Archive for the ‘Senior Health Care Reform’ Category

« Older Entries

U.S. Focuses on Alzheimer’s Research

Thursday, February 9th, 2012 by Angela Stringfellow

The U.S. government is taking serious action against Alzheimer’s disease with a special task force and a boost of $50 million towards Alzheimer’s research. In 2013, another $80 million will be awarded. The initial sum includes $26 million allocated to caregiver support, public awareness and education and data infrastructure support, DailyRx reports.

It all started with The National Alzheimer’s Project Act, signed into law last year, which aims to develop strategies for improving diagnostics, treatment options and social support for those afflicted with the disease, their loved ones and caregivers. The initiative came to fruition in light of the staggering statistics demonstrating that more than 5 million Americans have Alzheimer’s disease, which has a significant financial and emotional toll on families affected and contributes an estimated $180 billion in healthcare costs each year.

Alzheimer's research

Image by hberends on Stock.xchng

The National Plan to Address Alzheimer’s Disease

The Department of Health and Human Services advisory panel rolled out its draft framework of The National Plan to Address Alzheimer’s Disease early in 2012. The plan includes ambitious goals, such as both preventing and treating Alzheimer’s disease by the year 2025.

While the plan evoked mixed responses from leading senior living groups, including ALFA, which drafted a response expressing concern that assisted living wasn’t considered as part of a plan to manage and care for individuals with the illness. Kaiser Health News asked a number of leading health executives to share their thoughts on the initial plan, including areas it may be falling short.

While most of those interviewed were pleased with the effort to tackle this growing problem, several interviewees pointed out some potential shortcomings. Robert Egge, Vice President of Public Policy for the Alzheimer’s Association, says he hopes the first draft will contain specific, measurable and attainable outcomes, noting that “the stakes are high.”

Dr. Rachelle S. Doody, the Effie Marie Cain Chair in Alzheimer’s disease research at the Baylor College of Medicine, who directs the Alzheimer’s Disease and Memory Disorders Center, also weighed in with her reactions.  Doody tells Kaiser Health News that the overall objective to prevent and effectively treat the disease by 2025 is promising and illustrates the government’s dedication to advancing research, but the draft framework fails to identify how new research will be translated to practice, nor a target date for doing so.

One thing is clear: No time for delays

Experts and commentators consistently agree on one point: There’s no time to hesitate implementing a plan of action to address this disease. As the population continues to age, the number of people with Alzheimer’s disease could double by the year 2050. The devastating emotional and financial impacts on both family members and the healthcare system as a whole mean that doubling the current impact could be the country’s tipping point. But will it be enough, and will the plan work? Many are anxiously awaiting the first draft of the National Plan with hope that it outlines a solid and attainable strategic course of action.

Tags: ,
Posted in Memory Care, Senior Health Care Reform, Senior Living News | No Comments »

Ohio Legislation makes Medicaid payments contigent on Quality of Care

Wednesday, November 30th, 2011 by mackenzie

image courtesy of juliaf on stock.xchng

In recent years, there has been a surge of news exposing the neglect and often abuse of the elderly in nursing homes.  This has made states’ take a greater interest in the quality of care in nursing homes and how they regulate it.  Ohio has come up with a bill that will aim to improve the overall quality of care their residents pay for.  Their house bill 153 seeks to use medicaid payments to motivate nursing homes to improve their practices.

Measuring Quality of Care

A subcommittee made up of elderly advocates, nursing home representatives, state officials and legislators.  They created a list of measures that were defined, and developed into a calculated point system that could determine the quality level of a nursing home. For example to receive one point the nursing home must enroll in “Advancing Excellence in Nursing Home Campaign” and select at least three goals.  Another point was given to homes that assured that at least 50% of Medicaid certified beds were in private rooms. There are 20 measures that will earn the nursing home one point, they are divided into categories: framework, choice, clinical, environment, and staffing.

Calculating Payments

A facility is required to get 5 points to receive the full quality payment, which is $16.44 per Medicaid bed day in 2013. Facilities with less than 5 points receive one-fifth of the full quality payment per point. The budget assumes that every nursing facility will receive the full quality incentive payment. If some facilities do not achieve 5 points and there is a residual amount left at the end of the fiscal year, then that amount will be distributed to facilities that earned more than 5 points based on each facility’s Medicaid bed days and total points received.

To see a full list of these measures and how they are calculated in this 5 point system go here.

Goals

These measures aim to:

  • Encourage person centered care
  • Limit staff turnover
  • Improve family Satisfaction
  • Reduce Bed sores and Urinary track infections

If Bill 153 is successful in passing it may act as an example to other state governments on how to attain quality care in their nursing homes.

What has your state been doing to try to improve the quality of care available to seniors?

