Earlier this month, the federal department of Health & Human Services concluded that more than one of every five skilled nursing facility (SNF) patients suffered serious harm from events such as medication errors, falls, or infections in 2011. Half were sent to the hospital as a result of these events. Six percent died. And 60 percent of these adverse events [...]
Federal senior services programs are in for another very difficult year. In the 2015 budget he released yesterday, President Obama proposed freezing or even cutting spending for many key programs. And Obama’s blueprint may be the highwater mark for many initiatives, which are likely to see even deeper cuts as the budget works its way through Congress. Key House Republicans have [...]
The most important trend in care for the frail elderly and younger people with disabilities may be what’s called managed long-term supports and services, or MLTSS. This effort to combine medical care with long-term care would replace today’s disorganized, ineffective, and even dangerous system with one that can bring together complex care that’s being delivered by many different providers. Done [...]
Should young people self-insure against the risk of needing long-term care later in life, or should they buy insurance? In a Feb 13 Wall Street Journal commentary (behind a pay wall), Manisha Thakor, chief executive of Santa Fe, N.M.- based MoneyZen Wealth Management LLC, argued they should self-insure. “By taking the money you would have put in long-term-care premiums and [...]
It sounds like a great idea: Move people out of long-stay nursing facilities and back into their communities, and give them flexibility to spend government dollars on the care they need. Such a change could make care more person-centered and reduce costs. But a federal/state demonstration aimed at achieving that goal has moved very few people. For six years, the federal government and state [...]
For years, it has been an article of faith that Medicare would not pay for services such as skilled nursing or physical therapy unless that care improved a patient’s health status. I cannot tell you how many times I’ve heard doctors, nursing homes administrators, and even case workers say Medicare would stop paying once a patient was no longer getting better. [...]
A new Medicare payment model would encourage health systems to provide fully-integrated medical care for people with chronic disease, according new bipartisan legislation sponsored by senators Ron Wyden (D-OR) and Johnny Isakson (R-GA), and congressmen Erik Paulsen (R-MN) and Peter Welch (D-VT). The measure would allow, but not require, participating providers to offer long-term services and supports as well as medical [...]
Congress is about to agree to a bipartisan budget for 2014 that will at best freeze federal spending for many critical senior services. In a few cases, the fiscal plan will increase funding a bit from the low levels driven by last year’s across-the-board “sequester” spending cuts. But for the most part, programs will have to meet growing demand for [...]
Imagine your widowed father is 96 and living alone in a distant city. He’s got severe heart disease and mild dementia but is still competent to make his own choices. And is decision is: He refuses to move to a care facility but will not accept any supports and services that could help him remain safely at home. He won’t let [...]
The Washington Post published an extensive investigative story on hospice the other day. The take away: Hospices (mostly for-profits) are making big bucks by manipulating their case loads to maximize Medicare payments. In short, they are taking on many patients who are frail but not dying and thus staying on hospice care for a very long time. But the Post [...]