The document discusses rising healthcare costs in the US, especially for the aging population, and potential solutions. It notes that Medicare and Medicaid costs are unsustainable and many doctors do not accept those patients due to low reimbursement rates. Several solutions are proposed: 1) Reconsidering elder care options like home care instead of nursing homes could reduce costs while improving quality. 2) Using technology to deliver home-based care may improve financial outcomes. 3) Educating elders on healthy behaviors could reduce expensive chronic diseases. Overall, changes are needed to make elder care more efficient and reduce healthcare spending.
Getting Real About Single Payer:
The Economic Argument for the Long Term
Walter Tsou, MD, MPH
Health Care for All Pennsylvania (www.healthcare4allpa.org)
February 7, 2015
Getting Real About Single Payer:
The Economic Argument for the Long Term
Walter Tsou, MD, MPH
Health Care for All Pennsylvania (www.healthcare4allpa.org)
February 7, 2015
DataBrief No. 22: Medicare Spending by Functional Impairment and Chronic Con...The Scan Foundation
In 2006, Medicare spent almost three times more per capita on seniors with chronic conditions and functional impairment than on seniors with chronic conditions alone?
This is a training on the financial crisis facing Medicare in the next generation. Are Democratic of Republican proposals for Medicare reform able to address the crisis, or can only single payer save the Medicare entitlement for seniors?
Better health outcomes at less cost - future nhs stage, 4pm, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Virginia AFP's lobbyist Hunter Jamerson's presentation from the 2013 SLC on the unique Medicaid reform approach being followed in the state of Virginia.
Health Economics and Health Finance :Jordan Health Policy Directions Musa Ajlouni
This presentation includes general introduction to health economics,the concept of market failure in health, health financing including health insurance and major challenges related to healthcare financing in Jordan and some policy directions to face these challenges.
DataBrief No. 22: Medicare Spending by Functional Impairment and Chronic Con...The Scan Foundation
In 2006, Medicare spent almost three times more per capita on seniors with chronic conditions and functional impairment than on seniors with chronic conditions alone?
This is a training on the financial crisis facing Medicare in the next generation. Are Democratic of Republican proposals for Medicare reform able to address the crisis, or can only single payer save the Medicare entitlement for seniors?
Better health outcomes at less cost - future nhs stage, 4pm, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Virginia AFP's lobbyist Hunter Jamerson's presentation from the 2013 SLC on the unique Medicaid reform approach being followed in the state of Virginia.
Health Economics and Health Finance :Jordan Health Policy Directions Musa Ajlouni
This presentation includes general introduction to health economics,the concept of market failure in health, health financing including health insurance and major challenges related to healthcare financing in Jordan and some policy directions to face these challenges.
Health Economics with Taxation and Land Reform Midterm.ppt
Discusses:
The Demand for Health Care
: Introduction
: Determinants of Health Seeking Behavior
The Supply of Health Care Services
: Factors that affect the Supply of Manpower
: The Supply of Hospital Services
The Concept of Demographic Transition
11 minutes agoJessica Dunne RE Discussion - Week 3COLLAPS.docxdrennanmicah
11 minutes ago
Jessica Dunne
RE: Discussion - Week 3
COLLAPSE
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population Health
INITIAL POST
Economic Challenges of Healthcare Policy
The economics of the healthcare system in the United States is complex and fragmented. Costs associated with care and the prices healthcare consumers pay are determined by a wide variety of factors making it extremely difficult to find a one size fits all solution. Knickman and Kovner (2015) argue that healthcare is neither a commodity or a service, because of the high variabilities in need, cost, and consumption. The United States spends 80% of all healthcare revenue on just 20% of the population. Health insurance can be provided by the government, the private sector, or an employer. Some citizens do not have any form of healthcare coverage. Regardless of type, insurance coverage generally only pays a portion of the total healthcare cost leaving the consumer to pay the remaining balance. Moreover, reimbursement standards differ for facilities and providers. The government reimburses healthcare facilities, such as hospitals a fixed amount per patient, which creates a higher incentive to work efficiently. Healthcare providers, on the other hand, are reimbursed based on a fee for service model, meaning the more services they provide, the more money they are reimbursed (Knickman & Kovner, 2015).
