(MIKE REDDY FOR STAT)
by Mike Reddy
“CLEVELAND — Seven floors, and long odds, were stacked against John S. He was undergoing a test on the first floor of a Cleveland Clinic hospital when his nursing team — on the eighth floor — got a call, telling them the 57-year-old had developed a dangerously rapid heartbeat that was spiraling toward cardiac arrest.
“It is a predicament that often ends badly. Only about 25 percent of U.S. patients survive when their hearts stop in hospitals. Crucial minutes elapse before help arrives, sometimes because alarms are missed amid the din of beeping monitors.
“But the call that day didn’t come from within the hospital. It came from a darkened room in an office park several miles away, where a technician in the clinic’s Central Monitoring Unit (CMU) was watching the patient’s vital signs on a computer monitor and noticed the onset of ventricular tachycardia.”
Continue reading this STAT news article in its entirety, click here.
Today is the beginning of National Nurses Week.
“Clinical Nurse Elise Ross stands in front of the nurses station central monitor for patient vital signs in the Neuro Intensive Care Unit in MedStar Washington Hospital Center in Washington, DC on June 25, 2013.”
“Nurses consistently rank at the top of the country’s most trusted professionals. And this week, America celebrates them.
“National Nurses Week begins on National Nurses Day, May 6, and concludes on May 12, the birthday of Florence Nightingale.
“Here are some facts about the nurses that tend to you when you’re sick — and the week that celebrates them:” continue reading this WNGO.com article here.
LIBRARY OF CONGRESS
Here’s another article that reinforces the trust that people have in nurses:
“More than half of middle-income seniors will lack resources for housing and care, study says” – The Boston Globe
(SUZANNE KREITER/GLOBE STAFF/FILE/2012)
by Robert Weisman
“For more than half of middle-income Americans over 75 years old, senior housing with health care services will be out of reach in the coming decade, a new study warns.
“The report, published Wednesday in the journal Health Affairs, is the first comprehensive look at a vast and growing demographic group researchers call the ‘forgotten middle’ — people who can’t afford private assisted-living facilities but don’t qualify for subsidized nursing home care unless they spend down the assets they accumulate during their working years.
“As the ranks of retired baby boomers swell and many live longer than their parents, the study projects that by 2029 about 14.4 million middle-income seniors — nearly double today’s number — will lack the financial resources for housing that offers personal care assistance.”
“Proponents held up signs as Senator Bernie Sanders introduced the Medicare for All bill in Washington this month.” Credit: Aaron P. Bernstein/Reuters
by Reed Abelson
“For a patient’s knee replacement, Medicare will pay a hospital $17,000. The same hospital can get more than twice as much, or about $37,000, for the same surgery on a patient with private insurance.
“Or take another example: One hospital would get about $4,200 from Medicare for removing someone’s gallbladder. The same hospital would get $7,400 from commercial insurers.
“The yawning gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of ‘Medicare for all,’ a government-run system.
“If Medicare for all abolished private insurance and reduced rates to Medicare levels — at least 40 percent lower, by one estimate — there would most likely be significant changes throughout the health care industry, which makes up 18 percent of the nation’s economy and is one of the nation’s largest employers.”
A new white paper released today from the nonprofit FAIR Health looked at medical pricing and other health care trends from 2012 to 2017 and found that people in the U.S. used more telehealth services and urgent care centers in 2017 than during the previous year.
Here’s a closer look at the report’s findings:
- Telehealth: Use of telemedicine services grew nationally by 53 percent between 2016 and 2017, with 55 percent growth in urban areas and 29 percent growth in rural areas. Oklahoma had the most telehealth usage, New Jersey the least.
- Urgent care centers: The use of urgent care centers in urban areas increased by 15 percent in 2017 compared to 2016, while staying the same in rural areas. The average price per 30-minute visit was most expensive for urgent care centers, at $213, compared to $207 in a doctor’s office and $129 in a retail clinic.
- Emergency care: Emergency department use decreased 2 percent between 2016 and 2017 — by 1 percent in urban areas and 10 percent in rural areas. Women were more likely than men to use the ED, and among adult patients not in college, the diagnosis with the most ED visits was acute respiratory infections.
Community HealthChoices (CHC) is coming in January 2020.
The counties included in the third and final phase of the program’s implementation are:
- Lehigh/Capital Zone: Adams, Berks, Cumberland, Dauphin, Fulton, Franklin, Huntingdon, Lancaster, Lebanon, Lehigh, Northampton, Perry, York.
- Northeast Zone: Bradford, Carbon, Centre, Clinton, Columbia, Juniata, Lackawanna, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northumberland, Pike, Schuykill, Snyder, Sullivan, Susquehanna, Tioga, Union, Wayne, Wyoming.
- Northwest Zone: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango, Warren.
What you need to know:
CHC information for providers or participants can be found at www.healthchoices.pa.gov. The website will be updated as events are scheduled, so please check back often.
Click here to take our online trainings and read CHC fact sheets.
