Posts Tagged ‘health care reform’

Advance Care Planning Now Possible Under Medicare

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?

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Navigating Care Options is About to Become Easier

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

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Seniors Receive Free Preventative Care Under Health Law

Beginning in January 2011, seniors will find it easier to access preventative care. Medicare recipients will receive free annual wellness visits, free preventative care, and free screenings with an A or B recommendation from the U.S. Preventive Services Task Force, which include tests like mammograms, colorectal cancer screenings, and bone mass analysis. free preventative care

As additional recommendations are available from the U.S. Preventive Services Task Force, these routine and preventative tests will also be free of charge. Annual wellness visits will assess medical and family history, as well as a personal risk assessment and an analysis of the patient’s abilities and risk of injury.

Identifying these risks at an early stage will allow physicians and other medical professionals to recommend and make referrals to appropriate support services prior to injuries and progression of chronic disease. For example, a patient at risk of developing heart disease or diabetes may be referred to a nutritional counselor.

No out-of-pocket costs will apply to preventative care, which can add up to a significant savings for a senior. For example, an article on SeniorMarketAdvisor.com notes that an average female Medicare recipient could be paying up to $300 out-of-pocket for a mammogram, colon cancer screening, flu shot, diabetes and cholesterol testing, and a pap smear — all of which will be free under the new Affordable Care Act.

These new rules will result in cost savings for the Medicare program over time, as well, by avoiding some costly medical procedures and treatments that occur as a result of inadequate preventative care. Chronic conditions, such as heart disease, cancer, and diabetes account for 75% of health care spending in the United States, according to the newly-launched government health care resource HealthCare.gov, and many of these conditions are preventable.

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Seniors Confused by Health Care Reform

A recent survey by the National Council on Aging suggests that many seniors are perplexed about health care reform — in fact, only 17% of respondents could correctly answer half of the questions related to health reform posed during the study, and only 9% said they felt “very familiar” with the law.roundabout

Despite the attempts of many senior care organizations to dispel popular myths about health care reform and to promote understanding among the senior population, many seniors remain unaware of how certain aspects of the law will impact them. For example, in relation to the widespread myth that Medicare payments will be cut to physicians, only 14% of seniors surveyed knew that was not true. 41% said they did not know the answer, and 45% said they believed the law would cut Medicare payments to physicians.

Only a third of respondents (33%) were aware that the new law would mandate a free, yearly wellness visit to a doctor each year. Closer to half (43%) of respondents knew that health coverage would be expanded to 32 million currently uninsured Americans, and 42% were aware that the Medicare Part D “donut hole” will be phased out.

The National Council on Aging has published a fact sheet entitled “5 Key Facts on the Affordable Health Care Act,” which provides details on the following points:

  1. Medicare benefits won’t be cut under the new law. In fact, some benefits will be improved.
  2. Medicare spending will still grow, but at a slower pace. The budget deficit is projected to decrease as a result of these changes.
  3. Obtaining long-term care at home will be easier and more affordable.
  4. Care for older adults will be improved in other ways, such as advanced training for providers and improved quality standards.
  5. Health insurance coverage for younger Americans who don’t have Medicare will be improved.

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Obama Administration Reassures: Seniors Won’t Lose Benefits Under Health Care Reform

Among all the buzz about health care reform, perhaps one of the more prominent sticking points has been how this new legislation will affect seniors. Opponents of the plan have been vocal about their concerns over cuts to Medicare, while supporters (which include the AARP and other senior-focused organizations) say health care will become more affordable for many seniors.

Linda Douglass, with the White House Office of Health Reform, weighed in with some reassurance for concerned seniors and other citizens on the White House Blog, making note of several important points that will benefit senior citizens. For example, Medicare’s prescription drug program, introduced just a few years ago where there was no prior prescription coverage under Medicare, will be improved.

Under the original Medicare Part D program, seniors are responsible for paying 100 percent of the cost of prescription drugs in a coverage gap known as the “donut hole” once they reach certain coverage limits. The health care reform bill implements a series of changes that will completely eliminate this coverage gap by the year 2020. In addition, preventative services will be covered in full for seniors as of next year — right now, they’re paying 20 percent of the cost of preventative care.

What about Medicare cuts? Will seniors be losing their Medicare coverage?

While there will be cuts to Medicare, the cuts focus on reducing fraud and waste by reducing subsidies and eliminating overpayments to private insurance companies offering Medicare Advantage plans, which typically cost the government more than traditional Medicare. Traditional Medicare benefits will remain intact. This is part of an overall goal to improve the health of all Americans by increasing the accountability of insurance companies and providers. Under the plan, incentives will be offered to providers (including physicians and hospitals) for reducing medical errors and coordinating care, which will both improve and simplify the overall health care system for seniors.

Because the goal is to keep costs down without limiting access to health care for seniors, an Independent Payment Advisory Board will be created. This board will keep an eye on Medicare spending and will submit legislative proposals to help control costs. Seniors can rest knowing that their health care benefits will not be cut significantly in the near future, but it’s likely that we’ll see more changes in the coming years. It’s vitally important for seniors to have a trusted friend or relative to help them navigate complex health care and financial issues.