Reindart (2010) maintains the passage of the Affordable Care Act (ACA) created more strain on the system by adding approximately 30 million uninsured Americans to the market. The projected cost to provide such coverage is around 8 billion to 1 trillion dollars over the next decade. However, the estimated expense of healthcare with no legislative intervention is 35 trillion dollars over the next decade (Reindart, 2010). Laureate Education (2012) contends that the human resources required to provide healthcare to an additional 30 million people is another consideration the ACA does not address. The United States is already experiencing staff shortages for key healthcare jobs like nurses and physicians. Additionally, with baby boomers retiring from the workforce and simultaneously needing more healthcare resources as they age will inevitably exacerbate the shortage of providers (Laureate Education, 2012).
Ethical Considerations
It is important to recognize that the private sector often follows the public sector when deciding what services will be covered (Knickman & Kovner, 2015). Therefore, the implications of Medicare deciding not to pay for a drug or service will likely affect the entire population. Stein (2010) asserts that cost should not be a consideration in determining if medications or services will be paid for by Medicare. Nonetheless, that is what happened with Provenge, a vaccine indicated for late stage prostate cancer patients. The drug prolonged the lifespan of patients by about four months. Provenge costs around 93,000 dollars per p.
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DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
Running head: PUBLIC HEALTH
1
PUBLIC HEALTH
6
Public Health
Student’s name
University affiliation
Public Health
•
Briefly describe the public health problem and the policy that addresses the problem.
The public health problem of interest is limited accessibility of quality and affordable health care due to a rising cost of health care services. This is a major issue which has affected millions of Americans especially those who cannot afford to pay for their health care insurance or pay directly for health care services. The rising cost of health care services includes the rising prices of prescription charge, primary care, and specialized care which have limited the accessibility of quality health care. Some of the effects of rising health care cost include; i) rising insurance premiums, ii) limited access to specialized care such as breast cancer screening and maternal care for women, and iii) limited access to specialized care for different vulnerable groups such as persons who have chronic health conditions or those who are at a high risk of getting chronic illnesses.
To address this public health problem, the federal government introduced the Patient Protection and Affordable Care Act which famously known as Obama Care. This policy was signed by President Barack Obama in March 2010 with the goal of bringing key reforms in the health care sector to address the problem of health care cost, quality, and access. The primary objectives of the Affordable Care Act (ACA) were to; prevent the increase in the cost of prescription drugs and health care services, ensure that all citizens could have access to affordable health insurance coverage, promote patient protection, and deliver better services (Amadeo, 2019).
• Examine the nature and magnitude of the problem and the people who are affected.
Generally, the issue of increasing health care cost affected all Americans, especially those who could not afford health insurance coverage and the vulnerable population groups. Persons who could not afford health insurance could not access quality health care services since they were very expensive and they would not afford to cater for out-of-pocket payments. Vulnerable population groups included the aging population who are the most vulnerable group to be affected by chronic illnesses. The high cost of medication limited the ability of the affected group to access quality health care thus leading to a high mortality rate. The magnitude and nature of the high cost of health care can be analyzed as follows.
Rising insurance premiums
As of 2004, the cost of health care services had increased by 4 percent. Quality health care services and prescription drugs were getting expensive forcing the healthcare insurance providers to increase their premiums. Premiums were rapidly increasing between 2000 and 2010 at a rate of 8 percent for family premiums covered by employers (Amadeo, 2018). Due to this, hundreds of tho.
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Overview - Health Care IssuesHealth Care IssuesOpposing .docxgerardkortney
Overview - Health Care Issues
Health Care Issues
Opposing Viewpoints Online Collection, 2015
In recent years, the availability and affordability of health insurance in the United States has become
the subject of much debate. The United Nations’ Universal Declaration of Human Rights lists medical
care among the basic human rights to which all people are entitled. In 2011, however, about 17
percent of Americans had no health insurance at all. For many people who are insured, the cost of
coverage is a financial hardship. This situation has led some people to call for the government to
provide health insurance for all citizens. Others, however, are skeptical of government’s ability to
efficiently manage health insurance and oppose any plans that involve government. The issue is made
more urgent by rapidly rising health care costs that threaten to overwhelm the country’s current
system of health insurance, and the national economy in general. Health care reform has become one
of the most important issues in contemporary American politics.
