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 [...]
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 [...]
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 [...]
Paul Ryan, Mitt Romney's vice-presidential pick, would fundamentally remake federal health and long-term care services for the frail elderly and adults with disabilities. He'd completely restructure Medicare, slash funding for Medicaid, and likely abolish most of the other safety net programs that this vulnerable population has come rely on over the last half-century. It is fair to say that no major party candidate for [...]
Everybody wants to do a better job coordinating care for the frail elderly and younger adults with disabilities who have extensive medical and personal care needs. But just how to do it is becoming increasingly controversial—especially on Capitol Hill. The current flashpoint is an aggressive new Obama Administration initiative aimed at improving care and cutting costs for those who are [...]
Insurance giant Wellpoint is the latest carrier making a big bet on managing care for those seniors and adults with disabilities who are eligible for both Medicare and Medicaid. About 9 million people, called “dual eligibles” receive benefits from both programs. They are both very poor and very sick and often have significant needs for personal assistance. Medicaid alone spends $145 [...]
People often say that the patients most at risk in the U.S. health system are the elderly who suffer from multiple chronic diseases. But it may be that a subset of these seniors—those with chronic disease who also need personal assistance with routine activities—are in the most jeopardy. An important 2011 research paper finds they are the most costly to care [...]
By upholding the constitutionality of the Affordable Care Act, the Supreme Court has preserved—at least for now—major changes in the way long-term care supports and services are delivered and financed. Here are some provisions of the law that directly affect the frail elderly and younger adults with disabilities. Medicaid: The law is filled with important changes to this state/federal program [...]
What if you could be admitted to the hospital—in your own bedroom? That’s the idea of a health care model called Hospital at Home, which is aimed at elderly patients with diseases such as congestive heart failure, emphysema, urinary tract infections, or pneumonia. According to a new study published in the journal Health Affairs, people receiving this care through the [...]
Let me tell you about Frank. At 86, he has heart disease, diabetes, and kidney failure. He lives at home but struggles with the 16 medications he must take every day. He could also use some social support--maybe an adult day program, help shopping, or just somebody to keep him company. What Frank needs most of all is somebody who can help organize all of his medical [...]