Blue - All Rise

[Allen Yerke]

Coveringseventy percent of our globe, the oceans are the world largest solar collectors. This solar energy is captured as heat in the upper layers of the oceans. From the natural temperature difference that exists between the upper and deep layers of the ocean, energy can be extracted. This is called Ocean Thermal Energy Conversion (OTEC) and is in particular of interest in the tropics where it can be instrumental in helping islands and coastal regions in achieving a sustainable future. It is considered among the biggest renewable energy sources. Using the ocean database of Copernicus Marine Service, Bluerise in collaboration with TU Delft, has evaluated the year round and ten year average ocean characteristics in the Caribbean analyzing the ocean currents, density and temperature profiles over depth. Particular attention was spent on ocean upwelling and seasonal fluctuations. Bluerise has developed a model, using the data from the Copernicus Marine Service, to analyze oceanographic features such as natural ocean current patterns and their variability relevant for OTEC. This enables a quick assessment of the feasibility of OTEC locations.

Ocean Thermal Energy Conversion is a renewable electricity source that uses the natural temperature difference in tropical oceans between the surface water and deep water. The technology can transform a temperature difference of 20 C or more into clean, reliable, and predictable base load electricity. Tropical regions, with population centers near the coast, have ideal conditions to deploy OTEC technology to fully meet their rapidly growing energy needs. Although tropical regions currently account for less than 30% of the current global energy demand, the tropics will become the most significant energy market within the next 20 years.

Bluerise develops Ocean Thermal Energy solutions. Bluerise is a private company which mission is to bring the cost of OTEC down to a competitive level and to provide a vast, baseload source of renewable energy to its customers. Bluerise was conceived in 2009 by a team of experts convinced that OTEC can become a substantial part of the future sustainable energy mix.

Provides free, open, regular and systematic reference information on the blue (physical), white (sea ice), and green (biogeochemical) ocean state, variability and dynamics across the global ocean and European regional seas.

Covering seventy percent of our globe, the oceans are the largest solar collectors and can provide a vast amount of clean and renewable energy, day and night. Ocean energy is destined to become the leading source of renewable energy worldwide.

Bluerise develops energy systems that use temperature differences in the oceans to generate electricity and cooling. We enable full energy independence for tropical islands and coastal regions and can help to save up to 90% on cooling related electricity use.

At more than $54 billion, spending to treat all orthopedic pain conditions (including pain in the muscles, bones and joints) represents more than 14 percent of overall healthcare spending for commercially insured adult Blue Cross Blue Shield (BCBS) members.1,2 This report identifies trends in cost and quality of care for elective or planned orthopedic surgical procedures (specifically total and partial knee replacements and total hip replacements) by examining the medical claims of BCBS commercially insured members from 2010 through 2017.3 This report is based on analysis of data from Blue Cross Blue Shield Axis (BCBS Axis), the largest collection of commercial insurance claims data in the U.S. BCBS Axis was completed in 2015 to support cost transparency and data-driven decision making. Cost transparency is key for patients to work with their doctor to compare and consider the best setting of care (whether inpatient or outpatient) and specific facility for these planned procedures.

This is the second Health of America Report since 2015 highlighting trends in planned orthopedic procedures for commercially insured BCBS members. As each of these Health of America Reports reveal, utilization and costs of planned knee and hip procedures both continue to rise, impacting overall healthcare costs. In response to these trends, BCBS companies developed solutions to help inform and empower individuals to select quality, affordable sites of care that best meet their needs. Two solutions are detailed below.

BCBS companies have implemented a number of value-based, care management and cost transparency initiatives in collaboration with employers and local medical communities to help members understand and access the best care to meet their needs.

As expected, the largest increases for knee and hip procedures were among those within the 55 to 64 age group from 2010 to 2017. However, both procedures also grew among most of the younger age groups.

Complication rates for knee and hip procedures have also improved in the outpatient setting and, in fact, are below rates in the inpatient setting. Outpatient complication rates were down 23 percent for knee procedures and 36 percent for hip procedures from 2013 to 2017.8,9

Planned knee and hip outpatient procedures are 30 to 40 percent less expensive on average than inpatient procedures.10 To emphasize the differences between costs in each care setting, the analysis in this section presents procedure prices incurred during the surgical visit.11

Access to outpatient facilities and the use of outpatient facilities for both knee and hip replacement procedures varies widely from state to state.13 For knee procedures, Alaska, Colorado, Georgia, Hawaii, Indiana, Kentucky, Minnesota, Mississippi and Ohio show outpatient surgery rates above 20 percent. For hip procedures, Alaska, Colorado, Minnesota and Mississippi have outpatient surgery rates above 20 percent.

Planned knee and hip replacements are becoming more common among Americans, including people under age 55. Since orthopedic procedures have considerable price variation across the U.S., it is essential that individuals work with physicians to select a site of care that meets their needs for both quality and affordable costs. This report is based on analysis of data from BCBS Axis, the largest collection of commercial insurance claims data in the U.S. BCBS Axis was completed in 2015 to support cost transparency and data-driven decision making.

This is the 23rd study of the Blue Cross Blue Shield, The Health of America Report series, a collaboration between Blue Cross Blue Shield Association (BCBSA) and Blue Health Intelligence (BHI), which uses a market-leading claims database to uncover key trends and insights in healthcare affordability and access to care. The report was done in partnership with HealthCore, a wholly owned and independently operated health outcomes subsidiary of Anthem, Inc.

This report identifies trends in cost and quality of care for elective or planned orthopedic surgical procedures (specifically knee and hip replacements) by examining the medical claims of more than 48 million Blue Cross and Blue Shield commercially insured members from 2010 through 2017.18 In this analysis, a knee replacement is defined as a total or partial knee replacement or a revision surgery. A hip replacement is defined as a total hip replacement or revision surgery. Inpatient settings include surgeries that are performed in a hospital, whereas outpatient settings include surgeries that are performed in an ambulatory surgery setting or dedicated hospital outpatient unit with no overnight stay.

Total spending amounts were extrapolated from the study population to the entire adult BCBS commercially insured population in 2017 and are adjusted for membership growth in prior years. All dollar amounts have been adjusted to reflect inflation and are presented in 2017 dollars.

Covering seventy percent of our globe, the oceans are the world's

largest solar collectors. This solar energy is captured as heat in the

upper layers of the oceans. From the natural temperature

difference that exists between the upper and deep layers of the

ocean, energy can be extracted. This is called Ocean Thermal

Energy Conversion (OTEC) and is of particular interest in the

tropics where it can be instrumental in helping islands and coastal

regions in achieving a sustainable future. It is considered among

the biggest renewable energy sources. Using the ocean database

of Copernicus Marine Service, Bluerise, in collaboration with TU

Delft, has evaluated the year round and ten year average ocean

characteristics in the Caribbean analyzing the ocean currents,

density and temperature profiles over depth. Particular attention

was paid to ocean upwelling and seasonal fluctuations. Bluerise

has developed a model, using the data from the Copernicus

Marine Service, to analyze oceanographic features such as natural

ocean current patterns and their variability relevant for OTEC. This

enables a quick assessment of the feasibility of OTEC locations.

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