The Basics of Health Care
In most developed countries, health care systems involve government control or sponsorship. For
instance, in Great Britain, Scandinavia, and the countries of the former Soviet Union, the government
controls almost all aspects of health care, including access and delivery. For the most part, health
services in these countries are free to everyone; the systems are financed primarily by taxes. Other
countries, such as Germany and France, guarantee health insurance for almost all their citizens, but
the government plays a smaller role in managing health care. Both systems are financed at least in
part by taxes on wages.
The US government, by contrast, does not pay for most of its citizens’ health care. Generally,
Americans receive health care through employer-sponsored insurance, or they arrange to pay for
insurance on their own. Like all forms of insurance, health insurance operates by pooling the
resources of a group of people who face similar risks. This creates a common fund that members can
draw upon when needed. Each person in the group pays a certain amount, called a premium, every
month. These premiums are used to cover the medical expenses of group members who become sick
or injured.
Health Insurance in the United States
Today, most Americans receive health insurance through their place of work. Employers typically pay
for part of the premiums. Most employer-sponsored plans are administered through payroll
contributions. People who are self-employed and those whose employers do not provide health
insurance must purchase individual health insurance. Individual plans are generally more expensive
than group plans. Certain low-income individuals and families may be eligible for Medicaid, a form of
government-sponsored health insurance. In 1997, the US government introduced the Children’s
Health Insurance Program (CHIP) to assist the children of families who do not qualify f.
Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
Running head: HEALTH CARE 1
HEALTH CARE 2
Healthcare
Healthcare is still a rare commodity in many households within the United States today. It might come as a surprise, but many people still cannot afford basic medical care because of the high costs. It is an expensive industry because of the intricacies that it comes with. The government has a role in making it accessible to the citizens through subsidies where it helps in footing part of the bill. An example of this is the Obamacare or the Affordable Care Act signed into law in 2010 (World Health Organization, 2014). It still reports that despite such measures taken by the government to address this issue, people still cannot afford this insurance, 18% of individuals under the age of 65 are thus unable to access healthcare. My research paper shall, therefore, address the problem of access to health care and the challenges surrounding this industry and some of the mitigations that have been taken or could be taken.
1. Access to healthcare
The introduction of Obama care in the United States meant that the health care system was not accessible to more people. The country spends close to 28 trillion dollars in the medical industry (World Health Organization, 2014). This cost the country a huge percentage of the Gross Domestic Product; it was also one of the highest amounts spent in comparison to other first world countries. People who do not have insurance with either a state-sponsored insurance, Medicare, Medicaid, State Children's Health Insurance program or a military health plan are therefore unable to receive healthcare. It is only restricted to those who have any of the above insurance covers. Because of the financial obligation that these guarantees comes with, many people are unable to afford them. As a result, they end up not getting access to healthcare whenever the need arises.
Research carried out by Agency for Healthcare Research Quality, showed that the number of people who were unable to get insured was lower than the ones who could afford. The statistics revealed that White Americans were more likely to have access to healthcare because of their ability to pay premiums. The numbers of black Americans, Native Americans, and Alaska Natives were much lower. This can be attributed to the opportunities the minorities have as opposed to their white counterparts. For one to be able to pay the premiums, one needs to have a stable source of income that allows one to spend on the necessities and on top of that pay the government for health care. The amount is subsidized but still quite high for most people who are either poor or low-income earner. Some middle-income earners also have a problem paying these premiums. Efforts, therefore, need to be under ...
Similar to Health%252 b care%252breform%252bproject%252bpart%252bii-1-1 (3) (17)
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Prix Galien International 2024 Forum ProgramLevi Shapiro
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Health%252 b care%252breform%252bproject%252bpart%252bii-1-1 (3)
1. Health Care Reform Project
Part II
HCS/ 440 - Economics: The Financing of
Health Care
2. Introduction
Rising healthcare costs and expenditures have become a growing concern in the United States.
This concern has become even greater due to a rapidly aging population. These rising costs place
a burden on our families, our economy and on our health care organizations. Government and
State and State funded programs such as Medicare & Medicaid cannot keep up financially
therefore, families and individuals are still dealing with limited access to care and coverage.
Because of the increasing low reimbursement rates of these programs many physicians are
choosing not to accept patients who are covered by them. Every year the United States spends
more on healthcare than they do on our National defense. This greatly adds to our Federal Budget
deficits. The spending has increased even more as people have begun to live longer and as more
people begin to retire. There are more people retiring in this generation than there are people who
are working and paying into these programs.
