Health and Disability

AMA supports reforms for disabled patients: The AMA passed new policy supporting Medicaid reforms that would provide disabled patients with equal access to home and community-based services so that they can live as independently as possible. The AMA supports passage of congressional legislation, the Community Choice Act of 2007, that would achieve these goals. This policy was recommended to the AMA by the American Academy of Physical Medicine and Rehabilitation and the American Association of Neuromuscular and Electrodiagnostic Medicine.

“People with disabilities who rely on Medicaid should not have to choose between the important care they need and the ability to live independently,” said AMA Board Member Rebecca J. Patchin, MD. “We support Medicaid reforms so that disabled patients, together with their physicians, can decide where the best place is to receive medical care and support based on patients’ individual needs.”

The Wall Street Journal on Wednesday examined efforts to provide assistance to an estimated 45 million adults in the U.S. who care for a family member with a severe or long-term illness. According to the Journal, "care giving responsibilities can exact a drastic emotional, physical and financial toll" on people who look after an ill or aging relative, which can lead to "high rates of depression, stress and other physical and mental health problems."

However, the Journal notes that increasing evidence has shown that caregivers can better handle their responsibilities and the accompanying stress when they are provided with counseling and support group opportunities, in-home skills training and additional help. Some advocacy groups currently are lobbying for increased federal funding for caregiver assistance programs, and some experts are calling for formal evaluation programs that health care groups can use to determine what kind of support caregivers might need, according to the Journal. In addition, more hospitals are offering caregiver services and social worker assistance to family members when their relatives are discharged. Experienced caregivers also are "being tapped to help others new to the role," the Journal reports (Landro, Wall Street Journal, 11/28).

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This report examines the structure and impact of Medicaid’s role in long-term care. Based on a roundtable discussion of policy makers and experts and drawn from a body of health services research, the report highlights policy challenges facing the Medicaid program today and identifies issues in providing long-term care going forward. By gathering evidence to address key policy issues, such as integrating services, benefit design, quality monitoring and financing, the report can serve as a foundation for the current and ongoing policy debate regarding Medicaid’s future role as a provider of long-term care services and supports for low-income elderly and disabled Americans. Report (.pdf)

A year ago, I couldn’t turn around at startup events without bumping into someone launching a social-networking business.

They knew it was the next big thing and a great opportunity to connect with a young demographic sought by advertisers. Now it seems the market is maturing. Literally.

As in, everywhere I go lately, I meet someone starting a company targeting the older population.

This isn’t about more gadgets for grandma and grandpa.

The new thing is services, online and off, aimed at people entering the senior phase of life and seeking help, advice and tools to navigate the transition.

These entrepreneurs see opportunity to reduce friction and complexity in this market, just as others have done with online travel and retail, using tools and processes honed by tech companies.

Full time physicians spend an average of one full day a week providing services for patients that are not reimbursed by Medicare, according to a new study conducted by Jeffrey Farber, MD, Assistant Professor of Geriatrics at The Mount Sinai Medical Center, and published in the journal Annals of Internal Medicine.

The study results could potentially prod insurance companies and Medicare to catch up to physicians' current levels of productivity by reimbursing them for the care that is increasingly taking place outside of formal office visits.

"These services that are going un reimbursed are not unusual or luxury services," explained Dr. Farber. "These are basic elements of good patient care and include such things as talking with adult children, managing pain over the telephone, calling pharmacies, coordinating home care services like physical therapy and visiting nurses, and ordering equipment like canes and wheelchairs."...

WASHINGTON— AARP Legislative Counsel David Certner made the following statement today in response to the Centers for Medicare and Medicaid (CMS) announcement regarding poor performing nursing homes in the Special Focus Facility (SFF) program:

“Residents in the poorest performing nursing homes and their families have a right to know that the care they receive may be sub-standard. Earlier this year AARP called on CMS to release this information, and we are pleased CMS has agreed. People in need of 24-hour care should not have to be concerned that their nursing home is a potentially harmful environment. This information will also be helpful to individuals and their families who are looking to choose a quality facility.

The entire long term care profession is concerned with the way in which long term care will be legislated and regulated in the coming years and is eager to hear how the candidates will address the care needs of an Aging America. AHCA/NCAL encourages the candidates to discuss the long term care needs of our nation and to consider the following questions.

Questions for Presidential Candidates:

1. The Medicare and Medicaid systems have come under increasing pressure at a time when the population is aging. Do you believe the U.S. can afford to cut these safety net programs as a means of balancing state and federal budgets?
   
2. Most Americans do not understand that health insurance and Medicare do not cover the cost of long term care services. Presently, nearly two-thirds of the residents in America's nursing homes rely on Medicaid. Do you believe that we need to encourage personal responsibility with the purchase of long term care insurance to take the pressure off the Medicaid program? If yes, how do we achieve this?
   
3. We all know that there are 77 million aging baby boomers rapidly nearing retirement – they have changed every aspect of our culture during their lives, and it is clear that they will also have a significant impact on our long term care system. What should the nation's long term care system look like in order to meet this population's clinical health care needs and very specific preferences?
   
4. With the recent trend to move the frail and elderly out of nursing facilities and into home- and community-based care, what sort of oversight system should be in place to ensure that those vulnerable populations are receiving the care and services they require--and that those services are of a high quality? Do you believe that all individuals who are frail and elderly can receive the around-the-clock care that they may require in the home or community?
   
5. In cases where individuals who are frail and elderly outlive their savings and are too sick to manage on their own, what do you see as the most practical way to pay for their care? Where should they be housed?....

The causes of apathy and insubordination in long-term care facilities are numerous. The following article approaches some of these causes with the understanding that the medical care of the residents in these facilities is at stake, and apathy and insubordination undermines efforts to provide medical attention to these individuals. Many long-term care facilities in America today do not staff by acuity of resident needs, and this is one of the leading causes of such apathy and insubordination among staff members. Nurses and Nursing Assistants are left to work with large numbers of residents and a minimum of fellow medical staff, resulting in lack of patient/resident medical treatment.

Another issue is the ever increasing amount of paperwork...

ecently AARP began making over its member newsletters, which are customized and distributed in each of the fifty states, along with Washington, D.C., the Virgin Islands, and Puerto Rico. We’ve been editing and producing these newsletters for the past year and a half, and have learned our share of lessons about what works and what falls short.

The goal of the cover story, says Pete Wiley, manager for AARP state member communications, “should be to draw an uninterested member” into a newsletter “in a few seconds.”

Based on AARP’s revamped model, here are guidelines that will help any organization craft a sharper, more sophisticated publication.

• Focus on hard news, not staff picnics. Readers are eager to learn about the ways in which often complex legislation affects them. The redesigned newsletter presents concise stories with digestible facts on long-term care legislation, tax breaks, and various programs for low- and moderate-income residents. Most important, the stories conclude with calls-to-action, including Web links, e-mail addresses, and phone numbers that members can use to learn more.
• Use quotes, and conduct interviews with third-party experts—not internal staff. If Republican and Democratic legislators have cooperated on a bill to improve long-term care,.....

A bipartisan group of senators last Tuesday introduced a bill that would allow employees to pay long-term care insurance premiums with pre-tax dollars, CQ HealthBeat reports. Under the Long-Term Care Affordability and Security Act -- sponsored by Sens. Chuck Grassley (R-Iowa), Blanche Lincoln (D-Ark.), Olympia Snowe (R-Maine), Debbie Stabenow (D-Mich.) and Gordon Smith (R-Ore.) -- employers could offer long-term care insurance under so-called cafeteria plans, which allow employees to select from a number of tax-exempt benefits, as well as flexible spending accounts.