Posts Tagged ‘medicare’

We Endorse Telehealth Across State Lines

Medicine Unplugged: Your phone, your DNA, your data

By Wayne Caswell

Modern Health Talk strongly endorses telehealth and efforts to break down barriers to wider adoption nationwide. The TELE-MED Act of 2013 (HR 3077) is still not out of committee but is intended to start breaking down barriers related to licensure and payment when medical care is given online across state lines, starting with Medicare providers. Hopefully Congress will pass this bill and then start extending telehealth to all insurance carriers. Read the rest of this entry »

Fee-For-Service is Pervasive yet Perverse

The FFS payment model was created long ago, during a time when physicians treated less-complex problems and offered only a few inexpensive therapeutic interventions. It worked back then but a significant percentage of patients today have multiple chronic conditions. Meanwhile, the number of complex and very expensive tests, medications and interventions available are practically unlimited.

Economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn’t hold true in medical care – not when the supplier also controls demand.

In health care, doctors can stimulate demand because (a) health insurance blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one.

As a result, we have seen a major increase in utilization of complex services over the past 20 years.

That’s a short extract from an important FORBES article, The High Cost Of American Health Care: You Asked For It. Everything in the article is consistent with my understanding of economics and long-held view that the problem with our healthcare system is perverse incentives in the payment model. I highly recommend it. Read the rest of this entry »

Regulations Not Keeping Up with Technology

Health ReformBy Wayne Caswell

The rapid and accelerating pace of tech innovation has profound implications for healthcare delivery & payment, aging, and disability employment, but regulations that support that are spotty or nonexistent.

The good news

“Durable medical equipment” is a class of assistive technology that can be paid for by Medicare, Medicaid and many private insurance plans. Motorized wheel chairs most often fall into this category. Read the rest of this entry »

Telehealth Enhancement Act takes Important Step

Telehealth KioskAs a member of the American Telehealth Association (Austin chapter), I too support the Telehealth Enhancement Act, however I see it as just a baby step and think much more is needed. Still, it’s a step in the right direction.

The proposed bill would modernize the Medicare program by allowing Medicare patients to be cared for remotely by a licensed healthcare provider from any state. That way, if you need medical help while on vacation, you could connect online or by phone with your own doctor back home without requiring that they be licensed in the state you traveled to. I urge Congress to adopt this bill and expand it beyond Medicare, to other federal agencies and health benefit programs.

Read the rest of this entry »

The Forgotten Civil Right – Healthcare

MLK - I have a dreamIn honor of the 50th anniversary of the March on Washington and Dr. Martin Luther King Jr.’s ”I Have a Dream” speech, Dan Munro wrote a wonderful column on Forbes reminding us that King saw healthcare as a civil right. Sadly, we have made little progress on healthcare inequality, with roughly 50 million Americans without health insurance and another 40 million under-insured.

The Affordable Care Act (Obamacare) is poised to relieve some of that, with the individual mandate to buy healthcare insurance and subsidies for low-income Americans. But individual states are still allowed to choose whether or not to support and fund a key component of the ACA – Medicaid expansion. Many will, but some won’t.

Many doctors have walked away from taking Medicaid patients, and some have abandoned Medicare patients too. Read the rest of this entry »

Middle Generation: Rising Cost of Care for America’s Elderly

Middle Generation LadiesBy Caroline Montague

With an aging population and a generation of young adults struggling to achieve financial independence, the burdens and responsibilities of middle-aged Americans are increasing. Nearly half (47 percent) of these adults have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). In addition, about one in seven middle-aged adults (15 percent) are providing financial support to both an aging parent and a child.