Medicare & Medicaid rely on private health care infrastructure therefore, when there are
inadequacies or inefficiencies in the private health care services both Medicaid and Medicare are
also affected. In order to reduce our healthcare spending while continuing to provide access to
everyone we must address the inadequacies or inefficiencies in the healthcare market. The aging
population is not temporary. It is a problem that needs to be addressed because it has become a
major economic issue for Social Security, Government spending, and Health Care Providers. It has
also become a challenge to the aging population because it is becoming increasingly harder for our
economy to provide sufficient resources to support the health needs of the elderly.
We intend to provide some possible solutions that could help provide more adequate and more
efficient healthcare services to our aging population.
3. Reconsidering Care
Options for the
elderly
∙ State and Federal Governments
pay for approximately 70% of
nursing home costs
∙ Approximately 85% of nursing
home residents entire costs are
covered by Medicare or Medicaid
∙ Many nursing homes are losing
money because of the current
system.
∙ Providing medical care to elderly
patients in their own home could
be very promising both for patients
and healthcare systems if they are
carefully coordinated and if the
correct changes in payment
structures are implemented.
4. Using Technology to
deliver home based
care
∙Using Technology to
deliver home based
care
∙ Can it improve the
financial state of our
healthcare system?
5. Medicare’s current
financial state
Medicare’s unfunded
obligations increased by
$2 trillion (The Heritage
Network)
Low reimbursement
How is health care coverage
effecting the elderly?
How can we improve it?
How will improving it help the
current economic issues is an
aging population?
6. The high cost of
treating chronic disease
in the elderly
Alzheimer’s Disease
Stroke
Diabetes
End-Stage Renal
Disease
Chronic Lung Disease
Heart Disease
Cancer
Cost
How can we reduce the cost?
Shifting the health care system ,
will it change the current
economic crisis?
8. Lack of Geriatric Care
for the Elderly
Training and
programs
More physicians are
being trained
Medical students
being exposed to
geriatrics
Who will take care of the elderly?
Lack of physicians
Lack of training and education
9. The High cost of
prescriptions for the
elderly
Part D Prescription
Coverage
The Donut Hole
How soon do they meet the Donut
hole gap.
Ideas to help through this period
or coverage?
10. The high cost of Fraud ,
Waste and Abuse
Waste and abuse cost
taxpayers.
OIG
Health Care Fraud Schemes.
Patients, Physicians, nurses and
providers may be involved.
Pharmaceutical companies and
fraud
11. Conclusion
The solution that we thought would best reduce the healthcare cost
of an aging population could not be limited to just one solution. We
decided that the best solutions for reducing the rising cost of
healthcare in an aging population would be to educate the aging
population on eating healthy and regularly, exercising and taking the
medication they have been prescribed on time and the correct
portion they are supposed to take. This solution would reduce their
chances of ending up with Alzheimer’s disease, Strokes, Diabetes,
End-Stage Renal Disease, Chronic Lung Disease, Heart Disease,
Cancer, and many other expensive illnesses. However, we also feel
that reconsidering care options for the elderly is another very
important solution to reducing the high healthcare costs that come
with aging. Many changes could be brought to the current care
options that would further reduce healthcare costs.
