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, [...]
Too many people make the dangerous roundtrip from hospital to nursing facility and back again. These transfers may increase risks of delirium, medication errors, falls, and infection. There is no doubt that some patients die as a result of these transfers. And, they cost payers—Medicare, Medicaid, and private insurance—hundreds of millions of dollars each year. The real tragedy: By some [...]
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 [...]
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 [...]
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 [...]
The fiscal plan proposed this week by House Budget Committee Chairman Paul Ryan (R-WI) would profoundly change the way seniors and younger adults with disabilities receive health care and personal assistance. For many programs, it would reduce funding from today’s levels even though the population of those over 65 will double by mid-century. In many ways, it would end the [...]
I spent this morning at an interesting Capitol Hill conference on an important—but often ignored —topic: What role should home health aides play in the delivery of care to people with chronic disease? Health care providers and policy experts are spending lots of time thinking about ways to better integrate medical and personal care. They are finally recognizing that people [...]