Adult children, worried about costs and the loss of their parents’ independence, must make difficult decisions about the best options for care for their loved ones. Assisted living communities, such as Emeritus assisted living, allow individuals to remain independent as long as possible in an environment that maximizes the person’s autonomy, dignity, privacy and safety. These types of communities also encourage family and resident involvement. (Editor: Emeritus is one of the largest and most well known, but you can also compare facilities in your area by zip code.)  Read the rest of this entry »

Understanding Confusing Medical Bills for Seniors

Senior couple studying Confusing Medical BillsThe rising cost of medical bills is a concerning issue, particularly if you are retired and are facing health challenges. As the cost of medical procedures increases, a large number of American adults are filing for bankruptcy. The high cost is expected to cause 1.7 million individuals and families to file for bankruptcy, reported Today.com. Although the numbers are troubling, it does not mean you do not have options to help improve your personal situation.

Check For Obvious Errors

Before you assume that the price given on your medical bill is accurate, read through the details and check it for accuracy. Roughly 80 percent of medical bills have an error, according to Mint.com. The errors can come from simple mistakes in inputting data, coding errors or bugs in the system. Read the rest of this entry »

OBAMACARE – a moving infographic

Obamacare does so many things to give people better access to affordable, quality health care. The folks at Colorado Consumer Health Initiative just like to say THANKS OBAMACARE with this moving infographic about President Obama’s healthcare plan and how it actually helps people. Nothing is perfect, but we think there are a lot of positives that came out of this whole thing, and politicians focus only on negative talking points. ugh.

Long-term Care – 11 Myths and Facts

Long-term Care Myths & FactsMost people over 65 will need some kind of help with the activities of daily living such as bathing, dressing, or moving around. The need for such help can stem from a chronic illness or the natural decline of eyesight, hearing, strength, balance, and mobility that comes with aging. It’s never too early, or too late, to start planning for long-term care.

Many people think the phrase “long-term care” refers to an insurance policy. While insurance may be part of your strategy, long-term care encompasses many other decisions. You will need to decide where you will live, how you will navigate the myriad of legal, family, and social dynamics along the way, and the many options for paying for everyday help. Though a number of government programs may help pay for some long-term care services, many people are faced with significant out-of-pocket costs.

In partnership with LongTermCare.gov, Huffington Post took a look at eleven myths that may be keeping some from planning for long-term care, and ways you and your loved ones can prepare for the future.

Myth 1: I won’t need it

About 70 percent of Americans over 65 will need some kind of help with the activities of daily living for months or years as they age. It may be due to an illness, chronic disease, or disability. But often, the care is required because of the natural decline due to aging of one’s eyesight, hearing, strength, balance, or mobility. Read the rest of this entry »

Affordable Care Act tests home care for Medicare patients

Health care reform law aims to improve care,
lower costs for seniors and people with disabilities.

House Call

The Problem

3-4 million seniors living with multiple chronic illnesses such as diabetes, lung and heart disease are too ill or disabled to easily visit their physician when they need care. Instead, they go to the ER or are hospitalized. These seniors represent about 10% of Medicare beneficiaries but account for two thirds of Medicare’s expenditures, and it’s a problem that’s not going away. The number of people with multiple chronic illnesses will grow to 6-8 million by 2025.

The Solution

House calls, directed at these highest cost patients first, are a solution to the rising Medicare costs. The average $1,500 per ER visit, for example, can more than justify the cost of 10 house calls. Savings are even greater for avoided hospitalizations. Home-based primary care programs have the potential to save 20-40% on Medicare’s most expensive patients by bringing them care in their homes. But this is a new and relatively unproven healthcare delivery model.

Testing the Solution

The Independence at Home Demonstration, authorized by the Affordable Care Act, will test the viability of a new service delivery model that utilizes physician and nurse practitioner directed primary care teams to provide services to certain Medicare beneficiaries in their homes. Up to 10,000 Medicare patients with chronic conditions will now be able to get most of the care they need at home.

“This program gives new life to the old practice of house calls, but with 21st Century technology and a team approach,” said Marilyn Tavenner, Centers for Medicare & Medicaid Services (CMS) Acting Administrator.

The new Independence at Home Demonstration greatly expands the scope of in-home services Medicare beneficiaries can receive. It’s a voluntary program for chronically ill Medicare beneficiaries that will provide them with a complete range of primary care services.  Read the rest of this entry »

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