12. References:
(2007) Lombardi. Health Care Management Chapter 4: Leading and Developing Work Teams. Retrieved from Wiley and Sons
American Geriatrics Society (2012) retrieved
http://www.americangeriatrics.org/files/documents/Adv_Resources/PayReform_brief4.pdf
Baburajan, Rajani (2010) “Remote Monitoring Technology Reduces Elderly Care Costs for Providers: Report”
CMS. (2011). National Health Expenditure Data. Centers of Medicare & Medicaid Services. Retrieved from: http://www.cms.gov
Daniel R. Levinson Inspector General U.S. Department of Health & Human Services (2011) The United States Senate Committee on
Finance. Retrieved from: www.finance.senate.gov
Gleckman, Howard (2012) “In your own home”
Health Affairs, http://content.healthaffairs.org/content/31/6/1227
James D. Reschovsky, Laurie E. Felland (2009) Access to Prescriptions Drugs for Medicare Beneficiaries, Tracking Report NO 23,
Retrieved from http://www.hschange.com/content/1044
Lewis Morris Chief Counsel Office of Inspector General U.S. Department of Health and Human Services (HHS) (2010). Reducing
Fraud, Waste, and Abuse in Medicare. Retrieved from: www.hhs.gov/asl/testify/2010
Mattke, Soeren (2010) “Health and Well-Being in the Home”
Swarts, Kimberly (2012), The Hastings Center, Healthcare Cost Monitor,
http://healthcarecostmonitor.thehastingscenter.org/kimberlyswartz/projected-costs-of-chronic-diseases
The Hasting Center, Health Care Cost Monitor, Kimberly Swartz (2012)
http://healthcarecostmonitor.thehastingscenter.org/kimberlyswartz/projected-costs-of- chronic-diseases
The Heritage network, Medicare’s Deteriorating Financial Condition, http://blog.heritage.org/2011/05/13/medicare%E2%80%99s-
deteriorating-financial-condition/
Tracking Reports (2012) Effects of Health Care spending on the U.S. Economy. Retrieved from:
http://aspe.hhs.gov/health/costgrowth.
Zini, Aldo (2012) “Hospitals Find Robots Deliver Cost Savings & Greater Efficiency”
Editor's Notes
Pan American Health Organization (2002)” Primary Health Care in the Americas: Conceptual Framework, Experiences, Challenges and perspectives”
Reconsidering Care Options for the elderly
∙ Will it improve the financial state of our healthcare system?
There are currently many types of care options for the elderly. However, the most common of the care options has become nursing homes because many of the elderly are living with chronic disease. Most of the elderly patients who are living in nursing homes are there because of physical or mental needs that require help from skilled nurses or therapists as well as the assistance of the nursing home staff and most of them are over 65 years old. A majority of nursing home patients are considered long – term care patients. In other words, they will never recover nor will they stabilize enough to return to their homes or care for themselves. Many of these patients will pass away while living at a nursing home only to be replaced by another elderly individual waiting for an open bed. The average stay of an individual who stays in a nursing home until he or she passes away is around 2 years.
Individuals who reside in a nursing home are charged daily flat rates for private or semi private rooms as well as being charged for services and supplies that they may not even use. Patients are being charged the same amount across the board regardless of their medical care or supervision requirements. The costs of these nursing homes are normally paid for by private pay patients, Medicare or Medicaid. Private pay patients may even be charged a surcharge.
Currently State and Federal Governments pay for approximately 70% of nursing home costs, and approximately 85% of the residents entire costs are covered by these programs. Because a majority of patient care is paid for by our States and Government through Medicare and Medicaid, nursing homes structure their delivery system around the Government payment system.
Many nursing homes are losing money because of the current system. Inadequate Government payments are the number one reason that so many nursing homes seek bankruptcy protection. Even the nursing homes that are making a profit are not making enough of a profit to improve their infrastructure, hire more or better qualified staff, or purchase technologies that could improve their patient’s quality of care.
But what if we could change the way we care for our elderly? What if we reconsidered how we look at care options for our elderly? We need an entire new approach to services provided to care for our elderly. What if rather than building more institutionalized care facilities we expanded our community based models of care? We need to encourage the elderly to remain in their homes as long as possible and make this possible by improving and better integrating home support services. Since many aging individuals end up in nursing homes or other institutionalized care centers because they have one or more chronic illness shouldn’t we provide funding to train home health care providers to manage these conditions for elderly patients in their own home?
In order to encourage elderly patients to remain in their own homes as long as possible we must first train home health care workers to provide even those with chronic disease quality health care, we could encourage more people to train as home health care providers by paying them travel time, to be consistent in their training and their auditing, Only face to face assessments should be allowed by law, Care needs to be consistent and providers should be monitored, they should have to follow all privacy, abuse and neglect laws that institutionalized caregivers are required to follow, We would need to make home healthcare more integrated providing caregivers a network of assistance, and we need to be sure that specialized home health training is offered to caregivers to care for dementia patients in their home. Caregivers pay need to reflect their training and their audit results.
In the long run providing medical care to elderly patients in their own home could be very promising both for patients and healthcare systems if they are carefully coordinated and if the correct changes in payment structures are implemented. I feel that this solution has now become a financial, medical, staffing and social necessity.
