CAPABLE means Home, not Nursing Homes, for Seniors

Source: Newswise (6/26/2012) — Nursing homes do not have to be inevitable destinations for frail older adults. Many—even those with long-term health problems—can remain at home and be independent. All it takes is a little help to change “disability” to “capability”.

A handyman with a few nails to fix a wobbly bannister can make the difference between staying at home and a nursing home stay. Visits from a nurse or occupational therapist can help simplify a bewildering medication regimen or improve the ability to get around the house and neighborhood. Simple, inexpensive steps may change the equation for thousands of seniors, but in reality, services like these are rarely available for many at greatest need—the poorest and sickest older adults receiving Medicare and Medicaid.

CAPABLE, short for “Community Aging in Place, Advancing Better Living for Elders,” and a $4 million Health Care Innovation Award from the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services, is about to change that reality. Read More …

It’s Fall – Time for Talking Turkey about Healthcare…

 

Medical Economics - follow the Money

We need to talk about healthcare, the role of funding, the need for healthcare teams, and core infrastructure from workplace culture to technology.  Parts of this post began as a comment in Employee Benefit News, a LinkedIn group.  Let’s start with the money.

There’s a pattern here—banks collect a 5% margin on health insurance cash flow.  This is not small potatoes.  Healthcare insurance, mostly self-insured employer costs, was about 33.5 percent of the $2.3 trillion spent on healthcare in 2008, i.e., almost 70 percent of the half of health cost not paid by Medicare and Medicaid (see National Health Expend Data). This annual $770 billion allows the 5% margin to feed some $38 billion into the banking sector’s P&L statement.  And, the annual $770 billion flow is money banks can invest in securities markets, or can lend.

 

In Snake Bit, I took a different look at annual health insurance evaluation and the danger of getting Snake Bit if we don’t dig into the details, compare plans, and consider our historical and anticipated medical costs.

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Putting Patients at the center of their Health Care

HealthITBuzz logoHere is full text of an article by by by Jodi G. Daniel / JD MPH, Director of the Office of Policy and Planning at the U.S. Department of Health & Human Services. It is provided with full attribution and a link to the original article but without copyright concerns, because I believe it’s important enough to be promoted widely and don’t expect any complaints. If, however, the Office of the National Coordinator for Health Information Technology (ONC) asks me to remove it, I will surely do so.

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What do you Want from Health Care?

World HealthI posed the following challenge to the Innovations in Health group on Linkedin and got some interesting responses, including a well crafted wish list from Colleen that inspired this blog post.

HOW CAN WE STIMULATE INNOVATIVE IDEAS FOR A TOTALLY NEW HEALTHCARE SYSTEM?

As a fun exercise to stimulate creative, out-of-box thinking, pretend you have all been been appointed to the new World Health Commission by the new King of the World (or whatever title you prefer). You have absolute power to determine health strategy, for the whole world. Think like a child, and forget the constraints you’re used to dealing with as adults. There are no financial hurdles, no political worries, no cultural barriers, no legacy to contend with, no managers looking over your shoulders, and no imposed time frames.

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In Sickness and in Health, till Death do us part

read the Pat Robertson story at MSNBC

Rev.Pat Robertson, by Clem Britt/AP

I’ve written occasionally about Medical Ethics and the misalignment of incentives that pay doctors & hospitals for treating symptoms rather than keeping us well. As we consider reforms to contain runaway deficit spending, we must come to grips with many ethical questions. Since individual choices can determine our health and well being, and therefore the cost of care, we’re less sympathetic of people still smoke, drink or eat too much of the wrong things. We know that obesity is America’s #1 health & financial risk and that it can cause heart disease, stroke, diabetes and certain cancers. Since half of our population is overweight from lifestyle choices, should they get the same level of care at taxpayer expense?

A new question arose this week about medical ethics and marriage when religious leader Pat Robertson told his 700 Club television audience that divorcing a spouse with Alzheimer’s disease is justifiable. He was taking questions from the audience when Robertson was asked how to advise a man who began seeing another woman after his wife started showing symptoms of Alzheimer’s.

“I know it sounds cruel,” he said, “but if he’s going to do something, he should divorce her and start all over again, but make sure she has custodial care and somebody looking after her.” After all, it’s “a kind of death.”

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ONC: Helping Consumers Be Partners in Their Own Health

HealthITBuzz logoHere is full text of an article by Lygeia Ricciardi, Senior Policy Advisor for Consumer e-Health at the U.S. Department of Health & Human Services. It is provided with full attribution and a link to the original article but without copyright concerns, because I believe it’s important enough to be promoted widely and don’t expect any complaints. If, however, the ONC asks me to remove it, I will surely do so.

