by Casey Ross
“A closely watched experiment in health care has unfolded over the last few years: Financial incentives for hospitals to reduce readmissions. It was a feature of the Affordable Care Act, and researchers are now assessing its impacts. But even as data have arrived, an impassioned argument has broken out among experts — looking at the same numbers, they have reached different conclusions about whether the policy is making Americans healthier.
“And, underscoring that disagreement is a deeper one — about what kind of evidence is needed before a health policy is enacted on a national scale.
“The policy, known as the Hospital Readmissions Reduction Program, created financial penalties for hospitals whose readmissions exceed the national average for patients suffering from heart failure, heart attacks, and pneumonia.”
Keep reading this STAT article, click here.
The Department of Human Services (DHS) is committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. If you’re 21 or older and have both Medicare and Medicaid, or receive long-term supports through Medicaid because you need help with everyday personal tasks, you’ll be covered by Community HealthChoices.
Community HealthChoices will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.
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“CVS to Buy Aetna for $69 Billion in a Deal That May Reshape the Health Industry” – The New York Times
Credit Shannon Stapleton/Reuters”
“CVS Health said on Sunday that it had agreed to buy Aetna for about $69 billion in a deal that would combine the drugstore giant with one of the biggest health insurers in the United States and has the potential to reshape the nation’s health care industry.
“The transaction, one of the largest of the year, reflects the increasingly blurred lines between the traditionally separate spheres of a rapidly changing industry. It represents an effort to make both companies more appealing to consumers as health care that was once delivered in a doctor’s office more often reaches consumers over the phone, at a retail clinic or via an app.
“The merger comes at a time of turbulent transformation in health care. Insurers, hospitals and pharmacy companies are bracing for a possible disruption in government programs like Medicare as a result of the Republicans’ plan to cut taxes.”
Wolf Administration Celebrates Living Independence For the Elderly’s 20th Anniversary in the Commonwealth
“Harrisburg, PA – Harrisburg, PA – Last week, the Department of Human Services recognized the 20th Anniversary of the Living Independence For the Elderly (LIFE) program in the commonwealth. LIFE provides services to more than 6,000 Pennsylvanians in 41 counties across the state.
“The Wolf Administration is committed to serving people in the community, and LIFE is an option that allows older Pennsylvanians to live independently while receiving services and supports that meet the health and personal needs of the individual,” said DHS Acting Secretary Teresa Miller. “Today, we celebrate this program for its 20 years of contributing to the quality of life of the seniors in our commonwealth.”
LIFE is a managed care program that provides a comprehensive all-inclusive package of medical and supportive services. The program was established by the Balanced Budget Act of 1997 and is known nationally as the Program of All-Inclusive Care for the Elderly (PACE).
All of the PACE providers in Pennsylvania have ‘LIFE’ in their name. The first LIFE program agreements were signed in 1997 with services implemented in Pennsylvania in 1998.
“While we prepare to launch Community HealthChoices in the southwest region of Pennsylvania, it’s critical that folks know that LIFE is also an option,” said Miller. “We want our older Pennsylvanians to be aware that there are choices available.”
To be eligible for LIFE, you must:
- Be age 55 or older
- Meet the level of care needs for a skilled nursing facility or a special rehabilitation facility
- Meet the financial requirements as determined by your local County Assistance Office or be able to privately pay
- Reside in an area served by a LIFE provider
- Be able to be safely served in the community as determined by a LIFE provider
Some of the many services available under the LIFE program include dental, meals, medical and non-medical transportation, LIFE Center services, nursing care, personal care, social services, recreational activities, and more. LIFE also fully integrates Medicare and Medicaid services for individuals eligible for both programs.
To locate a LIFE provider in your area click here, or call the toll-free CHC Helpline at 1-844-824-3655 (TTY 1-833-254-0690).
November is Living Independence for the Elderly month and Governor Wolf issued a proclamation declaring it as such.