Reference:
Gleckman, Howard (2012) “In your own home”
Image Credit: http://www.bocahomecareservices.com/blog/home-health-care-include/
Because there is a great shortage of nurses there are simply not enough nurses to provide around the clock care to elderly patients who choose to reside in their homes and to receive a majority of their medical care in their homes. Many of these patients require daily monitoring and that would be very costly if they had to visit a physician’s office for that monitoring. Additionally, many elderly patients live on a fixed income and having a private duty nurse at their home is just not affordable to them.
Technology in home based health care could reduce health care costs and cut down on ordinary tasks for health care providers. Now I am not just talking about Technology such as robotic vacuum cleaners that would vacuum floors for those who are unable to do so, I am talking about technology that would actually help health care providers care for individuals in their own home even when they are not present. One of these technologies is already available but has not yet been accepted by many insurance providers including Medicare and Medicaid. That technology is called telehealth. According to Miller-Keane Encyclopedia and Dictionary of Medicine (2003) “Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, professional health-related education, public health, and health administration.”
The advantages of using telehealth for patients who are receiving in home health care is that patients can wear sensors that monitor everything from their vital signs, the number of steps they have taken, to the food that they have eaten and then that information can be transported to health care providers. The transmission of this information to the patient’s healthcare provider can help the provider to offer that patient advice without the individual having to visit the provider or the emergency room. If something were to go wrong with the individual, the provider would receive that information via the transmission and could act immediately. Telehealth can also send reminders to patients making them aware of what medications they are suppose to take and when they are suppose to take them, teach them new ways of living or eating that may be required due to an illness. In other words, it gives patients their own self-management routines. Many times patients simply do not remember what to do or eat, and as a result are frequently hospitalized and cost our healthcare system more.
There are many possibilities for technology in home health care that could help the elderly remain in their homes longer while still receiving quality health care. For instance, Robot nurses, drug dispensing robots, robots used in surgeries, personal robots that help paralyzed individuals perform simple tasks, and robots that perform chores and even monitor patients vitals are all soon a great possibly in the healthcare industry. Many of these robots are already in use.
One of the largest costs in the healthcare field is labor. If we could reduce that labor by utilizing technology and by reducing unnecessary visits to physicians and hospitals we could provide the elderly quality care in their own homes, reduce labor costs and gain revenue from exports of sophisticated consumer health products.
Without the utilization of these advanced technologies, health care facilities will not be able to keep up with the rapidly rising number of aging individuals. We would see short term cost reductions by reducing on site health care providers both in institutions and in home health care and long term cost reductions by reducing by reducing the number of costly visits to physicians, hospitals and emergency rooms.
References:
Zini, Aldo (2012) “Hospitals Find Robots Deliver Cost Savings & Greater Efficiency”
Baburajan, Rajani (2010) “Remote Monitoring Technology Reduces Elderly Care Costs for Providers: Report”
Photo Credit: http://www.med3000.com/resources/blog/bid/63090/Information-Technology-in-the-Patient-Centered-Medical-Home
With the Medicare budget gaining another $2 trillion dollars in debt the system has to make changes or the whole Medicare Trust Fund Part A will be no longer by year 2024 .Over the full 75-year budget window for the entitlements, about 90 percent of the growth of Medicare and Social Security is going to occur by 2035 (The Heritage Network). This is why the government had to implement a new plan, which makes large cut backs on the coverage areas.
Health care coverage is a must for the elderly. As we age in life our bodies become more acceptable to diseases, disorders, and conditions. With the new changes in the Medicare and Social Security Funds, it makes it almost impossible to survive. For elderly you are basically cutting back on the income, creating a larger medical expense, and increasing the economy which makes it hard for them to diet properly. There is another factor that our aging population is struggling from, cancer. Cancer is the number one killer, “over 2/3’s of the elderly are affected by this disease” (at Home Personal Care, 2009).
Ways to improve are many but not easy. We can make cut backs in Medicaid funding by making a sliding scale co-payment determination. There can also be more limitations to visits and medications. The goal would be to make people work and pay or “contribute” in some shape or form for those who cannot. We need to make healthier lifestyles. This is one of the easies pats to do physically but the hardest to do mentally. We carry the most obese people in the world! Obesity is not just being over weight. It carries many long term health illnesses that can cost thousands in treatment such as; hypertension, diabetes, asthma, high cholesterol, respiratory, and joint damage. There are free programs that provide free medical screening to let you know what's going on inside your body. People need to take this information seriously and make the changes necessary. Making the changes to your diet or exercise can reduce health risk tremendously. This is the goal we all need to strive for. The more we take care of ourselves, the less time we spend in the doctors office, and the less medications we have to buy or take.