Helping Consumers Be Partners in Their Own Health

by Lygeia Ricciardi, Senior Policy Advisor for Consumer e-Health

We at the Office of the National Coordinator for Health Information Technology (ONC) know that patients are asking themselves, “How do I manage my health information?” We are working to bring the U.S. health care system into the 21st century through technology to address that concern. We understand that it’s not all about health care providers and hospitals—it’s also about you: the patient, the individual, the person who should be the focus of the health care system.

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States Slash Home Health Care & Services for the Neediest

Senior with Home Care Bound for Adult Day Care States Slash Home Health Care & Adult Day Care Services for the Neediest; Likely to Increase Costs

Republished with permission from HelpingYouCare.com.

Several reports recently have noted that across the nation, U.S. states are slashing Medicaid dollars for home health care services and adult day care services that help keep the elderly and disabled out of nursing homes. State lawmakers cite budget shortfalls, yet these cuts may end up costing Medicaid and taxpayers more in forced nursing home costs, authorities say.

According to a July 16 report by the Associated Press, “Aging and disability services in three out of four states have been reduced over the last two years or face cuts, even though demand is increasing.”

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AARP Finds Toll On Family Caregivers Is ‘Huge’

AARP: Join the Fight for Medicare and Social SecurityValuing the Invaluable: The Growing Contributions and Costs of Family Caregiving is a new study by the AARP that estimates a value of $450 billion a year for work done by more than 40 million Americans caring for an elderly or disabled loved one. That may be a bargain for society, but it’s a “huge” burden on the family members.

Cymando Henley’s mom was diagnosed with Multiple Sclerosis as he started college. Now she’s in a wheelchair, and Henley has been taking care of her ever since – for nearly twenty years now – helping her in and out of bed and onto the toilet, and even rolling her over in the middle of the night if she gets uncomfortable. Social programs help pay for about 35 hours a week of in-home health care, but Henley puts in at least that much himself for free, on top of working at a full-time job. Such non-medical care from a professional can cost tens of thousands of dollars a year.

Listen to the story or read about it at NPR.org.

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When Healthcare Hits Home

illustration of gall bladder with stonesGuest article by Jessica Wapner (www.jessicawapner.com, @jessicawapner), from WorkInProgress blog.

Jessica gained a new perspective of our healthcare system when a relative needed emergency surgery in a small village in Cyprus to remove gall stones and her gall bladder. Her story is included because it relates to Health Concerns for Oversees Travel. If you’d rather not see this type of story, reply below.

Over the course of the decade-plus that I’ve been writing and editing material on healthcare (cancer research and treatment, in particular), people have asked from time to time whether my interest is driven by some personal stake in the matter. Read More …

Does Medicare Cover Home Health Care?

By Shannon Martin (reprinted with permission)

Nothing is more discomforting than not knowing if you or a loved one will receive the adequate care for a full and safe recovery after hospitalization.  Neither Medicare nor traditional medical insurance cover many of the home care services that can help reduce otherwise preventable injuries and hospital re-admissions. These services, usually referred to as long term care, or “custodial care,” include companion services, general supervision for health and safety and long term home help with personal care and hygiene, meal preparation, transportation and errands.

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You Really Are Paying a lot More For Health Care

Julie Rovner posted this article on the NPR Health blog, but she didn’t include my reader comments, so I’m summarizing key points here and adding my comments afterwards.

  • The good news – Health costs rose 7.3% last year, which was the slowest rate in more than a decade but still nearly 5 times faster than the Consumer Price Index.
  • The bad news – Since 2002, the annual health care cost for American families has more than doubled from about $9,000 to over $19,000.

So what’s driving the increases? It’s not Obama Care, the new federal health law.

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Understanding the Healthcare Law

Yesterday Yvonne heard a great presentation by Dr. James Rohack on Health System Reform. Rohack is a practicing cardiologist and Director of Scott & White Center for Healthcare Policy. He is also a professor at Texas A&M Health Science Center and was the president of the American Medical Association from 2009 to 2010 during debates over Obama’s Healthcare Law.

The presentation was held in Sun City, a planned community north of Austin for retirees with active lifestyles. It didn’t include handouts, but I was able to find some of Rohack’s slides online and offer them below with my notes.

Understanding the Health Care Law, by Dr. James Rohack

 

A MUST SEE: The New York Times provides this timeline of nearly 100 years of legislative milestones and defeats.