For months, physicians have been refusing to take new Medicare patients, and some are now even dropping long-time patients. The problem: Congress's inability to resolve a now 13-year-long argument over how much Medicare should pay docs. The whole mess started in 1997, when the government concluded that Medicare was overpaying many doctors. The reality was that some physicians probably were being paid too much while others were [...]
For the first time since President Bush's ill-fated effort to privatize Social Security five years ago, the future of the nation's flagship retirement program is back on the policy agenda. For example, Social Security will almost certainly be an issue for President Obama's deficit reduction commission. Unfortunately, we may be headed for the same non-productive shouting match we had over the Bush [...]
The Senate Finance Committee has begun an investigation into four big home-health agencies that, it alleges, artificially inceased their home therapy visits to take advantage of higher Medicare billing rates. A May 12 letter from committee chairman Max Baucus (D-MT) and senior Republican Charles Grassley (R-IA) asked the four for-profit agencies--Amedisys, Almost Family Inc. Gentiva Health Services, and LHC Group-- for records and [...]
Receiving personal care at home, as opposed to in a nursing facility or other institution, is not possible without two things: Somebody to provide the assistance and an appropriate place to live. A southern Virginia minister has come up with a possible solution to the second. MEDCottage is a portable, modular self-contained 24x12 dwelling that could be attached to the home [...]
By now, long-term care providers and consumers may know something about MRSA, the antibiotic-resistant infection. But chances are they don't know nearly enough. If you want to learn more--and believe me, you need to learn more--pick up a copy of Maryn McKenna's new book Superbug. (Free Press 2010). Part detective story, part expose, part careful explanation of the science of bacteria, Superbug is a frightening [...]
Private long-term care insurance got a nice boost from a new study by the federal Department of Health and Human Services. The report, by the consulting firm LifePlans Inc, concluded that nearly 98 percent of those filing claims against their LTC policies received benefits, despite articles by The New York Times and others suggesting that claims denials are widespread. The study also [...]
A new model from the SCAN Foundation and the consulting firm Avalere Health concludes that premiums for a national voluntary long-term care insurance program similar to the newly-enacted CLASS Act would average about $115-a-month. The study concludes that a mandatory long-term care insurance program could provide identical benefits for one-third the cost, or about $40. Premiums would vary by the buyer's age and increase by inflation over time. The CLASS [...]
The new health law creates, for the first time, a national, voluntary long-term care insurance system called the Community Living Assistance Services and Supports (CLASS) Act. Participation will be optional, but if you enroll, you'll get a basic cash benefit for life to help pay for personal assistance if you are disabled or very frail and unable to care for [...]
Earlier this week, I participated in a panel with Connie Garner, the Senate staffer who was a key architect of the CLASS Act, the national long-term care insurance program that is included in the new health reform law. Garner challenged the audience, which included several private long-term care insurance company execs, to work with her to help turn CLASS into workable [...]
President Obama has signed health reform, including the CLASS Act, into law. Now, his administration needs to turn a law into an insurance product people will buy. It won't be easy. No other country has tried to create a voluntary public long-term care insurance program, which is what CLASS is. The challenge will be to design a policy that provides a respectable benefit at an [...]