For more information on LIFE, visit www.dhs.pa.gov.
Living Independence For the Elderly (LIFE), which is celebrating its 20th anniversary in November, provides services to more than 6,000 Pennsylvanians in 41 counties across the state.
LIFE provides an innovative, community-based approach to integrated health care, as well as social and family support services. The program is designed to help seniors remain in their homes and communities instead of receiving care in a nursing facility.
by Diane Archer
“The 2018 standard monthly Medicare Part B premium, which covers medical and outpatient care, remains at $134.00, the same as in 2017, for people with incomes of $85,000 or less. But, only about three in ten people with Medicare have been paying that standard premium. Now, millions of other people who have been paying a lower monthly Medicare Part B premium will see a large increase in their premium because their Social Security benefits are increasing 2 percent.
“‘Nothing could have prepared us for this event.’ | Heroes of Las Vegas: the hospital staff called to action after the mass shooting” – The Guardian
by Dan Hernandez in Las Vegas. Pictures by Hector Torres
“Heather Brown with Thea Parish and Tatiana Banassevitch.” Photograph: Hector Torres for the Guardian
“Sunrise Hospital’s emergency room was already full at about 10pm on 1 October when a police officer dropping off an accident victim received a call on his radio announcing: ‘Shots fired.’
“Doctor Kevin Menes and nurse Rhonda Davis looked up from their charts. ‘Is this for real?’ Menes asked. A series of gunshots crackled through the officer’s radio in automatic bursts. It sounded like a combat zone. As he ran out, the officer said, ‘That’s the Route 91 concert.
“Immediately, Menes realized there would be hundreds if not thousands of victims, and Sunrise – Las Vegas’s largest trauma center and the hospital nearest to the site of the country music festival – would probably receive the most.
“He and Davis started to prepare.”
Continue reading this article at The Guardian.
Key in responding or reacting to incidents for any agency, entity, organization is having understanding of the nation’s Incident Command System (ICS) – introduced following the attacks of September 11, 2001. Since then agencies, municipalities, schools, hospitals, nursing homes and other organizations across the united States have continued to learn, train, develop plans and refine their ICS and emergency planning.
These resources can help your agency, entity or organization begin the planning process.
- CMS Emergency Preparedness Rule – effective November 2016
For more information or for assistance about planning for emergencies and critical incidents that “are never gonna’ happen here”, send an email to email@example.com.
“ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurace Could Pay Less for Health Plan than Individual Mandate Penalty” – Kaiser Family Foundation
About 4 in 10 Could Obtain Bronze Plan at No Cost
“A new Kaiser Family Foundation analysis finds that more than half (54% or 5.9 million) of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.
“Within that 5.8 million, about 4.5 million (42% of the total) could obtain a bronze-level plan at no cost in 2018, after taking income-related premium tax credits into account, the analysis finds.
“Most people without insurance who are eligible to buy marketplace coverage qualify for subsidies in the form of tax credits to help pay premiums for marketplace plans (8.3 million out of 10.7 million). Among those eligible for premium subsidies, the analysis finds that 70 percent could pay less in premiums than what they’d owe as a tax penalty for lacking coverage, with 54 percent able to purchase a bronze plan at no cost and 16 percent contributing less to their health insurance premium than the tax penalty they owe.
“Among the 2.4 million uninsured, marketplace-eligible people who do not qualify for a premium subsidy, 2 percent would be able to pay less for marketplace insurance than they’d owe for their 2018 penalty, the analysis finds.
“The Affordable Care Act’s individual mandate requires that most people have health coverage or be subject to a tax penalty unless they qualify for certain exemptions. The individual mandate is still in effect, though Congress may consider repealing it as part of tax legislation.
“Consumers can compare their estimated 2018 individual mandate penalty with the cost of marketplace insurance in their area with KFF’s new Individual Mandate Penalty Calculator.
“The deadline for ACA open enrollment in most states is Dec. 15, 2017.”