The fate of many important health reforms aimed directly at seniors is in the hands of the Supreme Court. While the public has focused most of its attention on whether the High Court will strike down the individual mandate in the 2010 health reform law, the justices today are hearing arguments about another critical issue: What should happen to the rest of the Affordable Care [...]
Hospital-based palliative care programs that focus on patient comfort rather than simply medical treatment are growing rapidly. And for patients, their families, and hospitals themselves, that is a very good thing. A new study by the National Palliative Care Research Center finds the number of these important new programs has grown from 600 to more than 1500 over the past decade. Of the nation's [...]
Skilled nursing facilities whose patients are too frequently admitted to the hospital would face stiff new penalties according to the deficit reduction plan proposed by President Obama on Sept. 20. These admissions are often caused by falls, infections, or poor medication management. Overall, as part of a broad deficit reduction plan, Obama would cut more than $300 billion from projected [...]
We all know the sad story: Despite extensive rehab, a patient in a skilled nursing facility is failing. Instead of improving, she is finds herself returning to the local hospital with trouble breathing, heart failure, or unmanaged pain. Eventually, she may die in the hospital hooked up to a ventilator and feeding tube that she never wanted. A team at [...]
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: [...]
I recently had the pleasure of speaking to NICHE, (Nurses Improving Care for Healthsystem Elders) a joint venture of the Hartford Institute and the New York University School of Nursing dedicated to improving the quality of geriatric nursing. NICHE understands that caring for elders is not like caring for younger patients, and it has developed new techniques to both assess [...]
Instead of admitting patients, hospitals are increasingly keeping them under "observation status." This decision results in lower Medicare payments to the hospitals and more out-of- pocket costs for patients. But it also means that Medicare is no longer paying for some admissions to nursing homes, and is instead shifting those expenses to residents and their families. What's going on? It is complicated. But here is [...]