Health and Disability

http://goo.gl/E8vRGq

To help minimize the risks and maximize the benefits of this overhaul, consumer advocates and other stakeholders can assess and work to shape state programs using this tool, which combines a checklist with examples of good practice. The checklist draws from federal guidance, Community Catalyst’s paper on states’ best practices and expert advice from other stakeholders, including agencies serving people who are aging and/or have disabilities.

Each of the sections provides a robust set of criteria for assessing and shaping your state’s program paired with examples of practices, policies or contract language that implement the criteria. We chose examples from the states that best meet a particular criteria. No one state meets all the criteria, and the lack of mention of a program does not necessarily mean it needs overhaul. Advocates can draw on these examples to improve practices in their states. However, good contract language or policies are only effective if they are enforced, so it is essential that advocates and other stakeholders actively monitor LTSS programs.

http://goo.gl/p0od9K

According to the January ruling, state payments for “difficulty of care” now qualify as nontaxable income and will be treated the same as foster care payments. The average family like Freeman’s could see $2,000 to $3,000 in tax relief, depending on the amount of state aid received.

“This decision has national impact,” Freeman said. “I think we connected the dots in a way that gave the IRS a solution that could be made to work.”

http://goo.gl/mZkxBO 

Superimposed limbs and augmented reality 'provides pain relief'

Using muscle signals from the patient's arm stump, Catalan was able to trigger a system called "augmented reality."

Explaining the process in detail, Catalan says the muscles in the arm stump send out electrical signals that are sensed by electrodes on the skin. Complex algorithms then translate these electrical signals into arm movements.

On a computer screen, the patient was shown an arm that was superimposed onto his stump. He was able to control the movements of this arm using his own neural command in real time.

After a period of treatment using this method, Catalan says the man now has periods where he is completely free of pain - something that never happened when using already-existing treatment methods.

http://goo.gl/gXooeE

Conclusions

• Having a personal health record resulted in significantly improved quality of medical care and increased use of medical services among patients.
• Personal health records could provide a relatively low-cost scalable strategy for improving medical care for patients with comorbid medical and serious mental illnesses.

http://goo.gl/ISyJyS

This is a call to action to comment on CMS-4159-P. The proposed rule revises the Medicare Advantage program (Part C) regulations and prescription drug benefit program (Part D) regulations. As stated in the Executive Summary, one of the goals is to “strengthen our ability to identify strong applicants for Part C and Part D program participation and remove consistently poor performers.” While part of the intent of the revision is to identify inappropriate prescribing of opioid and other potentially harmful medications, these new guidelines may have significant unintended consequences, including limiting access to appropriate symptom management for patients with serious illnesses.

http://goo.gl/yxcTaJ

The authors found that compared to nonprofit hospices, for-profit hospics:

• Were less likely to provide community benefits, including serving as training sites (55 percent vs. 82 percent), conducting research (18 percent vs. 23 percent) and providing charity care (80 percent vs. 82 percent)
• Cared for a larger proportion of patients with longer expected hospice stays, including those in nursing homes (30 percent vs. 25 percent)
• Had higher patient disenrollment rates (10 percent vs. 6 percent, patients who don't remain in hospice until their death)
• Were more likely to exceed Medicare's aggregate annual cap, which is a regulatory measure to control hospice length of stay and constrain Medicare hospice expenditures, (22 percent vs. 4 percent)
• Were more likely to do outreach to low-income communities (61 percent vs. 46 percent) and minority communities (59 percent to 48 percent), suggesting that the growth of the for-profit sector may increase the use of hospice by these groups and address disparities in hospice use.
• Were less likely to partner with oncology centers (25 percent vs. 33 percent)

http://goo.gl/wsA49i

Researchers examined the association between BP medication use and experiencing a serious injury from a fall in 4,961 patients older than 70 years with hypertension. Among the patients, 14.1 percent took no antihypertensive medications, 54.6 percent had moderate exposure to BP medications and 31.3 percent had high exposure.

During a three-year follow-up, 446 patients (9 percent) experienced serious injuries from falls. The risk for serious injuries from falls was higher for patients who used antihypertensive medication than for nonusers and even higher for patients who had had a previous fall injury.

http://goo.gl/aq28lo

Per federal requirement, individuals eligible for services under the Healthy Michigan Plan must have access to the following 10 Essential Health Benefits:

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care.

The Healthy Michigan Plan will cover other medically necessary services as appropriate.

http://goo.gl/mGY9X8

CMS is proposing that antidepressants and immunosuppresants lose protected status in 2015 andanti-psychotic medications in 2016.   This would likely mean that Medicare Part D prescription drug plans would not continue to cover all or substantially all of the drugs in these medication classes.  People who require medication not on the drug plan’s list would have to either: 

1. pay out of pocket; 
2. change to a potentially less effective medication or a medication that may have additional side effects; or
3. utilize the exceptions or appeals process to try to gain access to the drug (with no assurance that this process would be successful).

http://goo.gl/DSBEQb

One in every 10 Americans between the ages of 18 and 39 years old suffers from hypertension. Previous research has shown that young adults with hypertension are less likely to receive blood pressure medication than middle-aged and older adults because of lack of healthcare access. Because hypertension in young adulthood increases the risk of future cardiovascular events, medical treatment is advised if a patient's blood pressure isn't lowered through lifestyle modifications. Previous studies have also shown that medication can help control hypertension among young adults better and faster than is the case for older adults.