As health insurers adopt population health strategies they find that home-bound patients are the most difficult to reach. Under fee-for-service payment, insurers didn’t need to focus on these patients.
But the combination of the star-rating program that Medicare uses in its Medicare Advantage plans and the need to prevent hospital readmissions means health insurers now are paying extra attention to home-bound patients with chronic illnesses. Typically, these are the 5 percent of patients who account for half of all spending. Continue reading
Many Americans lose their private dental benefits when they retire.
But Medicare, the nation’s health insurance program for seniors, does not cover routine dental procedures.
The situation leaves millions of elders, living on fixed incomes, making hard choices about when to seek care – and, as in Thelma Chappell’s case, postponing a dental visit until the pain gets too bad to ignore. Continue reading
As the Department of Health and Human Services continues its shift towards an outcomes-based payment model, one small health system is working with its pharmacists to create an innovative disease management initiative to minimize hospital readmissions and improve health status for its most complex – and costly – patients.
The Comprehensive Health Management program developed by Martin Health System in Stuart, Fla., establishes a progressive role for pharmacists to work directly with older, chronically ill patients. Integrating these neighborhood-based professionals into the system’s primary care practices improves management of patients with chronic diseases such as diabetes, obesity, heart and lung disease, according to David Harlow, Pharm.D., assistant vice president for professional services, clinical imaging, clinical laboratory, clinical pharmacy and disease management at Martin. Continue reading
A recent special “Your Money” section in The New York Times looked at American spending habits from a variety of angles. One piece examined geographic patterns in the consumption of luxury goods. Another explored the emotional aspects of bargain hunting. Then there was an article by Ann Carrns that delved into the difficult spending choices retirees may face in obtaining dental care.
The piece opened with an anecdote about 73-year-old Terry O’Brien, a retired administrative assistant weighing the cost of a $2,000 crown for one of her teeth.
“I always took care of my teeth,” O’Brien told the Times. But since she lacks dental coverage, she opted for a less expensive filling. The call was a tough one that left O’Brien pondering how she will go on paying for her dental care. “I’ll make 100, I bet,” she said. “But I wonder how long my teeth will last.” Continue reading
Image by Enrique Bosquet via flickr.
A new study from the RAND Corporation calls on policymakers to improve long-term services and supports (LTSS) for the growing number of people diagnosed with Alzheimer’s and other dementias and their caregivers. The report focuses on policy options at the intersection of dementia and LTSS.
An estimated 15 percent of Americans over age 70 suffer from dementia, but the number of seniors with Alzheimer’s disease is projected to triple by 2050, affecting as many as 14 million in the United States. This will place an unsustainable demand on dementia-related long-term services and supports, according to the report.
The estimated annual costs of dementia care are between $159 billion and $215 billion, which could more than double by 2040 if the age-specific prevalence rate of the disease remains constant as the nation’s population grows older. U.S. policymakers have made funding for clinical responses to dementia a priority. Continue reading