What’s really happening with aging policy in Washington? At last week’s annual Gerontological Society of America Conference in New Orleans, a standing-room-only audience was privy to updates from key Congressional committee staffers.
Erika Salway, policy adviser for the Senate Health, Education, Labor and Pensions Subcommittee on Primary Health and Aging, discussed the committee’s work on issues affecting older adults, including federally qualified health centers, primary care, oral health, mental health and the Older Americans Act. Funding for the OAA is $1.8 billion, which may sound high, but she reminded the audience that its programs serve 10 million seniors every year and funding constitutes less than .06 percent of the federal budget. The OAA funds essential services such as Meals on Wheels, job training, caregiver support, transportation and elder abuse services. It expired in 2011 but continues to receive federal funds under the old legislative formula. Continue reading
Late Wednesday, the Centers for Medicare and Medicaid Services released its final hospital outpatient and ambulatory surgical center payment schedule for the 2014 fiscal year. A revised payment approach is designed to help hospitals and ambulatory surgical centers (ASCs) lower costs and strengthen Medicare’s long-term stability. One single code describing all outpatient clinic visits will replace the current five levels. CMS said this will encourage more efficient delivery of outpatient facility services by packaging the payment for multiple supporting items and services into a single payment for a primary service similar to the way Medicare pays for hospital inpatient care.
According to a story in Modern Healthcare, the move was triggered, in part, because too many hospitals practice upcoding – illegally picking billing codes that reimburse at higher rates than actual services provided. In a statement, Rick Pollack, executive vice president of the American Hospital Association said they are “extremely disappointed” with the new rule, which may hurt hospitals’ ability to provide outpatient care. The organization contends that CMS did not use accurate data when forecasting future reimbursements. “CMS has put hospitals in the difficult position of having only 35 days to implement significant changes in Medicare’s policies, procedures and payment formulas,” Pollack said. Continue reading
Humans have searched for a “fountain of youth” since before the time of Ponce de León. Now scientists may be on track to find a so-called “longevity gene.” SIRT3, part of a class of proteins known as sirtuins, help stem cells cope with stress. A study in mice by researchers at the University of California, Berkeley, points to potential for their findings to someday help scientists find targeted treatments for aging-related degenerative diseases. Researchers were able to turn back the molecular clock of older mice when their blood was infused with the proteins – triggering stem cell’s rejuvenating potential similar to that found in younger mice.
Get more resources to understand more about the “longevity gene” and how genetics affects healthy aging with these links in AHCJ’s Aging core topic area.
Image by Judy Baxter via flickr.
What is “successful” aging? According to experts at this week’s Gerontological Society of America Annual Scientific Conference, it depends on the lens through which it’s viewed. “Most of our current definitions are applicable to non-Latino white individuals,” said Linda Phillips, Ph.D., R.N., F.A.A.N., from the School of Nursing at the University of California, Los Angeles. “But these definitions may be inappropriate for elders in other ethnic and racial groups.”
For African-Americans, successful aging is directly connected to the life course process, said Kia Skrine Jeffers. “Health is either built or diminished based on social, economic and environmental experiences, that occur throughout life.” Stressors which occur during sensitive periods have significant impact on disease risk, and the cumulative effect, known as weathering, may also affect health-seeking behaviors. “Many racial and ethnic health disparities can be attributed to weathering, to the accumulated experiences of economic and social adversities.” Continue reading
Medicare reform is a hot topic on the agenda for the bipartisan congressional budget committee whose Dec. 13 deadline for a compromise deal on a federal spending plan is looming. Both political parties have proposed raising the Medicare eligibility age and premiums on older adults, among other changes.
In the midst of this debate, two policy experts will join AHCJ’s topic leader on aging, Liz Seegert, to help members understand: Continue reading
A new data brief from the National Center for Health Statistics compares residential care communities with and without special dementia care units in 2010. About four in 10 residents (42 percent) living in residential care communities had Alzheimer’s disease or another dementia. Some states have specific requirements for residential care for these patients such as locked doors and specially trained staff.
Among the major findings:
- 17 percent of residential care communities in the U.S. Had special dementia care units in 2010
- Beds in these special units accounted for 13 percent of all residential care beds
- Facilities with special dementia care units were more likely to be chain-affiliated and built specifically as a residential care community, and less likely to be certified or to participate in Medicaid.
- At least seven out of 10 residential care communities with dementia special care units had features such as specially trained staff (88 percent), an enclosed courtyard (82 percent), doors with keypads or electronic keys (79 percent), and locked exit doors (76 percent).
- More residential communities with dementia care units were located in the Northeast or a metropolitan statistical area and less likely to be situated in the western U.S.
There are some helpful charts to put the data in visual perspective. Reporters may want to see how local residential facilities compare to the national data, or use these figures in combination with a story like this one from KSWB-San Diego – on how a daughter decided her parents needed to move to a care facility.
Image by U.S. Pacific Air Forces via flickr.
Judi Kanne, a registered nurse and freelance writer for Georgia Health News took a look at dental care for seniors and found that her state, and many others, have been coming up short.
She interviewed elderly patients who sought care at Mercy Care, a downtown Atlanta charity clinic.
One of them was 71-year-old Johnnie Collier who told her he went there to get a tooth extracted that had been hurting him for years.
Despite the work of such charity clinics, Kanne wrote, millions of older adults are unable to get the dental services they need.
Then she offered a good summary of the predicament. Continue reading
Here’s a sign that paying more for better care and paying less for inadequate care is taking hold in a significant way. The federal Centers for Medicare & Medicaid Services (CMS) reported this week that 1,231 hospitals will get a performance bonus in fiscal 2014 under its Hospital Value-Based Purchasing program and 1,451 hospitals will receive an overall decrease in Medicare payment. Fiscal 2014 is the second year of the VBP program.
“We think this second anniversary deserves recognition – it’s a sign that value-based purchasing in Medicare is becoming routine,” wrote Patrick Conway, MD, in a blog post on the CMS site. Conway is CMS’ chief medical officer and director of the Centers for Clinical Standards and Quality.
“The Affordable Care Act gave CMS many new tools to convert Medicare from a program that paid for decades on automatic pilot into one that deliberately pays to promote better health,” Conway added. “Now, thanks to one of these tools, the Hospital Value-Based Purchasing program, Medicare is no longer a program that just pays the bills. Acute-care hospitals across the country not only are paid more for higher quality care, they also have skin in the game.” Continue reading
Older Americans can live in comfortable health, without needless treatment – and we can save money in the process, but only if we change the way we think and talk about the issue, according to Joanne Lynn, M.D., from the Center for Elder Care and Advanced Illness at the Altarum Institute. Lynn spoke about the need for reliable and sustainable comprehensive care for frail elderly during yesterday’s media briefing from the Journal of the American Medical Association on critical issues in U.S. health care. Authors of several of the articles in this special issue, published today, spoke about policy, economic, and societal changes needed for a viable, quality health system.
In a follow up-call today, Lynn said that, although most frail elderly – those over age 85 or anyone 65+ with multiple chronic conditions – would prefer to live out their lives at home comfortably and with adequate function and quality of life, that’s not how our system is set up.
“We have an array of disjointed services, that don’t take patient values about what matters to them most, into account,” she said. “We have all kinds of metrics that measure clinical outcomes but we don’t evaluate metrics that put patient priorities first.” Continue reading
The National Hospice and Palliative Care Organization just issued a new report on trends in hospice care use in 2011 and 2012.
In 2012, 83.4 percent of hospice patients were 65 years of age or older, and more than half (56.4 percent) were female.
While use of hospice in private residences remained steady at 41.6 percent, hospice use in nursing homes declined slightly, to 17.2 percent in 2012 from 18.3 percent in 2011. Continue reading