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
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