Access a list of frequently asked questions (FAQs) about CHC by clicking here.
Contact a CHC managed care organization (CHC-MCO) to become part of their provider network:
AmeriHealth Caritas | Phone: 1-800-521-6007 email: firstname.lastname@example.org
Pennsylvania Health & Wellness | Phone: 1-844-626-6813 email: email@example.com
UPMC Community HealthChoices | Phone: 1-844-860-9303 email: CHCProviders@UPMC.edu
Sign up and encourage your peers to subscribe to CHC emails here. By signing up, you will receive regular communications regarding CHC distributed from the Office of Long-Term Living.
Here’s a schedule of what’s coming in 2019
Late Spring/Early Summer 2019
Save the date for our upcoming provider summits in the Northeast, Northwest, and Lehigh/Capital zones. These summits are educational conferences specifically for providers to learn more about CHC. More information regarding times and locations coming soon!
Monday, May 13: Harrisburg Area Community College
Tuesday, May 14: Shippensburg University
Wednesday, May 15: Kutztown University
Thursday, May 16 (Transportation Session Only): Kutztown University
Monday, May 20: Edinboro University
Tuesday, May 21: Lock Haven University
Wednesday, May 22: University of Pittsburgh-Bradford
Thursday, May 23 (Transportation Session Only): University of Pittsburgh-Bradford
Tuesday, June 4: East Stroudsburg University
Wednesday, June 5: University of Scranton
Thursday, June 6: Bloomsburg University
Friday, June 7 (Transportation Session Only): Bloomsburg University
An introductory flyer will be sent to participants identified within the CHC population. View the flyer by clicking here.
- Notices and enrollment packets will be mailed to participants.
- Information on the LIFE program will be sent to potentially eligible participants.
- Informational sessions will be held for participants to learn about CHC and how to select a CHC-MCO.
We’ve been reading so much about advantages that aging persons can accrue with the introduction of emerging technology, we decided to list some of the articles.
Aging In Place Technology Watch shares this in today’s newsletter: “… it’s good to see that Envoy (concierge service for independent living), Kindly Care (home care agency), Caremerge (home care platform), and Seniorlink (care coordination) are in their same businesses from 2016 – and others from the period like Envoy and CareLinx received additional investment and moved forward.
“Smart Home Technology Becomes a Must-Have in Senior Living” – Senior Housing News
“Home Instead Inc. — the international franchise company behind the Home Instead Senior Care network — is joining forces with senior-friendly tablet startup GrandPad in an attempt to reduce client loneliness and improve connectivity.” – Home Health Care News
“Where the Home Health Aide Shortage Will Hit Hardest by 2025” – Home Health Care News
OPINION | “Seema Verma: Americans have the right to know their health care and hospital costs” – STATNews
by Seema Varma. Seema Verma currently serves as Administrator of the Centers for Medicare & Medicaid Services (CMS).
“Americans are prolific shoppers, constantly on the lookout for the best price for top-quality products and services. If you are searching for a new television, it’s easy to find prices and statistics transparently and prominently displayed at just about every store.
“Yet when it comes to maintaining our health, very few of us ever know price or quality before receiving a health care service. This is true whether it’s a simple visit to the doctor, a cancer screening, or a knee replacement.
“One reason health care costs continue to skyrocket is that the prices and quality of care are largely hidden from patients. That means health care providers don’t compete on cost or quality.”
by Maria Castellucci
“About 30% of emergency department visits among patients with common chronic conditions are potentially unnecessary, leading to $8.3 billion in additional costs for the industry, according to a new analysis.
“The report, released Thursday by Premier, found that six common chronic conditions accounted for 60% of 24 million ED visits in 2017; out of that 60%, about a third of those visits—or 4.3 million—were likely preventable and could be treated in a less expensive outpatient setting.
“The frequency of unnecessary ED visits from the chronically ill is unsurprising given the fee-for-service payment environment the majority of providers remain in, said Joe Damore, senior vice president of population health consulting at Premier. On average, only 10% of providers’ payment models are tied to value-based models, he said, so providers don’t have an incentive to effectively manage patients to prevent disease progression and promote wellness.”
“The Out-of-Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019” – Henry J. Kaiser Family Foundation
“Medicare Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs—defined by Medicare as drugs that cost more than $670 per month in 2019—are a particular concern for Part D enrollees in this context. Part D plans are allowed to charge between 25 percent and 33 percent coinsurance for specialty tier drugs before enrollees reach the coverage gap, where they pay 25 percent for all brands, followed by 5 percent coinsurance when total out-of-pocket spending exceeds an annual threshold ($5,100 in 2019). While specialty tier drugs are taken by a relatively small share of enrollees, spending on these drugs has increased over time and now accounts for over 20 percent of total Part D spending, up from about 6 to 7 percent before 2010.”
“Figure 1: Medicare Part D beneficiaries can pay thousands of dollars out of pocket for specialty tier drugs, with the majority of costs for many drugs above the catastrophic threshold.”