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Major Changes to Medicare Coming for Senior Health Care

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Obama senior health care

The Obama administration has announced a major change to the way the federal government pays doctors and hospitals under Medicare. It’s an historic attempt to shift away from the traditional, costly fee-for-service model and quell the ballooning costs of health care.

Here’s the plan: Starting next year, the federal government will begin paying Medicare providers based on their performance, rather than on the number of surgeries, check-ups or CT-scans they perform. Under the proposal, 30 percent of Medicare’s $362 billion in annual payments will be tied to performance. Health officials expect that will increase to 50 percent by 2018.

Related: If You Don’t Take Your Meds Should Your MD Be Punished?

Sylvia Mathews Burwell, secretary of Health and Human Services, said the goals are meant to drive transformative change.

Proponents of the pay-for-performance initiative say it is an effective way to slow health spending while improving the quality of care. It has the support of major industry trade groups and leaders, including the American Medical Association (AMA) and America’s Health Insurance Plans.

 

“Today’s announcement by the U.S. Department of Health and Human Services aligns with the American Medical Association’s commitment to work toward innovative care delivery reform that will promote high-quality and efficient care for our nation’s seniors who count on Medicare, while reducing the administrative and regulatory burdens physicians face today.” Robert M. Wah, M.D., president of the AMA, said in a statement.

Patient advocate groups also threw their support behind the announcement.

Related: Maryland Hospitals May Be Paid for Keeping People Out

“The transition away from fee-for-service is an important next step towards better care and lower costs in the Medicare program,” Joe Ditré, Families USA’s director of enterprise and innovation, said in a statement. “Since private insurers often follow Medicare’s lead, the announcement is likely to have a profound and positive impact.”

The plan focuses on patient outcomes. If patients fare well, their doctors are paid more; if the results are poor, doctors are paid less. The administration says about 20 percent of traditional Medicare payments are already going through similar programs that emphasize care, such as accountable care organizations and bundled payments. They hope to expand that reach significantly.

WHY THIS MATTERS

One unanswered question is tort reform. Is this plan placing doctors in a catch 22 if they don’t protect themselves by prescribing the scan, the medication or the surgery to protect themselves against lawsuits?

“Advancing a patient-centered health system requires a fundamental transformation in how we pay for and deliver care. Today’s announcement is a major step forward in achieving that goal,” America’s Health Insurance Plans (AHIP) CEO Karen Ignagni said in a statement.

Even so, questions remain on whether pay-for-performance programs actually achieve worthwhile results in quality as well as cost savings. In September, CMS released a report evaluating the ACA’s pilot programs and found mixed results. While the agency said patient results improved, cost savings were questionable.

February 24, 2015 |

Chronic Obstructive Pulmonary Disease

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Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that is often preventable and treatable. If you or a loved one has COPD, there are steps to take to help cope with the lifestyle changes this disease brings. Knowing about COPD and its treatment can help you feel more in control.

Understanding COPD

What Is COPD?

COPD (short for chronic obstructive pulmonary disease) is an obstructive lung disease that over time makes it hard to breathe. COPD is a disease that involves inflammation and thickening of the airways. It also involves destruction of the tissue of the lung where oxygen is exchanged.

Obstruction in COPD means that the flow of air in and out of the lungs is less than it should be. When that happens, less oxygen gets into the body tissues, and it becomes harder to get rid of the waste gas carbon dioxide. As the disease gets worse, it becomes more difficult to remain active due to shortness of breath.

Sometimes referred to as either chronic bronchitis or emphysema, most people will have symptoms of both conditions, so health professionals prefer to call the disease COPD.

However, some doctors think that chronic bronchitis may be present even though a person does not have the airway obstruction characteristic of COPD. Your doctor can explain your condition and the best way to treat it.

It is important to remember that in many cases, COPD can be prevented and can be treated.

How Serious Is COPD?

COPD is the third leading cause of death in the US. It causes serious long-term disability and early death. At this time there is no cure for COPD. More than 11 million people are known to have COPD and up to 24 million may have the disease due to some not even knowing it. The number of people dying from COPD is growing. Deaths due to COPD in women are higher than in men.

COPD is often not found until the disease is very advanced because people do not know the early warning signs. Sometimes people think they are short of breath or less able to do the things they are used to doing because they are “just getting old”. But shortness of breath is never normal. The good news is that COPD can be found early and there is much that can be done to treat and help manage the disease.

What Causes COPD?