By first making changes to our life style will automatically decrease the amount of money spend on health care because you will be visiting the provider less frequently. Then we nee to be mindful of our spending in health care just as we are mindful when we buy a house. Make sure that we are choosing the correct form of treatment at the time. I think that making everyone aware and in control of there own medical expenses will force then to look at what is really being spent and they will have to budget there medical expenses just as they do their household expenses. For the elderly this will allow more funding into the budget to keep the budget running.
Reference:
The Heritage network, Medicare’s Deteriorating Financial Condition, http://blog.heritage.org/2011/05/13/medicare%E2%80%99s-deteriorating-financial-condition/
The cost for treating chronic diseases range. Below is a broken down list showing an estimate cost per disease.
Alzheimer’s Disease: In 2005 Medicare spent an $91 billion treating Alzheimer’s Disease. This number is expected to increase to $189 billion by 2015 and $1 trillion by 2050
Stroke: Strokes have a short and long term cost. For the first thirty days following the stroke it ost an estimate of $13K for mild cases and $20K for severe. However, the lifetime effect that a stroke causes can cost an estimate of $ 140K.
Diabetes: With diabetes increase each year, it cost an estimate of $1.4 billion to treat this disease. (Swartz, The Hastings Center, 2012)
End-Stage Renal Disease: this disease is a aftermath of diabetes and hypertension. In 2006 Medicare spent an average of $23 billion treating this disease. (Swartz, The Hastings Center, 2012)
Chronic Lung Disease: Medicare spent over $8 billion in in respiratory disease not including pneumonia.
Heart Disease: this disease has been the leading cause in death for all ages. In 2007 the overall cost for treatment was $164.9 billion and the numbers are increasing each year. (Swartz, The Hastings Center, 2012)
Cancer: This is a hard disease to track cost on. The reason being is that each cancer is different and each person is treated different depending on age, health, stage, and medications. Medicare spent an estimate of $7.3 billion dollars on inpatient treatment. However, this does not include chemotherapy which is an outpatient treatment plan. (Swartz, The Hastings Center, 2012)
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Ways to reduce cost:
As we all know there are some things that are just uncontrollable when it comes to health. However, by changing our lifestyle to a healthier one, is one that we can contribute to. Looking at it from a government stand point, there has to be budget changes to reduce this cost. One way to change the budget is to eliminate certain coverage's from the plan. By making the patient responsible for more treatment will slow down the continuous hole we keep digging in the health care budget.
Shifting Health care:
By shifting the focus to disease prevention and chronic illness management would be a very beneficial way to help. According to Health Affairs, In a randomized controlled trial of 1,632 elderly patients, length-of-stay was significantly shorter—6.7 days per patient versus 7.3 days per patient—among those receiving care in the Acute Care for Elders Unit compared to usual care. This difference produced lower total inpatient costs—$9,477 per patient versus $10,451 per patient—while maintaining patients’ functional abilities and not increasing hospital readmission rates. (www.healthaffairs.org) Therefore you can see that if we focus on preventing accidents and managing chronic illness the less time the elderly have to stay in hospital receive care during recovery.
Reference:
The Hasting Center, Health Care Cost Monitor, Kimberly Swartz, 2012, http://healthcarecostmonitor.thehastingscenter.org/kimberlyswartz/projected-costs-of- chronic-diseases
Health Affairs, http://content.healthaffairs.org/content/31/6/1227
Information between patients and providers is crucial. Effective communication is needed in health care and especially with elderly patients. Poor communication can result in misdiagnoses and treatments. With providers that are not specialized in Geriatrics can easily misdiagnose or treat the patient ineffectively. Communication between providers are essential. Transferring information from one physician to another is important and making sure that the information is correct. It is very difficult for a primary physician to know and treat an older person because of lack of education that provides them with information to better help and treat an older person. To promote better communication between providers and patients is to making sure the patient’s information is accurate, testing and procedures are conducted and finished, providing clear and accurate information of the patient’s charts and medications. Healthcare personnel must ensure communication effectiveness when dealing with management, employees, specialist, and support services. When a message is communicated it must be done to ensure everyone understands the message clearly. This message has to also ensure quality patient care is in mind and that all entities understand their role from the message. With government and state laws, policies and procedures, and other regulations changing daily, it is of high importance that healthcare organizations and personnel have effective communication.
