News

May 22, 2018:
Maryland contingency with Senator Cardin

 

 

 

 

 

 

 

 

 

 

May 22, 2018:

2018 AAFP Vaccine Science Fellowship- Deadline: June 4, 2018. Learn more here.

May 18, 2018:

Key Element Of The Maryland Model—Maryland Primary Care Program—To Launch January 2019 
Program Supports the Delivery of Advanced Primary Care Allowing Providers Play an Increasingly Important Role in Improving Health Outcomes

Baltimore, MD (May 18, 2018) – Earlier this week, Governor Larry Hogan, together with the Maryland Department of Health and the Centers for Medicare and Medicaid Services (CMS), announced the federal approval of Maryland’s Total Cost of Care All-Payer Model, known as the “Maryland Model” contract. This innovative approach to health care provider payment is unique to Maryland and made possible via a contract between CMS and the state. The announcement also includes approval of the Maryland Primary Care Program (MDPCP), which will launch in January 2019.

The MDPCP is a voluntary program, open to all eligible Maryland Primary Care providers, that supports the delivery of advanced primary care throughout the state and allows providers to play an increasingly important role in improving health outcomes, while reducing unnecessary Emergency Department and hospital visits.

The MDPCP adds important care management tools for the primary care providers in Maryland, strengthening and transforming the delivery of Advanced Primary Care and Care Management as well as value-based bonuses. The program is also open to newly formed Care Transformation Organizations (CTOs) that provide Care Management support to practices.

“The Maryland Primary Care Program is a tremendous benefit to both patients and providers in Maryland and will ensure the highest level of care for patients who have the greatest need,” says Dr. Howard Haft, deputy secretary for Public Health Services at the Maryland Department of Health.  

The Request for Applications (RFA) for this program will be posted by CMS in early June 2018. 

In anticipation of the release of a formal RFA for MDPCP in the upcoming weeks, the Maryland Department of Health will be hosting a series of educational sessions to help potential applicants prepare for the program. For more information on MDPCP and a schedule of upcoming events, please visit our website.

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Marylanders who need help finding substance related disorder treatment resources should visit MdDestinationRecovery.org,BeforeItsTooLateMD.org or call the Maryland Crisis Hotline, which provides 24/7 support, at 1-800-422-0009. If you know of someone who could use treatment for substance related disorders treatment facilities can be located by location and program characteristics on our page at https://goo.gl/aRRExJ.   

The Maryland Department of Health is the State agency that protects Maryland’s public health. We work together to promote and improve the health and safety of all Marylanders through disease prevention, access to care, quality management, and community engagement. Stay connected: http://www.twitter.com/MDHealthDept and http://www.facebook.com/MarylandDHMH. ​

May 14, 2018:
2017 Maryland Maternal Mortality Review Annual Report

May 9, 2018: Family Physician Finds Antidote to Burnout in Innovation
The AAFP’s Alliance for e-Health Innovation is accepting applications for its Primary Care Innovation Fellowship. The 2017 fellow, Joey Nichols, MD, says innovation projects help him avoid burnout. Read More.

 

February 22, 2018:
Action Alert: Report 2017 MIPS Performance Data by March 31

February 13, 2018:
Advisory 181 Tamiflu and it’s generic Change on the PDL

February 12, 2018:
The Advisory Committee on Immunization Practices recommendations for the newly licensed recombinant zoster vaccine (RZV), Shingrix, by GlaxoSmithKline for the prevention were published in the MMWR on January 26, 2018. Shingrix is a 2-dose vaccine containing recombinant glycoprotein E and an adjuvant (AS01B).  RZV is approved for use in those >50 years for the prevention of shingles and its complications.  Initial clinical trials of RZV show higher vaccine efficacy across all age groups compared to zoster vaccine live (ZVL), Zostavax.  Please see the attached recommendations for detailed clinical guidance

Recommendations
Recombinant zoster vaccine (RZV) is recommended for the prevention of herpes zoster and related complications for immunocompetent adults ≥50 years.
RZV is recommended for the prevention of herpes zoster and related complications for immunocompetent adults who previously received zoster vaccine live (ZVL).
RZV is preferred over ZVL for the prevention of herpes zoster and related complications (see p 105 of the recommendations for rationale).

Clinical Guidance
-Please Note: 
Care should be taken not to confuse the two different zoster vaccine formulations. RZV (Shingrix) is stored in the refrigerator and administered intramuscularly (IM). ZVL (Zostavax) is stored in the freezer and administered subcutaneously (SC).
-Reconstitution. Shingrix consists of a lyophilized vaccine which needs to be reconstituted with the liquid adjuvant.
-Schedule.  2 doses should be administeredIM at 0 and 2-6 months.  The vaccine series need not be restarted if more than 6 months have elapsed since the first dose.  The minimum interval between doses is 4 weeks and doses given at shorter intervals should be repeated.
Shingrix can be given regardless of: 1) prior receipt of varicella vaccine; 2) prior receipt of ZVL; and 3) prior history of herpes zoster.  Do not screen for a history of varicella (verbally or via laboratory serology).
Timing of RZV for persons previously vaccinated with ZVL.  Age and time since receipt of ZVL may be considered to determine when to vaccinate with RZV.  Studies examined the safety and immunogenicity of RZV vaccination administered ≥5 years after ZV); shorter intervals have not been studied. However, there are no data or theoretical concerns to indicate that RZV would be less safe or less effective when administered at an interval of <5 years.  Clinical trials indicated lower efficacy of ZVL in adults aged ≥70 years; therefore, a shorter interval may be considered based on the recipient’s age when ZVL was administered.  Based on expert opinion, RZV should not be given <2 months after receipt of ZVL.
Coadministration with Other Vaccines.  CDC’s general best practice guidelines for immunization advise that recombinant and adjuvanted vaccines, such as RZV, can be administered concomitantly, at different anatomic sites, with other adult vaccines.  Administration of RZV and adjuvanted influenza vaccine (Fluad), either concomitantly or at other intervals, has not yet been evaluated.
Reactions.  Studies show Shingrix is safe.  Shingrix contains an adjuvant to improve immune response, so it can be associated with more temporary side effects than some other vaccines.  About 16% of those vaccinated reported reactions that might prevent them from doing regular activities. Local reactions were reported in about 9% of recipients and systemic reactions in 11%, which included fatigue, fever, nausea, vomiting, diarrhea, shivering.  The most common symptoms were pain (78%), myalgia (45%) and fatigue (45%).  However, they resolve in 2-3 days.
Counseling for Reactogenicity. Before vaccination, providers should counsel RZV recipients about expected systemic and local reactogenicity. Reactions to the first dose did not strongly predict reactions to the second dose; vaccine recipients should be encouraged to complete the series even if they experienced a reaction to the first dose of RZV.
 
Storage and Handling
Shingrix should be stored in the refrigerator at 2-8⁰C (not in the freezer).  After reconstitution, it must be used within 6 hours or be discarded. 

Resources for Healthcare Professionals and Patients
CDC has updated its shingles vaccination websites to reflect the new recommendations: 
Shingles vaccination main page
What everyone should know about Shingrix
Information about Shingrix for Healthcare Professionals
Package Insert

 

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