (PLA) codes and other items and services, for example payment for intensive cardiac rehabilitation services (ICR) provided by an off-campus, non-excepted provider-based department (PBD) of a hospital.

In the CY 2024 OPPS/ASC final rule, CMS excluded ICR from the 40 percent Physician Fee Schedule Relativity Adjuster policy at the code level by modifying the claims processing of HCPCS codes G0422 (ICR; with or without continuous ECG monitoring with exercise, per session) and G0423 (ICR; with or without continuous ECG monitoring without exercise, per session). “Under this change 100 percent of the OPPS rate for ICR is paid irrespective of the presence of the PN modifier on the claim…please not that claims for HCPCS A0422 and G0433 submitted with the PN modifier from January to April 2024 were paid at the 40 percent rate. However, upon the April IOCE release, an additional amount will be retroactively applied to these past claims so that they are paid at 100 percent of the OPPS rate.” https://www.cms.gov/files/document/r12552cp.pdf

March 1, 2024: CDC Updates Respiratory Virus Guidance

The CDC notes that respiratory viruses are responsible for millions of illnesses and thousands of hospitalizations and deaths in the United States every year. This new guidance “provides practical recommendations and information to help people lower risk from a range of common respiratory illnesses, including COVID-19, flu, and RSV. A downloadable infographic highlights five core prevention strategies (immunizations, hygiene, steps for cleaner air, treatment, and stay home and prevent spread).

March 5, 2024: HHS Statement Regarding the Cyberattack on Change Healthcare

HHS announced immediate steps being taken by CMS to assist providers. You can read their full statement at https://www.hhs.gov/about/news/2024/03/05/hhs-statement-regarding-the-cyberattack-on-change-healthcare.html.

March 11, 2024: OIG’s FY 2024 Justification of Estimates for Congress

The OIG published their FY 2025 budget requests to provide oversight of HHS programs. The OIG “is responsible for overseeing more than $2 trillion in HHS spending and more than 100 different programs that provide critical services for hundreds of millions of individuals. With just 2 cents to oversee every $100 spent by HHS, HHS OIG must target its resources to maximize the impact of oversight and enforcement work.” They are requesting a total of $499.7 million to provide oversight of HHS programs. This is a $67.2 million increase from FY 2023. https://oig.hhs.gov/documents/budget/9814/FY%202025%20OIG%20Budget.pdf

March 14, 2024: Health Related Social Needs FAQ Document

In the Thursday, March 21, 2024, edition of MLN Connects, CMS announced that they have published a Health-Related Social Needs FAQ document about four services in the CY 2024 Physician Fee Schedule (Caregiver Training, Social Determinants of Health Risk Assessment, Community Health Integration, and Principal Illness Navigation).

For example, “are there limits on how often I can bill for SDOH risk assessment? Yes, in the CY 2024 PFS Final Rule, we established a limitation on payment for the SDOH risk assessment service of once every 6 months per practitioner per beneficiary.” https://www.cms.gov/medicare/payment/fee-schedules/physician/care-management

March 21, 2024: New Video: HHS-OIG’s Perspective on Managed Care

In this just over four-minute video, the OIG advised notes that “Managed care is health care delivery model and an alternative way for Medicare and Medicaid patients to receive their health care benefits,” details potential risks and concerns with managed care and provide information on how patients can protect themselves. https://www.youtube.com/watch?v=CQEPszbprwY

In addition to this new video, on March 18^th, the OIG published their first Impact Brief highlighting the impact the OIG’s work has on HHS programs. This first impact brief addresses Medicare Advantage Prior Authorization issues, outlines specific concerns, and demonstrates the agency’s progress to address those concerns. https://oig.hhs.gov/documents/impact-briefs/9820/Medicare%20Advantage%20Prior%20Authorization%20Impact%20Brief.pdf

March 22, 2024: March ICD-10 Coordination and Maintenance Committee Meeting Update

CMS sent a notice letting providers know that the meeting materials for the March 19^th and 20^th meeting are now available at https://www.cms.gov/medicare/coding-billing/icd-10-codes/icd-10-coordination-maintenance-committee-materials.

March 2024: CMS Fast Facts Updated

CMS Fast Facts provides summary information on total program enrollment, utilization, expenditures, and the total number of Medicare providers including physicians by specialty area. This information is refreshed twice a year and was most recently refreshed this month. https://data.cms.gov/fact-sheet/cms-fast-facts

January 17, 2024: Acute Care Hospitals Required to join Joint Commission NHSN Group

Effective July 1, 2024, acute care hospitals with ORYX® performance measurement requirements and that are required through a CMS program to participate in the CDC National Healthcare Safety Network (NHSN) system will be required to join the Joint Commission NHSN Group.