Remember to always watch out for these warning signs of elder abuse and notify your local authorities if you suspect your aging loved one or community member is being abused.

Tags: , ,
Posted in Health News, Senior Health Care Reform | No Comments »

Nursing Homes Face Uncertain Economic Future

Wednesday, May 18th, 2011 by Angela Stringfellow

Nursing homes in nearly all 50 states are looking into their future with uncertainty, as Medicare and Medicaid cuts seem certain. Further, skilled nursing facilities are required to comply with the Affordable Care Act, which mandates that employers with 50 or more employees provide health insurance or pay a shared responsibility fee. According to a White House brief, 96 percent of all employers with more than 50 employees already provide ample coverage. Many nursing homes, however, do not offer health insurance to hourly employees. Many nursing home and home care workers are uninsured

The New York Times recently reported on the growing concern of many nursing homes and home care agencies who are petitioning for exclusion from the new law. Twenty-five percent of nursing facility staff and 33 percent of home care workers are uninsured. Low wage-earners who work for organizations that do offer coverage often can’t afford premiums.

Mark Parkinson, president of the American Health Care Association, is active in lobbying efforts to exclude nursing homes and home care providers from the requirement. According to Parkinson, Medicare and Medicaid reimbursement rates are too low to allow health providers to cover the cost of insurance for workers. Potential cuts to these reimbursement rates only further complicate the issue. Skilled nursing facilities who opt out of providing coverage will face a penalty, which The Times estimates could exceed $200,000 per year for a mid-size facility.

Charlene A. Harrington, professor at the School of Nursing at the University of California in San Francisco, has a different take on the situation. She feels that nursing homes and other healthcare providers should not be exempt from the requirements, pointing out that direct care workers with adequate health care coverage are more likely to be treated for illness and, therefore, less likely to pass dangerous infections to residents.

Parkinson has suggested a number of alternative solutions, such as exempting only those organizations who enter financial distress as a result of compliance or allowing penalties to be used as a tax write-off.

Image Copyright asterisco on Stock.xchng

Tags: , ,
Posted in Health News, Long Term Care, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | 2 Comments »

Senate Considers Stricter Assisted Living Regulation

Tuesday, March 15th, 2011 by Angela Stringfellow

In a roundtable discussion today, the U.S. Senate will consider taking a more active approach in the regulation of assisted living facilities, according to a report by Medical News Today. The primary issue is the common practice of some assisted living communities to deny admission to Medicaid-eligible residents–or even kick them out, despite the fact that the facility is a Medicaid-approved provider. Roundtable discussion to address assisted living regulation

Currently, regulation of assisted living in this regard falls to individual states, and rules vary dramatically. Assisted living facilities differ from other Medicaid-certified providers under federal law in that, while they can accept Medicaid, they’re not under any obligation to serve Medicaid-eligible constituents.

In some cases, an assisted living home may choose to de-certify and no longer accept Medicaid as payment. In this case, current residents may be evicted based on their payor source. Eric Carlson, National Senior Citizens Law Center Directing Attorney, recommended at the roundtable that states enact laws protecting current residents from being penalized if a facility opts out of the Medicaid program and to require facilities to accept residents regardless of their Medicaid status.

Carlson also suggests a federal law to protect residents in these instances, pointing to a tragic case of an 89-year-old Washington woman who grew depressed, stopped eating, and died within a month of receiving an eviction notice from her assisted living home. The woman was a Medicaid-eligible resident whose facility decided to stop accepting Medicaid as payment.

The roundtable discussion, “Assisted Living at the Dawn of America’s ‘Age Wave’: What Have States Achieved and How is the Federal Role Evolving?” will take place this afternoon, and will address the possibility of a more active federal role in the oversight of assisted living facilities in light of this and other issues.

Image Copyright svilen001 on Stock.xchng

Tags: , ,
Posted in Long Term Care, Senior Health Care Reform, Senior Living News | No Comments »

Nursing Homes Face Increased Documentation Requirements, but Changes are Positive for Residents

Monday, March 7th, 2011 by Angela Stringfellow

The L.A. Times reported on the increasing paperwork burden on nursing homes across the nation on March 6, 2011. According to author Michael Hiltzik, the nursing home application required by the federal government can span 38 pages. While this is a thorn in the side of many admissions directors, the application benefits residents in the long run by getting them involved in their own care. The Minimum Data Set required for nursing home residents now spans 38 pages.

It’s not just the initial application that is exceedingly lenghty–the same application must be filled out periodically during a resident’s stay, and at any discharge. That means whether the resident is being discharged home with family or discharged for an unexpected trip to the emergency room in the middle of the night. (And, yes, that means yet again upon re-admission.)

