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 [...]
My best guess is that Congress will formally repeal the CLASS Act in 2012. Already abandoned by the Obama Administration, CLASS has no champion on Capitol Hill and is likely to fall victim to implacable Republican opposition and a lack of Democratic support. Thanks to technical budget rules, Congress can now kill the national, voluntary long-term care insurance program without [...]
On Monday, a presidential advisory group set a goal to prevent and effectively treat Alzheimer's Disease by 2025. There is much to like about this proposal, but it should come with a consumer warning: There is a lot less to this plan than meets the eye. Let's start with the good news. This initiative is potentially an important step forward as [...]
Eighty-give percent of physicians say that unmet social needs lead to worse health outcomes, according to a new survey sponsored by the Robert Wood Johnson Foundation. But only 20 percent are confident in their ability to help patients and their families meet those needs. Talk about good news and bad news! The survey asked about a wide range of social [...]
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 [...]
The quality of care for the frail elderly and adults with disabilities and the assistance available for their family caregivers varies widely among the states. Now, for the first time, researchers at AARP have tried to measure where you can get the highest quality care. And the differences among the states are even more dramatic than I thought. A handful, including Minnesota, [...]
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'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 [...]