  • Smoking is the major cause of COPD. The poisons in cigarette smoke can weaken the lungs’ defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs. About 80-90% of all COPD is caused by cigarette smoking.
  • Pollution in the air and irritating fumes and dusts, especially on the job, can also cause COPD.
  • A small number of people have a rare form of COPD called alpha-1 deficiency related emphysema. This form of COPD is caused by an inherited lack of a protective protein in the blood.
February 21, 2015 |

Preparation can make more options as a senior’s health declines

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senior health

Many seniors get closed in by the weather and the cold and dark environment. Many have a medical event that destroys their finances, making life difficult.

The lack of assisted living facilities in our area means elderly people who fail to plan or who have no financial reserves end up having to move away from family and friends. Many end up in Anchorage, which has more facilities and facilities that accept the small reimbursement offered by the state.

Those with a mental illness and in need of an assisted living facility will need a “dual diagnosis” or mental health home that can only be found in Anchorage, Creighton said. And Alaska has the highest-priced assisted living facilities in the nation. There are a few retirement communities in Fairbanks for independent living, but there is a real lack of affordable choices for senior living.
Fairbanks Memorial Hospital Hospice is a good start for end-of-life care.

But as Creighton, who specializes in internal medicine, hospice and palliative care, says, “If you don’t have a large, devoted family, a team of devoted friends, or the resources to hire 24-hour care, you end up dying in the hospital. There is no in-patient hospice in Fairbanks and you may not get into Denali Center for end-of-life care if you don’t need skilled nursing care, i.e. you are actively dying or need IV medications.”

She said you might get stuck in the hospital while applications are made for an assisted living facility, which could take weeks. There is no formal outpatient palliative care access in Fairbanks, but an inpatient palliative care consultation service started in January.

The Fairbanks Pioneers’ Home and a facility in North Pole are available to those who need assisted living. It is a good idea to do the paperwork to get into one of these facilities before you need them. The Pioneers’ Home has an inactive list, kept by date, and an active list. First you get on the inactive list and the length of time you are on that list will determine where you end up on the active list.

The Senior Center in Fairbanks has Meals on Wheels that can help housebound seniors. There also are various activities and gatherings at the center. You can find out more from its website or by calling 452-1735. The Santa’s Senior Center in North Pole also hosts various activities and you can call 488-4663 to find out how to become a member or visit its website.
Fairbanks Resource Agency Senior Services offers home- and community-based services to adults with Alzheimer’s disease or age-related dementia, and seniors experiencing frail or disabling conditions. Its comprehensive range of services is designed for those who can no longer manage independently.

According to the Alaska Department of Health and Social Services website, “Aging and Disability Resource Centers connect seniors, people with disabilities and caregivers with long-term services and supports of their choice.
The ADRC network serves Alaskans statewide, regardless of age or income level, through regional sites.” The closest Aging and Disability Resource Center is in Anchorage.

Another website that might help is www.yellowpages.com/fairbanks-ak/senior-apartments. This has links to independent living and assisted living situations and senior help agencies.

So even before your “golden years” approach, it is a good idea to start planning for not only your retirement, but also for what will inevitably happen after.

Growing older is inescapable. You might have more choices and a better ability to cope with growing older by planning, communicating with family and friends, and becoming familiar with the choices available to you. It might behoove all of us to take a look at legislation that could help our elderly. We’ll all be there someday.

Eating right key to senior health

When it comes to diet and nutrition, the conversation in the media often focuses on the young, in hopes of curtailing childhood obesity.

However, Ohio Department of Health registered dietician Emia Oppenheim said in the Buckeye State there are different programs, including Creating Healthy Communities, that focus on helping Ohioans in their golden years by promoting access to healthy foods, increasing farmers market accessibility and physical activity opportunities. These programs are prevalent in Licking and Richland counties.

Further, Oppenheim’s mantra for seniors is simply not just living longer, but living well.

“In terms of guidance on eating, generally we suggest that the focus of nutrition for the elderly is really on successful aging,” Oppenheim said. “We follow the guidance put out by the National Institute on Aging, which really promotes eating many fruits and vegetables of many colors and types because that’s typically an area that seniors have a difficult time with.”

Mansfield resident Randy Lookenott, 68, said his diet is a major concern.

