Last week, Medicare agreed to expand its skilled nursing care and rehabilitation therapy benefit for some people with chronic disease, including many elderly. This added care, which came in a settlement of a lawsuit brought by a Vermont woman named Glenda Jimmo, the Center for Medicare Advocacy, and others is potentially very important for some Medicare beneficiaries. But the settlement [...]
With the presidential election in less than two weeks, consumers, advocates, and providers should pay attention to what Barack Obama and Mitt Romney would do about long-term supports and services for the frail elderly and younger people with disabilities. It is hard to know for sure, because neither man has said much. Yet, between the lines, there are important messages. [...]
Patient-centered care (as it is described by doctors) or person-centered care (the phrase-more frequently used in non-medical settings) is one of those concepts everyone supports--except when it comes to the details. On Nov. 8-9, I'll be participating in a two-day symposium sponsored by the Samueli Institute aimed at breaking down the barriers between the medical and non-medical world and seeking evidence [...]
Last week, I wrote about an important new survey of family caregivers that shows nearly half are performing work that is often done by nurses, such as managing medications, caring for wounds, and operating medical equipment. The report, by AARP and United Hospital Fund, sheds important light on the often unrecognized role of these family caregivers. And it raises a critical question: [...]
Being a family caregiver is a lot harder than it used to be. Providing personal assistance, such as help eating or bathing, is tough enough. But now, many family caregivers are acting more like nurses. They have to manage medications, change dressings on wounds, and even monitor and operate medical equipment, from home dialysis to mechanical ventilators. According to a new survey by the AARP Public Policy Institute [...]
In the past few months, important events and circumstances have highlighted the need for an effective, sustainable way to finance the often-astronomical costs of long-term care services and supports. The growing political and financial pressures on Medicaid--the state/federal program that funds nearly half of all paid long-term care; the deepening problems in the private long-term care insurance market; and the demise of the CLASS Act--the failed attempt to [...]
Too many people make the dangerous roundtrip from hospital to nursing facility and back again. These transfers may increase risks of delirium, medication errors, falls, and infection. There is no doubt that some patients die as a result of these transfers. And, they cost payers—Medicare, Medicaid, and private insurance—hundreds of millions of dollars each year. The real tragedy: By some [...]
Thank you, Bill Clinton, for reminding us that long-term care is a big part of Medicaid. In his Democratic convention speech this week, Clinton bungled a few of the details, but told a larger truth: Big cuts in Medicaid are likely to mean lost benefits for the frail elderly and younger people with disabilities. No other major speaker at either convention ever mentioned [...]
While many seniors and their families may not be aware of it, consumer groups, hospitals, and nursing homes are fighting a major battle with Medicare over how the federal program pays for patients who are cared for in a hospital, but not admitted to the hospital. Seniors caught in this regulatory purgatory may have to pay thousands of dollars for [...]
The long-term care insurance industry is in big trouble. Consumers aren't buying. Carriers are dropping out of the market. And those that are staying are raising premiums, cutting discounts, and eliminating products--all of which are discouraging even more consumers from buying. What's gone wrong? The industry has two fundamental problems. A long-standing one--buyers are dropping coverage less often than the industry predicted. And a more [...]