The Joint Commission indicated in their announcement that “In April 2024 The Joint Commission will e-mail the primary accreditation contact on file for the organization to determine the appropriate contact person to correspond with regarding the Joint Commission NHSN Group. After the contract has been identified, detailed instructions for joining the Group will be provided, and onboarding will take place May through June 2024.”

February 1, 2024: April 1, 2024 ICD-10-CM Updates

CMS notes the ICD-10-CM April 1, 2024 update addresses typographical errors and there are no new diagnosis codes being implemented. You will find downloads for discharges on and after April 1, 2024 on the 2024 ICD-10-CM webpage including an update ICD-10-CM Official Guidelines for Coding and Reporting that includes a few updates, for example on page 29 of this document a new subsection (f) Screening for COVID-19 has been added which provides the following guidance “for screening for COVID-19, including preoperative testing, assign code Z11.52, Encounter for screening for COVID-19.”

February 7, 2024: New Steps to Transform the Organ Transplant System

HHS issued a Press Release announcing that the Health Resource and Services Administration (HRSA) “is taking historic steps as part of its Organ Procurement and Transplantation Network (OPTN) Modernization Initiative, leveraging new legal authority…signed into law as part of the Securing the U.S. Organ Procurement and Transplantation Network Act in September 2023.  HRSA actions include:  

• Releasing a contract solicitation to break up the OPTN monopoly and create an independent OPTN Board of Directors,
• Issuing a multi-vendor contract solicitation to support broad competition and best-in-class vendors for critical OPTN functions,
• Launching the discovery and development phase of the transition to a modernized OPTN IT matching system, and
• Taking action to address “pre-waitlist” inequities in the organ waitlist process and reduce variations in referrals to transplant and in organ procurement practices.

February 8, 2024: CMS Reminds Providers about the Jimmo Settlement Agreement

CMS reminded providers in the Thursday, February 8, 2024 edition MLN Connects that “Medicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care to maintain function or to prevent or slow decline, as long as:

• The beneficiary requires skilled care for the services to be provided safely and effectively.
• An individualized assessment of the patient's condition demonstrates that the specialized judgment, knowledge, and skills of a qualified therapist are needed for a safe and effective maintenance program.

Note, on February 13, 2024, CMS sent a letter to all Medicare Advantage Organizations reminding them about the Jimmo Settlement Coverage and Training Policies. https://leadingage.org/wp-content/uploads/2024/02/HPMS-Memo_-Jimmo-Settlement_508.pdf

February 8, 2024: Accrediting Organization (AO) Proposed Rule

CMS published a proposed rule and related Fact Sheet noting that “CMS’s annual AO oversight Reports to Congress (RTCs) highlight the agency’s significant concerns regarding AO performance that need to be addressed.” Comments can be submitted until April 15, 2024.

February 8, 2024: Texting of Patient Information and Orders for Hospitals and CAHs Memorandum

Compliance Education Updates

December 2023: MLN Booklet: Global Surgery

CMS has updated this MLN booklet to include the instructions for critical care visits that are unrelated to the surgical procedure and performed post-operatively, report modifier -FY. https://www.cms.gov/files/document/mln907166-global-surgery-booklet.pdf

Other Updates

January 18, 2024: CMS Adds Utilization Data on Medicare.gov for the First Time

CMS noted in the Friday January 26 edition of CMS Roundup that they have “added utilization data, specifically procedure volume, for the first time on the Medicare.gov compare tool’s profile pages for doctors and clinicians…this is the latest example of CMS’ transparency efforts to ensure the compare tool on Medicare.gov provides patients and caregivers with information about services they may value as they search for clinicians.”

The dataset is currently published in the Provider Data Catalog. The initial list of procedures includes hip and knee replacement, spinal fusion, cataract surgery, colonoscopy, open hernia repair of the groin, minimally invasive hernia repair, mastectomy, CABG, pacemaker insertion or repair, coronary angioplasty and stenting, and prostate resection.

You can read more about this data release in a CMS Fact Sheet at https://www.cms.gov/files/document/utilization-procedure-volume-data-published-compare-tool-medicaregov-fact-sheet-195-kb.pdf.

January 22, 2024: New EMTALA Resources

CMS announced in a Press Release that they are launching “a series of actions to educate the public about their rights to emergency medical care and to help support the efforts of hospitals to meet their obligations under the Emergency Medical Treatment and Labor Act (EMTALA).” One action CMS has taken is to publish new informational resources on their website at https://www.cms.gov/priorities/your-patient-rights/emergency-room-rights. You can read the entire press release at https://www.cms.gov/newsroom/press-releases/cms-announces-new-actions-help-hospitals-meet-obligations-under-emtala.

