And it was designed to work in coordination with private payers by aligning provider incentives, which improved quality and health outcomes for patients across the ACO, and achieved cost savings for Medicare, employers and patients.
Menopause results in oestrogen deficiency and the effects on the skin include: 1  Atrophy. 2  Decreased collagen and water content. 3  Decreased sebaceous secretions.  Loss of 1  elasticity. Manifestations of hyperandrogenism.  Poor wound healing.
Hormone replacement therapy (menopause) - Adverse effects. 1  Upset stomach, stomach cramps or bloating. 2  Appetite and weight changes. 3  Changes in sex drive or performance. 4  Nervousness. 5  Brown or black patches on the skin. 6  Swelling of hands, feet, or lower legs due to fluid retention. 7  Changes in menstrual flow.