Health and Disability

from Medical News Today: 


Sen. Ron Wyden (D-Ore.) and Rep. Edward Markey (D-Mass.) have introduced legislation (S 3613, HR 7114) that would create a three-year Medicare demonstration project in 26 states that aims to expand at-home services for some beneficiaries with multiple chronic health conditions, CQ HealthBeatreports. Eligible beneficiaries would include those who have functional impairments, two or more chronic illnesses and recent use of other health services.

Under the bill, participating physicians or nurse practitioners would collaborate with beneficiaries to develop a comprehensive care plan. The legislation also includes minimum performance standards for health outcomes and would measure the satisfaction level of beneficiaries, caregivers and providers. The bill would require providers to demonstrate savings of at least 5% annually compared to the cost of serving non-participating Medicare beneficiaries with chronic health problems. Providers would be able to keep 80% of the savings as an incentive for participation.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

A COLLEAGUE RECENTLY introduced me to a young physician, noting that her research interest was difficult patients. "Really," I responded. "I’m a difficult patient, and it’s served me well." I assumed that she considered being a difficult patient a good thing, but her pained expression suggested otherwise. We shared an awkward moment before parting, and I walked away considering the plight of the "difficult" patient.

In the clinical world, the term difficult is applied to a variety of patients: the noncompliant; the rude, abusive, and manipulative; the malingering; the mentally ill; the skeptical. In my case, I too frequently challenged my doctors with questions and too often chose a treatment that differed from what they’d recommended. I consider myself to be an assertive patient, but it was clear on many occasions that some providers thought I deserved the "difficult" label.

How did I earn this distinction? Surely some of it was genetic predisposition; I was born with a feisty personality that compensates for my diminutive stature. But mostly it was born of necessity, a survival instinct that involved both fight and flight.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Both the connection to health care and its affordability worsened for many nonelderly U.S. adults living with chronic conditions between 1997 and 2006. This erosion varied by health insurance coverage, fundamental as it is to securing health services. Access to care among uninsured adults with chronic conditions deteriorated on all of our basic measures between 1997 and 2006. In addition, more of both the privately and publicly insured with chronic conditions went without health care because of its cost over this ten-year span, even while they were just as likely as or more likely than others to have a usual source of care over time.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The Primary Care Resources and Supports for Chronic Disease Self-Management (PCRS) is a self-assessment tool for primary care settings interested in improving self-management of chronic illnesses. It is consistent with the Chronic Care Model and specifically supports implementation of the management support component.

The PCRS is designed to help primary care settings evaluate supports for self-management and identify areas and ways in which they could enhance these services. It is intended for use by multidisciplinary patient care teams representing front-line staff, clinicians and administrative personnel who are committed to quality improvement.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

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."...