New Kepro Email Addresses

In the January 2024 edition of Case Review Connections, Kepro lets providers know that Kepro recently became a part of the Acentra health family, and you may notice some changes in email addresses, moving to acentra.com. They do not anticipate any other changes at this time and will provide guidance in the future of any potential required changes. You can sign up for this newsletter on the Kepro website at https://www.keproqio.com/newsletters.

January 24, 2024: HHS Releases Voluntary Cybersecurity Goals for the Health Sector & New Gateway Website

HHS announced the release of “voluntary health care specific cybersecurity performance goals (CPGs) and a new gateway website to help Health Care and Public Health (HPH) sector organizations implement these high-impact cybersecurity practices and ease access to the plethora of cybersecurity resources HHS and other federal partners offer.” https://aspr.hhs.gov/newsroom/Pages/HHS-Releases-CPGs-and-Gateway-Website-Jan2024.aspx

January is Thyroid Awareness Month. This article highlights the differences between hypothyroidism and hyperthyroidism and the next steps to thyroid awareness. 

Hypothyroidism, Just the Facts

Hypothyroidism is when your thyroid gland does not make enough thyroid hormones to meet your body’s needs and without enough thyroid hormones, many of your body’s functions slow down.

• Nearly 5 out of 100 Americans aged 12 years and older have hypothyroidism. Most cases are mild, or a patient has few obvious symptoms.
• Women are more likely to develop hypothyroidism,
• This disease is more common in people over 60 years old,
• Reasons making you more likely to develop hypothyroidism include:
  • A prior thyroid problem, such as a goiter,
  • Prior surgery or radioactive iodine to correct a thyroid problem,
  • Prior radiation treatment to thyroid, neck, or chest,
  • A family history of thyroid disease,
  • Being pregnant in the past 6 months,
  • Having Turner syndrome (a genetic disorder that affects women), and
  • Is more likely to occur if you have other health problems (i.e., celiac disease, pernicious anemia, Type 1 or Type 2 diabetes, rheumatoid arthritis, or lupus).
• Symptoms of hypothyroidism can include fatigue, weight gain, trouble tolerating cold, joint or muscle pain, dry skin, thinning hair, heavy or irregular menstrual periods, fertility problems, slower heart rate and depression. Note, many of these symptoms are common and do not necessarily mean you have a thyroid problem.
• Hypothyroidism can contribute to high cholesterol. If your cholesterol is elevated, you should get tested for hypothyroidism.

   

  Hyperthyroidism, Just the Facts

  Hyperthyroidism is when your thyroid gland makes more thyroid hormones than what your body needs and with too much thyroid hormone, many of your body’s functions speed up.

• About 1 out of 5 Americans aged 12 years and older have hyperthyroidism.
• Like hypothyroidism, women are more likely to develop hyperthyroidism and this disease is more common in people over 60 years old,
• Reasons making your more likely to develop hyperthyroidism include:
  • A family history of thyroid disease,
  • Other health problems (i.e., vitamin B deficiency, Type 1 or Type 2 diabetes, or primary adrenal insufficiency),
  • Eating large amounts of foods containing Iodine,
  • Taking medications containing Iodine,
  • Use of nicotine products, and
  • Being pregnant in the last 6 months.
• Symptoms of Hyperthyroidism can include weight loss despite increased appetite, rapid and irregular heartbeat, nervousness, irritability, trouble sleeping, fatigue, shaky hands, muscle weakness, sweating or trouble tolerating heat, frequent bowel movements, or a goiter. Note, in older adults this disease can be mistaken for depression or dementia.
• If left untreated, this disease can cause serious health problems (i.e., irregular heartbeat that can lead to blood clots, stroke, heart failure, Graves’ ophthalmopathy, thinning bones, osteoporosis, muscle pain and menstrual cycle and fertility issues).

What Can You Do?

Even though the symptoms you may experience with hypothyroidism and hyperthyroidism are common and may not be related to a thyroid problem, it is important to mention them during an appointment with your doctor.

Your doctor can check for thyroid disease during a standard physical exam by palpation of the thyroid gland and there are two standard blood tests that your doctor may recommend. One measures your thyroid hormone level (T4) and another measures thyrotropin (TSH) which is a hormone secreted from the pituitary gland that controls how much thyroid hormone your thyroid makes.

Treatment for thyroid disease will be specific to the type and severity of the thyroid disorder and the age and overall health of the patient.

Source:

National Institute of Health’s (NIH) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) articles at https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism

& https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism