Hospitals and post-acute care providers, Medicare drug providers, and older adults could see substantial changes in payments and benefits if President Obama’s 2015 fiscal year budget proposal is passed as presented.
The president’s $3.9 trillion plan includes more than $400 billion in cuts over the next decade in Medicare and Medicaid spending, as well as changes in provider reimbursement to place greater emphasis on quality. As Politico reported, additional savings would come from higher premiums of wealthier beneficiaries, changes in Medicare Part D payments to drug companies, and reimbursement cuts to post-acute providers like skilled nursing facilities and home health care agencies.
AARP criticized the proposal for “simply cost shifting.”
“We know that brand name prescription drugs are one of the key drivers of escalating health care costs, so we appreciate the President’s inclusion of proposals to find savings in lower drug costs, said AARP Executive Vice President Nancy A. LeaMond in a statement. “But instead of shifting additional costs onto Medicare beneficiaries, we must look for savings throughout the entire health care system, as the rising cost of health care threatens people of all ages.” Continue reading
Any journalist who covers nursing homes should check out this month’s special supplement in The Gerontologist, the Gerontological Society of America’s journal. It focuses on the two-decade long effort to change nursing home culture and many of the articles and studies raise important questions about whether enough progress has been shown.
For example, this study finds that nursing homes that are considered culture change adopters show a nearly 15 percent decrease in health-related survey deficiency citations relative to comparable nonadopting homes. This study looks at what is meant by nursing home culture change – the nature and scope of interventions, measurement, adherence and outcomes. Harvard health policy expert David Grabowski and colleagues take a closer look at some of the key innovators in nursing home care and what it might mean for health policy – particularly in light of the Affordable Care Act’s directive to provide more home and community-based care. Other articles look at the THRIVE study, mouth care, workplace practices, Medicaid reimbursement, and more policy implications.
Any of these studies — or several taken together — can serve as a jumping off point for local coverage. Continue reading
Providing mentally ill older adults with home based services can be logistically daunting and expensive. However, a study in the March 3 issue of The American Journal of Geriatric Psychiatry found 10 long-standing programs that the authors say can serve as successful models for other communities.
Being homebound is a significant barrier to the detection of mental health problems and mental health services delivery. A growing number of communities are developing programs designed to improve the identification, treatment, and ongoing care of mental health problems in homebound older adults, according to authors Burton V. Reifler, M.D., and Martha L. Bruce, Ph.D. Many can benefit from successful models that have proven effective over years, or decades.
About 10 percent of the 40 million people over age 65 are considered homebound and require home-based care. Homebound older adults are twice as likely to be suffer from depression and other mental disorders as their community dwelling counterparts. Inadequately treated or undiagnosed mental health problems can lead to poorer medical outcomes, greater functional limitations, increased social problems and increased risk of premature death. It also leads to higher rates of health care use and premature institutionalization. Continue reading
Image by Tobyotter via flickr.
Non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50, according to a new study in Arthritis & Rheumatology. Researchers in the United Kingdom found anxiety, memory impairment and poor physical health among older adults may also increase the risk of developing widespread pain.
Chronic pain affects more than 100 million Americans at a cost topping $600 billion annually, according to the Alliance for Aging Research. Musculoskeletal pain is more prevalent as people age, with up to 80 percent of people 65 years of age and older experiencing daily pain. Widespread pain that affects multiple areas of the body – the hallmark feature of fibromyalgia – affects 15 percent of women and 10 percent of men over age 50 according to previous studies. While there is no cure for chronic pain, several studies suggest that exercise and Vitamin D supplements may be beneficial. Continue reading
The recently released 2014 work plan sets up how the Inspector General’s office of U.S. Department of Health and Human Services will scrutinize claims CMS pays to hospitals, nursing homes, and home care agencies, as well as for prescription drugs, medical equipment and other care services. Continue reading
Gout is a devastating disease at any age, but can hit older adults especially hard. It is the most common inflammatory arthritis seen in the elderly. As this tip sheet by Eileen Beal describes, gout is very painful, manifesting with pain, swelling, heat, tenderness and stiffness in the joints.
A report published in the Jan. 15 issue of Annals of the Rheumatic Diseases shows an escalating incidence and prevalence of gout among people in the UK. As Medscape reported, researchers found gout prevalence increased by some 63 percent (from 1.52 percent to 2.47 percent) and incidence rose from 1.36 to 1.77 per 1,000 person-years between 1997 and 2012. A similar increase had been previously seen among people in the U.S. According to a 2011 study, researchers thought the higher rates were likely due to rising incidence of obesity and hypertension. Gout is also linked to a higher incidence of heart attack or stroke. Continue reading
The first in-depth look at long term care services in the United States was released last week by the National Center for Health Statistics.
“Long-Term Care Services in the United States: 2013 Overview“ (PDF) analyzes supply, organizational characteristics, staffing and services offered by providers of long-term care services provided to some 8 million people in 2012. These findings establish a baseline for monitoring trends and effects of policy changes within and across the major sectors of long-term care services as policy makers, providers, researchers and advocates look to meet the needs of an aging population.
Key findings include : Continue reading
With much of the country feeling the “polar vortex” and some of the coldest temperatures seen in 20 years in some places, reporters may be called upon to write about health – and death – in cold weather.
Hypothermia is the unintentional lowering of the body’s core temperature below 95º F. According to the Centers for Disease Control and Prevention, common risk factors for hypothermia include exposure to cold while under the influence of alcohol or drugs, altered mental status and immersion in cold water. Other factors can include advanced age, chronic medical conditions, substance abuse and homelessness.
The CDC has some winter weather health and safety tips to help people protect themselves from frostbite, hypothermia, carbon monoxide poisoning, chainsaw mishaps and more. Here are some other general resources: Continue reading
2014 promises to be a big year in health and aging – with plenty of stories on the horizon for health journalists:
Medicare payments, Alzheimer’s breakthroughs, long-term care financing, caregiving issues, the science of longevity, senior-friendly neighborhoods and technology are just some of the issues journalists will likely report on on during this coming year.
Medicare will see several important changes – the 2014 handbook is a handy reference to have nearby. The standard premium of $104.90 and $147 deductible for Part B–provider coverage, remains the same for most people; however, some higher-earning seniors may see their Medicare or Medicare Advantage premiums rise slightly or be affected by some taxes like the capital gains tax. Continue reading
What happens to quality of life when science actually slows the aging process? That’s what the emerging field of geroscience is all about, according to an interdisciplinary panel of researchers at this year’s Gerontological Society of America Conference. Geroscience tackles biological factors of chronic diseases and aging itself as a risk factor for developing chronic diseases. It has numerous implications for extending healthy life span, enhancing quality of life in later years and impacting public policy surrounding aging and long-term care.
Or, as S. Jay Olshansky, Ph.D., professor at the school of public health at the University of Illinois at Chicago calls it, the Longevity Dividend. “This is a very short way of saying we’re trying to find a way to extend the period of healthy life by going after all the things that go wrong with us as we grow older, which is to go after the biological process of aging itself.” Continue reading