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Related Concept Videos

Preparation of Epoxides03:00

Preparation of Epoxides

9.4K
Overview
Epoxides result from alkene oxidation, which can be achieved by a) air, b) peroxy acids, c) hypochlorous acids, and d) halohydrin cyclization.
Epoxidation with Peroxy Acids
Epoxidation of alkenes via oxidation with peroxy acids involves the conversion of a carbon–carbon double bond to an epoxide using the oxidizing agent meta-chloroperoxybenzoic acid, commonly known as MCPBA. Since the O–O bond of peroxy acids is very weak, the addition of electrophilic oxygen of peroxy acids to...
9.4K
Preparation of Amides01:29

Preparation of Amides

4.1K
Amides are synthesized by treating carboxylic acids with amines in the presence of dehydrating agents like dicyclohexylcarbodiimide (DCC).
The DCC-promoted synthesis of amides begins with the protonation of DCC by carboxylic acid. The protonation makes it a better acceptor. Next, the addition of carboxylate to the protonated carbodiimide gives a reactive acylating agent.
Subsequently, the amine acts as a nucleophile that attacks the acylating agent to form a tetrahedral intermediate. In the...
4.1K
Preparation of Nitriles01:12

Preparation of Nitriles

2.7K
One of the common methods to prepare nitriles is the dehydration of amides. This method requires strong dehydrating agents like phosphorous pentoxide or boiling acetic anhydride for converting amides to nitriles. Another reagent namely, thionyl chloride also accomplishes the dehydration of amides, where amide acts as a nucleophile. The first step of the mechanism involves the nucleophilic attack by the amide on the thionyl chloride to form an intermediate. In the next step, the electron pairs...
2.7K
Preparation and Reactions of Thiols02:33

Preparation and Reactions of Thiols

7.6K
Thiols are prepared using the hydrosulfide anion as a nucleophile in a nucleophilic substitution reaction with alkyl halides. For instance, bromobutane reacts with sodium hydrosulfide to give butanethiol.
7.6K
Preparation of Acid Anhydrides01:07

Preparation of Acid Anhydrides

4.0K
One of the methods for preparing symmetrical or unsymmetrical acid anhydrides involves the treatment of acid chlorides with the sodium salt of carboxylic acids. The reaction proceeds via a nucleophilic acyl substitution.
The carboxylate ion acts as a nucleophile that attacks the carbonyl carbon of the acid chloride to form a tetrahedral intermediate. Subsequently, the re-formation of the carbonyl group with the loss of the chloride ion as a leaving group leads to the formation of an acid...
4.0K
Preparation and Reactions of Sulfides02:26

Preparation and Reactions of Sulfides

5.8K
Sulfides are the sulfur analog of ethers, just as thiols are the sulfur analog of alcohol. Like ethers, sulfides also consist of two hydrocarbon groups bonded to the central sulfur atom. Depending upon the type of groups present, sulfides can be symmetrical or asymmetrical. Symmetrical sulfides can be prepared via an SN2 reaction between 2 equivalents of an alkyl halide and one equivalent of sodium sulfide.
5.8K

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Proactively Prepare for MIPS Now-Your Future Self Will Thank You.

Joy Rios

    The Journal of Medical Practice Management : MPM
    |June 27, 2018
    PubMed
    Summary

    The Medicare Access and CHIP Reauthorization Act of 2015 shifts healthcare reimbursement from fee-for-service to value-based care. Providers must prepare for the Merit-Based Incentive Payment System to succeed in this new healthcare landscape.

    Area of Science:

    • Healthcare policy
    • Health economics
    • Medical practice management

    Background:

    • The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) enacted significant changes to healthcare reimbursement.
    • The traditional fee-for-service model is transitioning to a value-based care approach.

    Purpose of the Study:

    • To explain the paradigm shift introduced by MACRA.
    • To highlight the importance of preparing for the Merit-Based Incentive Payment System (MIPS).

    Main Methods:

    • Analysis of the legislative framework of MACRA.
    • Explanation of the transition from fee-for-service to value-based reimbursement.
    • Identification of key components of MIPS.

    Main Results:

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    • MACRA mandates a move towards paying clinicians based on the quality and value of care provided.
    • Successful implementation requires engagement with health IT and quality reporting programs.
    • Proactive preparation for MIPS is crucial for provider adaptation.

    Conclusions:

    • The shift to value-based care under MACRA presents a significant challenge for healthcare providers.
    • Early and strategic preparation for MIPS is essential for navigating this new reimbursement model and ensuring future success.