The application, termed the Minimum Data Set, has been required by the federal government for all nursing home admissions and residents since October 2010. Three of the 38 pages are dedicated to questions regarding bed sores, and the remaining pages revolve around the resident’s perceptions of pain, whether or not the resident can correctly identify what month we’re in, number sequences, and so on.

State nursing home inspection officials (agencies vary from state to state) use the data to gauge a nursing home’s performance and quality of care. Medicare uses it to set the rate of reimbursement for skilled nursing facilities, so there’s no way to avoid completing this paperwork without impacting the bottom line. Because some of the questions are open-ended and require discussion with residents, the entire process can span several hours, taking a significant chunk of time from admissions coordinators, nurses and other staff.

Robert A. Applebaum, an expert on long-term care at Miami University in Ohio, says nursing homes are moving away from their old minset of being the last segment in life, as many residents stay for only a short time before moving to a specialized care facility or returning home with their families. One of the key components of the new Minimum Data Set requires the staff member to directly ask the resident about future plans and whether they intend to stay in the nursing home on a short or long-term basis.

The revamped Minimum Data Set is the first step by the federal government to take regulatory action to draw residents in as a more active player in the creation of their care plan and day-to-day activities.

Image Copyright MeHere on Stock.xchng

Tags: , ,
Posted in Senior Health Care Reform, Senior Living News | 2 Comments »

States Restructure Senior Care in Wake of Recession

Wednesday, January 26th, 2011 by Angela Stringfellow

Many states have made cuts to aging and disability services budgets, according to a recent report conducted by the AARP Public Policy Institute; yet, demand for such services hasn’t slowed — in fact, demand for senior care and disability services continues to grow at an alarming rate. The report surveyed programs and funding in all 50 U.S. states, finding that 31 states cut aging and disability budgets (non-Medicare) in the 2010 fiscal year, and 28 states expected to make cuts in the 2011 fiscal year. Balancing state aging and disability services budgets

The report, Weathering the Storm: The Impact of the Great Recession on Long-Term Services and Supports, finds that state incomes are expected to be below pre-recession levels in 2011, as funding from major sources is still down, including personal income, sales and corporate taxes. Increasing demands for services are forcing states to place restrictions on non-Medicaid long-term services and supports (LTSS), although these programs are currently bolstered through funds from the American Recovery and Reinvestment Act (ARRA). ARRA funds are set to expire in June 2011, when states will be faced with more difficult decisions.

Most Medicaid cuts focused on cuts to provider payments, although a few states implemented service cuts, particularly personal care services. This is a concern because during a recession, demand for payment assistance increases as more families facing financial hardship qualify for assistance.

One bright spot in the midst of this funding crisis is the Affordable Care Act, which aids states in expanding efforts for home and community-based services; however, many states are hesitant to embrace such programs until government initiatives provide ample guidance.

Image Copyright srbichara on Stock.xchng

Tags: , ,
Posted in Aging, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | 1 Comment »

Advance Care Planning Now Possible Under Medicare

Friday, December 31st, 2010 by Angela Stringfellow

Effective January 1, 2011, seniors will have the option of voluntary advance care planning under the Medicare benefit. This same benefit was initially included in the original health care overhaul, but opponents successfully abolished it from the initial reform bill with a public outry labeling the practice “death panels” and calling it “government-sponsored euthanasia,” according to OregonLive.com. End-of-life discussions

Some say that opponents of the reform bill merely took the opportunity to turn the public against health care reform. Others say that encouraging and funding end-of-life discussions may lead seniors to forego life-sustaining or life-extending treatments they may otherwise have opted to receive.

Encouraging end-of-life talk is not new in the healthcare industry. In the past decade, pioneers have stressed the importance of educating the public about their options when it comes to end-of-life treatments and encouraging them to make their own choices about the treatments they choose to receive. It’s standard practice in many assisted living facilities and nursing homes for social workers to aid residents in end-of-life planning.

Any adult can legally elect to receive — or not — different types of life-sustaining treatments in the event of terminal illness or catastrophic injury. These documents are referred to as advance directives, living wills, or “Do Not Resuscitate” orders. Laws on these documents vary from state to state, as do the specific meanings of the terms.

In some instances, a “Do Not Resuscitate” order simply indicates a person does not wish to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support if the heart stops beating, while an advance directive or living will — in most cases — details the different circumstances under which an individual wishes to receive a variety of life-sustaining treatments, such as intubation (feeding tube) or being placed on a ventilator.

The new regulation will enable seniors to (at their own choosing) consult with a physician and receive assistance filling out end-of-life forms. The question at the center of this debate is whether or not such discussions will cause seniors to feel pressure to opt out of treatments they actually want.

