Health and Disability

The Editors’ Blog

From Who Moved My Dentures:

In a follow up to yesterday’s guest post about end of life care and the engagement of health care providers comes this. The March 9 issue of Archives of Internal Medicine reports that patients with advanced cancer who discuss end-of-life care with their physicians appear to have lower health care costs in the final week of life than those who do not....

I am not saying that physicians and health care staff should sustain relationships with their patients after all hope is exhausted because it might imply lower health care costs. They should stay engaged because it is the right thing to do. That said some of the end of life decisions should be made by all of us well before we get sick. That requires having a living will and assigning durable medical power of attorney....

For More...

From Docuticker:

Source: AARP Policy & Research

The current fiscal crisis is causing most states to make deep budget cuts. In this climate, many state policymakers are targeting Medicaid home and community-based services (HCBS) because they are optional Medicaid benefits. However, this approach may be shortsighted. Recent evidence indicates that expanding HCBS can be cost-effective in the long run when combined with efforts that reduce reliance on nursing home care. Moreover, states that shift their mode of service delivery away from institutional services and toward HCBS can serve more beneficiaries with available dollars. With declining revenues, states should take the opportunity to focus on longer-term and more cost-effective reform options for their long-term care (LTC) systems, such as promoting HCBS over institutional care. Doing so has the dual benefit of not only slowing the growth in Medicaid LTC spending but also improving consumer choices....

+ Full Report (PDF; 127 KB)

For More...

From US Senate Special Committee on Aging:

WASHINGTON, D.C. – Senator Herb Kohl (D-WI), Chairman of the Senate Special Committee on Aging, and Senator Susan Collins (R-ME) were pleased to introduce today the Patient Safety and Abuse Prevention Act to prevent those with criminal histories from working within long-term care settings by creating a comprehensive nationwide system of background checks. The legislation would expand a highly successful three-year pilot program, spearheaded by Kohl and authorized under the 2003 Medicare Modernization Act, which prevented more than 7,000 applicants with a history of substantiated abuse or a violent criminal record from working with and preying upon frail elders and individuals with disabilities in long-term care settings. Congressman Joe Sestak (D-PA) is expected to introduce a companion bill in the U.S. House of Representatives...

For More...

From 4:

As we enter 2009, some significant trends are impacting the long-term care insurance industry.

Heightened consumer awareness, younger buyers, reformulated products and the intensification of multi-life sales — have led to a steady growth of long-term care insurance policies. Despite some adverse factors — in particular, the weakened economy — we anticipate that sales for the just-ended year will be in the 385,000 policy (and group certificate) range, with premiums up several percent over the prior year. For 2009, our predictions all point to continued growth in the number of Americans who are purchasing this form of protection....

For More...

From McKnight's:

The Long-Term Care Community Coalition (LTCCC) conducted a one-year study of 35 states that use a case-mix Medicaid reimbursement system—a system that reimburses nursing homes based both on quality performance and facility costs. The system has a few built-in disincentives for quality improvement, the study finds. Because residents who require a high level of care bring in more Medicaid money, those who don't may be passed over for care. Also, when heavy care patients improve, they are downgraded to a lower reimbursement category.

The coalition makes a few recommendations for nursing homes and states to improve the use of Medicaid reimbursements. By encouraging spending in direct care and by shifting the focus of reimbursements away from facility costs and toward quality measures, overall quality of care could improve. Also, identifying specific patient needs, setting goals for reimbursement incentives and mandating program and outcome requirements for residents may help improve access for both heavy-care and lighter-care residents.

The report focuses specifically on New York state and its reimbursement system, but takes into account 34 other states with similar systems. The full report can be found online at www.nursinghome411.org.

For More....

From The Future of Aging:

Since 2006, CAST Commissioner Kathy Bakkenist and members of the CAST Policy Committee she chairs have been touting the benefits of aging services technology to any federal legislator who will listen to them.

“I can’t tell you how many doors we knocked on and how many conversations we had,” says Bakkenist, who is the chief operating officer and senior vice president of strategy and operations at the Minnesota-based Ecumen. “But we were lucky. We had a compelling story to tell about the nation’s shifting demographics and the significant need to change how services are delivered to an aging population. It wasn’t a story of doom and gloom. It was a story of opportunity and solutions. Aging services technologies represent hope and a different way of thinking about how to support independence, choice and aging in place. To me, that was the power of our message.”....

For More...

From McKnight's:

Long-term care providers have an impressive arsenal of weapons at their disposal in the war against pressure ulcers. The key to victory is in executing the battle plan with them, experts say...

For More...

From Medical News Today:

New data, statehealthfacts.org: The Kaiser Family Foundation's statehealthfacts.org Web site recently added new data on Medicaid, CHIP and Medicare....

...Statehealthfacts.org also added new data from HHS and the Government Accountability Office about temporary federal Medicaid relief provided by the federal economic stimulus plan to states from October 2008 through March 2009, along with the total estimated federal stimulus allocations to each state through December 2010. The Web site also added new data from an analysis by the Urban Institute and the Foundation's Commission on Medicaid and the Uninsured of 2005 CMS data on dual eligibles. The new data include Medicaid spending for dual eligibles by service, Medicaid spending per dual eligible, dual eligibles as a percent of total Medicare and Medicaid beneficiaries and the distribution of dual eligible enrollment (Kaiser Family Foundation release, 3/11)...

For More...

From McKnight's:

The Centers for Medicare & Medicaid Services has completed a guide for providers who want to employ dining assistants in their facilities. After a drawn out battle, CMS agreed five years ago to allow the use of paid feeding assistants––provided they achieve a certain level of training and have the approval of the state.

Yet despite what was seen as a big victory for providers – because they would no longer have to use higher paid nursing staff to assist with many feeding tasks -- they have been relatively slow to train or use the assistants, federal regulators say...

For More...