“I watch what I eat,” Lookenott said. “I’m a diabetic, so it’s to my advantage to eat healthy. I eat a variety of fruits. Pizza is a favorite, but I struggle to eat a small amount. I also watch pre-packaged foods. You don’t know what’s in them. I know if I eat healthy it will help keep weight off, and keep my energy up and reduce my chance of health issues.”

Mansfield resident Carol Maduri, 80, echoed his concerns.

“I am eating healthy to stay alive,” she said. “I worked in the health food shop years ago, that’s where I learned about eating right and found out I felt better when I ate right. Eating right is old hat now.”

Within Richland County, OhioHealth MedCentral Hospitals Clinical, Outpatient and Community Dietitian Marlys Slone spends the majority of her time on the road providing education and presentations, much of it focused to seniors.

“We may not think about it as much because we kind of focus on the younger generation, but it’s really important to take care of yourself so you can continue to be a good example for the younger generation but also be there to care for them,” Slone said.

In a nutshell, the areas of concern for seniors when it comes to nutrition naturally involved making sure they have calcium and vitamin D in their diets, as well as fiber and healthier fats. There also are omega-3 fatty acids, which can be found in a seafood diet — twice a week is recommended.

Oppenheim stressed the importance of vitamin B12, which is critical to the elderly.

“It’s all based on the idea that there are certain nutrients of concern about seniors,” Oppenheim said. “Generally speaking, seniors have changes in their diet and in their metabolic rate and in the proteins that they produce. Those changes end up increasing concern around certain nutrients.”

That’s where B12 becomes important. The vitamin helps seniors with cognition. The good news is it’s typically found in meat; however, the bad news is the human body stops producing its own protein needed to absorb it into its system.

“B12 is one of those they actually want to see their doctor and find out what their status is and consider supplementing if they need to with their doctor’s assistance,” Oppenheim said. “Another is folic acid, potassium and magnesium. I put those together because those are nutrients of concern mostly because of fruits and vegetables in senior citizen diets tend to be low in the volume and freshness.”

She stressed seniors should look into increasing the amount of leafy greens and fresh fruits in their diets. Speaking of fruits, Slone said it’s a myth that bananas are the best source of potassium.

“Potassium is very important when it comes to electrical impulses for something like your heartbeat, your muscles to contract,” Slone said. “A banana is great but an orange, tomatoes and potatoes have more potassium.”

In case you haven’t noticed, colors are very important if a senior wants to have a nutritional and healthy diet. Slone said, “You’re looking at the things like the colors of your fruits and vegetables to really enhance nutritional value.

“With that, it reduces the inflammation inside your body. Reducing that internal flowing is going to improve not only your circulation but your ability to heal and that of course can be much better for something like your immune system.”

Licking Memorial Health Systems Dietitian Tricia Liesen pointed out that when cooking, seniors — who aren’t as physically active therefore need fewer calories — should use fresh ingredients and limit processed foods.

“Processed foods tend to include more sodium, which may increase the risk of hypertension,” Liesen said. “Seasoning foods with herbs or spice blends that do not include salt can add flavor to a meal.”

“Sometimes seniors need to modify the consistency of food due to teeth or swallowing difficulties,” she said. “Healthy smoothies could be used to assist in daily intake of protein, fruits, vegetables and dairy. Smoothies can provide access to nutrient dense foods in a consistency that may be better tolerated for some seniors.”

Still, when it comes to diet, some seniors may not be as focused on health — lifelong habits of living unhealthy, including smoking, are hard to break.

Richland County’s Ohio District 5 Area Agency on Aging Chief Marketing and Development Teresa Cook said she knows some seniors who are alone and may not cook large meals anymore or need assistance.

“If they are struggling with eating, we do have options that we can offer them at the Area Agency,” Cook said. “It could be a home-delivered meal, maybe getting that meal a few times a week would really supplement that healthy eating. We also have congregant meal sites for other people their age.”

Another concern is cost, with groceries continually going up in price while some seniors are on fixed incomes. Cook said if the elderly find themselves being priced out of healthy food, her agency (Ohio Area Agency on Aging officers are located throughout the state, including in Licking County) can help them get enrolled in SNAP — Supplemental Nutritious Assistance Program — or direct them to a local food bank or food pantry.

Finally, Cook had one last piece of advice for seniors looking to stay healthy: “The key is making sure they stay physically active.”

For more information, visit www.healthy.ohio.gov.

 

Eating right

Dietary Guidelines for Americans recommends:

• Eat fruits and vegetables. They can be fresh, frozen or canned. Eat more dark green vegetables like leafy greens or broccoli and orange vegetables like carrots and sweet potatoes.