(2007) Lombardi. Health Care Management Chapter 4: Leading and Developing Work Teams. Retrieved from Wiley and Sons
In medicine, physicians are known to diagnose and treat patients. Although many are trained to treat patients, there are a percentage of patients especially the elderly that gets misdiagnosed because of the lack of education, training, and physicians. Between the years 2004 -2008, there were only 320 physicians that entered Geriatrics, while there was many physicians that choose pediatrics, gynecology, and other areas. There are more elderly patients now than ever in history. Who will take care of them? According to USA TODAY, “Journal of the American Geriatric Society, warns that as the proportion of older adults spikes from 12% to a projected 20% by 2030, caring for 70 million people 65 and older and 10 million 85 and older will be a challenge.” There should be more training and education brought in classrooms to exploit and promote the necessity of this growing problem. Raising awareness of this problem is to encourage upcoming physicians of the importance of elderly care. Utilize programs, trainings, and workshops that will help physicians not only treat patients but the elderly also.
American Geriatrics Society (2012) retrieved http://www.americangeriatrics.org/files/documents/Adv_Resources/PayReform_brief4.pdf
Medicare Part D is available to anyone who is eligible for Medicare. Medicare part D is paid for separately and is run through private insurance carriers, these carriers are contracted with Medicare. There are many different plans. That have different out of pockets for plans. Medicare eligible recipients may also elect to not take part D but then they will have to pay out of pocket for all medications. There is a donut hole that once you have met a certain amount of prescription cost you will have to pay out of pocket. Once you have paid $4,700 out of pocket for prescriptions you then get catastrophic coverage. Most Medicare Recipients will reach the donut hole gap by July. Once people meet the donut hole they will either cut their medications in half or ration out what they have or they will quit taking it all together which then can lead to more illness and hospitalizations. Ideas on how to get through this gap is consider using generic drugs, work with pharmaceutical companies for their assistance programs, free medications, order 90 day supplies this is much cheaper than ordering monthly and look into community based charities that will help with the cost.
References:
Tracking Reports (2012) Effects of Health Care spending on the U.S. Economy.
Retrieved from: http://aspe.hhs.gov/health/costgrowth.
CMS. (2011). National Health Expenditure Data. Centers of Medicare & Medicaid
Services. Retrieved from: http://www.cms.gov
The waste and abuse from health care programs cost tax payer billions of dollars yearly. Improper billing and payments for Medicare payers is rising. This is a serious problem and needs to be dealt with aggressively. Some of the common health care fraud schemes include billing for services that were never provided to the patient, misreporting data and cost to increase reimbursements, paying , kickback and stealing identities or billing for the decease. The Office of Inspector General (OIG) investigates providers that that are Medicare providers and suppliers who will bill for services with out providing any legitimate service. These people will often pay poor Medicate reciepeints to be able to use their Medicare numbers. They will also pay kickbacks to physicians, nurses to help in fraud schemes. It is not always just one person or a criminal it could be a corporation. Major corporations such as pharmaceutical and medical device companies can committed fraud. This could include complex billing frauds, kickbakcs, accounting shcedmes, illegal marketing and physcians that will self referal. These abuses cast the taxpayer billlions of doollar every year. To be able to combat health care fraud there has to be prevention, detection and enforcement. The OIG uses five principle in strategic work and planning to assist in combating fraud. The 5 principles are Enrollment: this allows entities that would like to participate as providers to have their process reviewed, Payment: this will have methodologies that are responsive to that changes in the market place. Compliance: this will help in adopting practices that promote compliance, Oversight: monitoring the programs for an fraud, waste and abuse, Response this will allow the OIG to quickly respond to any detected fraud and the impose punishment for the fraud.
References:
Tracking Reports (2012) Effects of Health Care spending on the U.S. Economy.
Retrieved from: http://aspe.hhs.gov/health/costgrowth.
CMS. (2011). National Health Expenditure Data. Centers of Medicare & Medicaid
Services. Retrieved from: http://www.cms.gov