The loud debate over how many people have gotten health insurance under the Affordable Care Act misses the point. Yes, reducing the number of uninsured was one goal of the ACA. But only one. The law’s most enduring legacy will come from its historical—but largely unnoticed—changes in the way health care is delivered. Unlike the insurance expansion, which largely excludes Medicare, many [...]
Where in the world would you want to age? According to a comprehensive new study by the group HelpAge International, you want to live your golden years in…Sweden. True, it’s cold. Really cold. But based on more than a dozen key indicators, including income security, health status, employment and education, and ability to live independently, Northern European countries such as [...]
It is a cruel paradox: As the cost of long-term care rises and the number of people needing it grows, traditional options for paying for these supports and services are narrowing. Traditional private long-term care insurance is largely disappearing from the marketplace. Reverse mortgages, already something of a niche product, are likely to become harder to get-- especially for those [...]
It is often a tough question: Mom has an illness that could be treated with surgery. The operation is routine for a younger patient. But is it too risky for an elder like mom? Today, doctors who consider the special risks of surgery for older patients must use complicated and time-consuming assessments to judge whether an operation is the best choice. But University of [...]
Baby Boomers are in serious denial when it comes to their medical and long-term care costs in retirement. Yes, Medicare provides excellent health insurance (subsidized in large part by taxpayers). But it doesn’t come close to paying for a senior’s medical costs. And doesn’t pay for long-term supports and services at all. Those holes in the Medicare system mean a [...]
Seniors continue to be readmitted to the hospital too frequently. But when it comes to explaining why, patients and providers are on Mars and Venus. The patients blame doctors and nurses. Doctors and nurses blame patients. And everybody blames the hospitals. The problem, everyone seems to agree, is that hospital discharges are a mess. Patients don’t understand what they need [...]
Broad-based, integrated, community-wide initiatives can help keep seniors out of the hospital, says an important new study from the Journal of the American Medical Association. The study, done by a team led by Dr. Joanne Lynn of the Altarum Institute’s Center on Elder Care and Advanced Illness is new evidence that by working together, hospitals, physicians, social workers, nursing homes, [...]
In 2012, about 13 million seniors participated in Medicare Advantage (MA) managed care plans—about 27 percent of the Medicare population and twice as many as were enrolled just seven years ago. This rapid shift to managed care by seniors may be just a first step towards a fundamental change in the way Medicare is delivered and financed. And it has the [...]
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 [...]
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 [...]