More than 8,000 general practitioners in the United Kingdom will soon begin displaying in their offices seven "end-of-life" promises to their patients. It is a great idea. According to an article in The Independent, every GP (much like primary care physicians in the U.S.) will post this end-of-life pledge on the wall of their waiting room. The Charter for End of [...]
Next week, I'll be speaking to faculty and others at the University of Massachusetts School of Medicine on the importance of fully integrating long-term care services and supports with medical care. On May 23, I'll be delivering the same message to a large non-profit health system that includes more than two dozen hospitals. Physicians and health system adminstrators are beginning to get it: [...]
The House Republican Budget proposal released today calls for the biggest changes in health and long-term care services for the elderly in a half-century. While there is no chance that these proposals will be enacted as proposed, they reflect a profound sea change in the way many in Washington look at assistance for seniors, and especially for the frail elderly. [...]
Hospital readmissions are bad for patients—especially seniors who may already be weakened by multiple chronic disease. They cost tens of billions of dollars. They are not even good for hospitals (at least not top-quality facilities that regularly fill their beds). About one in five Medicare patients are readmitted within 30 days, and one-third within 90 days, according to a New [...]
For the second time, President Obama has bowed to conservative critics and backtracked on a plan to allow Medicare to pay physicians for end of life consultations with their patients. He should be ashamed. In late November, the government adopted new rules that included discussion of advance directives as one of many services physicians could provide during routine annual physicals for their Medicare patients. [...]
The Obama Administration has decided to pay doctors for discussing end of the life issues with their Medicare patients. You may recall that this would have been permitted by the 2010 health law, but the provision was dropped in the face of withering criticism by opponents of health reform, who dubbed these important conversations "death panels." The new rules are an important first step. Doctors absolutely [...]
I'm just back from a two day conference sponsored by the Catholic Health Association on ways we can do a better job integrating both medical and personal care for chronically-ill seniors. There may be no more important issue for the delivery of care to this population. If you don't believe me, ask Don Berwick, who runs the Medicare and Medicaid programs for the federal [...]
Senior Obama Administration official Richard Frank says he is "cautiously optimistic" that the Department of Health and Human Services (HHS) can build a viable government sponsored long-term care insurance program under the CLASS Act. CLASS is a national, voluntary long-term care insurance system that was included in the 2010 health reform law. Frank, a highly respected professor of health policy at Harvard Medical School, is Deputy Assistant [...]
It is a tough time to try to sell long-term care insurance. The private market was stunned on Nov. 11 when MetLife, one of the nation's biggest carriers with insurance on 600,000 lives, announced it would stop selling new policies. At the same time, surveys by two of the nation's most respected long-term care researchers suggest why it will continue to be very [...]
There is lots of quiet speculation in Washington about the fate of the CLASS Act in the wake of the huge Republican 2010 election day victory. Will CLASS be repealed? Will it be changed in any major way? My best guess is that CLASS--the national voluntary long-term care insurance program passed as part of the 2010 health reform law--will neither be repealed nor fundamentally [...]