• Vary your protein choices with more fish, beans and peas.

• Eat at least three ounces of whole-grain cereals, breads, crackers, rice or pasta every day.

• Have three servings of low-fat or fat-free dairy (milk, yogurt or cheese) that are fortified with vitamin D to help keep your bones healthy.

• Make the fats you eat healthy ones (polyunsaturated and monounsaturated fats). Switch from solid fats to oils when preparing food.

Health Tip: Exercising as a Senior

If you’re a senior who is considering starting an exercise routine, you may have a number of questions.

The American Council on Exercise offers these answers to common questions:

  • If you’re wondering if it’s too late for you to start exercising, it’s not. You’ll enjoy more health benefits if you’re active.
  • If you have any medical conditions, talk to your doctor about exercises that are safe for you.
  • If you’re looking for joint-friendly exercises, consider swimming or water aerobics, biking, elliptical machines or rowing. Talk to your doctor about walking and jogging for healthier bones.
  • Start out slowly, for just five minutes a day. Gradually, work up to 30 minutes per day on most days of the week.
  • Even if you’re at a healthy body weight, you do need to exercise.
  • If you’re concerned about money, just start walking — it’s free and great for your health.
January 24, 2015 |

Special Education

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Special education or special needs education is the practice of educating students with special needs in a way that addresses their individual differences and needs. Ideally, this process involves the individually planned and systematically monitored arrangement of teaching procedures, adapted equipment and materials, accessible settings, and other interventions designed to help learners with special needs achieve a higher level of personal self-sufficiency and success in school and community than would be available if the student were only given access to a typical classroom education.
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September 16, 2014 |

Health & Fitness Fit And 40 Plus

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Health & Fitness How to get (and stay) active, no matter what your age.

In your 40′s and beyond, fitness tends to take on a new shape. Exercise routines you once found merely challenging may become painful or even impossible by the time you’re 40, 50, or 60. It doesn’t matter whether you’re male or female, a kickboxer or a mall walker — sooner or later, age will have an effect on your body. It happens to everyone — even Sheila Cluff, 68, founder of The Oaks at Ojai Destination Spa in Ojai, Calif. Cluff, a former professional figure skater, is quick to tell you that she can do 70 pushups and ski black diamond runs with her grandchildren. But she can’t do everything she used to do.
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August 26, 2014 |

FreeConference.com – Free Telephone Conference Call Service

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conference_calling

How much does it cost?
Question:
Are there any costs at all for this service?
Answer:
In order for conference participants to reach our service, each one must call a telephone number. For Reservationless Standard and Web-Scheduled Standard conferences this number may be local or long distance, depending on their location. The only costs for these type of conference calls are whatever long distance rates are charged by each individual conference participant’s long distance carrier (Sprint, MCI, AT&T, etc.). We do not require the use of any specific carrier, nor do we know what rates you pay on your calling plan.
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February 22, 2014 |

Exercise For Beginners

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Learn how to get started on your exercise program from your Exercise Guide.

Beginning an exercise program is confusing, at best. Whatever your goal is, the links below will help you get started. Find out what to wear, how to set goals, how to set up a complete program and more.
Getting Started

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February 16, 2014 |

Tax Planning Basics

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Tax Planning Basics

3 Ways to Reduce Your Taxes The goal of tax planning is to arrange your financial affairs so as to minimize your taxes. There are three basic ways to reduce your taxes, and each basic method might have several variations. You can reduce your income, increase your deductions, and take advantage of tax credits.
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February 16, 2014 |

Electric Vehicles

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An electric vehicle (EV), also referred to as an electric drive vehicle, uses one or more electric motors or traction motors for propulsion. Three main types of electric vehicles exist, those that are directly powered from an external power station, those that are powered by stored electricity originally from an external power source, and those that are powered by an on-board electrical generator, such as an internal combustion engine (hybrid electric vehicles) or a hydrogen fuel cell. EVs include plug-in electric cars, hybrid electric cars, hydrogen vehicles, electric trains, electric lorries, electric airplanes, electric boats, electric motorcycles and scooters and electric spacecraft. Diesel submarines operating on battery power are, for the duration of the battery run, electric submarines, and some of the lighter UAVs are electrically-powered. Proposals exist for electric tanks.
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February 16, 2014 |

About Diabetes

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Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger).
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February 16, 2014 |
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