What are your thoughts on the subject? Do end-of-life discussions discourage seniors from receiving life sustaining treatments or serve as a means to educate on the options and empower seniors to make their own decisions?

Image Copyright mapelc on Stock.xchng

Tags: , ,
Posted in Aging, Health News, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | No Comments »

It’s Official: Medicare Physician Fees Reduced by Nearly 25 Percent

Wednesday, November 3rd, 2010 by Stuart Grinnell

Today, November 3, 2010, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that improves access to preventative care for Medicare beneficiaries — but also issues a steep 23% cut to Medicare physician fees that will take effect December 1, 2010. The cut will be followed by an additional reduction of 1.9% scheduled to take effect on January 1, 2011. Medicare physician fees reduced

The cut comes under the sustainable growth-rate formula. While previous attempts to reduce Medicare physician payments were thwarted by Congress (they delayed a scheduled cut of 20% in June 2010), CMS calls the current measure “critical,” according to an article on ModernHealthcare.com, and says officials “are committed to permanently reforming the Medicare payment formula.”

Home health care agencies will also experience a reduction of 4.89% in 2011. However, the new rules also include payment incentives of 10% for primary-care providers and general surgeons in areas considered health professional shortage areas under the Patient Protection and Affordable Care Act. The reduction figure does account for inflation, wage updates, and other factors.

Finally, outpatient hospital payments face greater accountability in the form of increased quality reporting requirements. In order to qualify for full payment, hospitals must report a total of 15 quality measures in 2012 and an additional 8 quality measures in 2013.

Senior advocates fear that these latest measures will actually result in reduced access to medical care for seniors, as they predict that physicians and hospital systems will stop accepting Medicare payments due to reduced fees and increased accountability.

Image Copyright linusb4 on Stock.xchng

Tags: , ,
Posted in Home Care, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | 2 Comments »

Navigating Care Options is About to Become Easier

Wednesday, September 29th, 2010 by Angela Stringfellow

On Monday, September 27, 2010, the Department of Health and Human Services announced $68 million in grants to help seniors, families, and caregivers navigate available health care options. The grants are part of the Affordable Care Act and will be distributed to states, territories, and community-based organizations. wheelchair

The funds will be used to help both seniors and persons with disabilities (along with their families and caregivers) navigate the complex landscape of care options in several ways:

  • Understand Medicare and Medicaid benefits (including preventive services coverage)
  • Navigate options for long-term care, including community-based services that help individuals remain in their homes
  • Assist in transitioning individuals from nursing homes and rehab facilities back to the home through support services

The grants will be administered by the Department of Health and Human Services Administration on Aging and the Centers for Medicare and Medicaid Services and will compliment President Obama’s Community Living Initiative.

The focus of the Affordable Care Act is to empower individuals to take control over their own care, while at the same time lowering costs and improving quality, according to HHS Secretary Kathleen Sebilius. The grants announced Monday will help individuals and their families cope with sudden or chronic illness by providing easier access to information about the care that’s available, eliminating one of the many complexities that can cause unnecessary stress during already difficult times.

Read the HHS Press Release

Image Copyright betacam on Stock.xchng

Tags: ,
Posted in Health News, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | No Comments »

Implementing “Accountable Care Organizations” a Priority for Berwick

Monday, September 6th, 2010 by Tom Blumer

Newly-instated Medicare chief Donald Berwick is wasting no time implementing the government’s proposed new health care model of accountable care organizations, according to a report that appeared in The Boston Globe today. Berwick, former Harvard professor and Cambridge health guru, has kept a low profile after controversy surrounded his appointment as head of Medicare. reducing Medicare costs

Behind the scenes, however, Berwick has been moving ahead quickly with plans to launch between 100 and 300 sites that will test new models of care designed to cut costs and improve the quality of care. The new model is expected to pave the way for a shift from “fee-for-service” care to a “global payments” system. “Under global payments, physicians are paid flat fees for coordinating care for populations of patients, with built-in financial incentives for keeping them healthy and reducing hospital stays,” says Christopher Rowland, Globe Staff.

Test sites are expected to launch by the end of 2011, but this also marks an important turning point for Berwick and the Medicare program. Berwick, who was at the center of politicial controversy at the time of his recess appointment, will have to win over some Republican senators over the next year to avoid being ousted when his recess appointment expires — accordingly, at the end of 2011.

Among Berwick’s other priority tasks are cutting the fat from extra payments being made by the government to private insurance companies for sponsoring Medicare Advantage programs, as well as overseeing the drastic expansion of Medicaid services in many states.

Image Copyright alexkalina on Stock.xchng

Tags: , ,
Posted in Aging, Health News, Obama's Health Care Plan, Senior Health Care Reform, Senior Living News | No Comments »

« Older Entries