Archive for the ‘Medicare’ Category

  • Medicare Services Diminished, Geriatric Care Management Services to the Rescue

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    Last week we witnessed that last minute finagling of Congress and the Obama Administration to avoid the much-hyped “fiscal cliff”.

    What does this deal ultimately mean? Congress has simply rearranged our huge national debt, entitlements and taxes at the expense of Medicare benefits to seniors. Make no mistake: Across-the-board Medicare reimbursement reductions will hit physicians, hospitals and home health care agencies.

    Enter the Geriatric Care RN.

    Geriatric Care RN’s are be available to provide a number of services to ensure quality and continuity of care, including Extensive Registered Nurse Assessments, a therapeutic plan of care, safe and comprehensive discharge planning from hospitals, nursing homes, rehabilitation facilities, MD care, Home visits by MD’s, prescription facilitation, finding the least expensive pharmacy to refill your medications, arrange long distance transfer of clients accompanied by an RN.

    In general, Geriatric Care RN’s help local and long-distance families navigate the changes with the new healthcare system to protect and assist loved ones.

    We plan and provide the best individualized care and initial assessments to determine a plan of care and applicable services for seniors and all age groups that want to receive optimum healthcare with the very best outcomes.

  • Where Have All of the Doctors Gone?

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    Now well into 2012, we are starting to see the vast changes in Medicare takingshape and it’s not pretty.  Expect the doctor shortage crisis that’s been picking up steam in America to come to a boil in a couple of years.

    Beginning in 2013, doctors and hospitals treating individual patients will be held accountable for “rehospitalizations” within 30 days and face penalties if they have high 30-day readmission rates. The reason behind this move is that readmissions are costly to Medicare and the public. Watch for even more doctors and health care facilities to turn away older patients out of fear their readmission rates will spike.

    Beginning this year, Medicare reimbursement rates will be cut yet again, further slashing into the income MDs make along with the incentive to take on older patients. Couple that with rising liability insurance premiums, office space rental fees and salaries for qualified office personnel. Note too that Medicare does not cover for state of the art medical equipment. Private insurance reimbursements aren’t enough to bridge the gab while more and moreof our population is aging.

    The Great MD Squeeze is fully underway.

    » Read the rest of the entry..

  • American Doctors in Crisis, Many Going Broke

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    I have written often about crisis doctors are facing with the challenges government policies are presenting for them.

    Now CNN Money has a new article out about how doctors across America are going broke, and we need look no further than Obamacare and the related changes in Medicare to know why.

    The article quotes Dr. William Pentz, a cardiologist in Philadelphia:

    …recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue.

    These cuts have destabilized private cardiology practices,” he said. “A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well.

    This crisis isn’t limited to cardiologists. We know that many doctors have quit seeing Medicare patients entirely, and more are sure to follow. Many health facilities, including hospitals and hospices will fail. Further Medicare cuts will total $575 billion over the next decade and 7.5 million people will lose their Medicare Advantage plans and be forced into paying higher premiums for fewer benefits.

    America’s once superb healthcare system is crumbling before our eyes. Reversing this trend must begin with a change in leadership at the top in 2012 and the repeal of Obamacare. President Obama and his allies in socializing our healthcare system cannot be allowed to continue pushing forward. We’re seeing the results of their handiwork already.

  • Why hire a Geriatric care manager?

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    The medical/healthcare system has been getting more complex for everyone. Adding to this complexity are all of the new mandates included in Obamacare, which serve to only make our healthcare system more confusing, convoluted, and legally questionable.

    One thing’s for certain: Obamacare does not benefit any one over the age of sixty.

    Every day more MD’s are refusing to accept Medicare, thus nearly eliminating access to MDs, let alone the regular visits needed by many.

    Long term insurance policies, Medicare supplemental insurance options and Medicare Part D are all getting more confusing for those trying to ascertain which benefits they really have.

    Finally, critical medication shortages are plaguing community pharmacies and hospitals, leading to unacceptable delays for many who need them.

    What does this mean for someone who is elderly, disabled or suffers from dementia? How do they begin to make sense of this mess and get the care and treatments they need?

    c/o Rep. Brady (R-TX) and Sen. Brownback (R-KS)

    Enter the Geriatric Care Manager (GCM). Typically an experienced Registered Nurse with home health experience, the GCM is the person to hire to alleviate the stress of navigating the healthcare system.

    A GCM is not an entirely new concept, but rather one that has developed over the past 12 years. As the healthcare system becomes more complex, the demand for GCM’s has increased accordingly.

    Imagine an 80+ year old client that faces the prospect of having no regular MD and cannot get themselves to the pharmacy or complete errands. Now imagine that this individual has hearing, vision, mobility and memory issues. These are the people our increasingly complex healthcare system is leaving behind.

    A GCM offers quality, individualized assessments, customized care plans, and care coordination to ensure appropriate care is administered that is unique to each individual.

    A GCM can offer the following services:

    • Assistance in getting to medical appointments
    • Support for shopping and socialization
    • Healthcare advocacy to ensure the right care and benefits are received
    • Relocation and alternate living assistance
    • Home modification and medical equipment assistance to ensure a safer living environment.

    When family members live a long distance from their loved one, the services of a GCM can bridge this gap by managing and observing the care received on a regular basis. The GCM can also review their benefits and conduct an Insurance Policy Review.

    The transient nature of our society means the days when family members are directly responsible for the care of their extended families are in the past. The Geriatric Care Manager’s role has expanded and covers more services, and serves individuals and families for acute and chronic conditions, produces referrals for elder law attorneys, physicians, Adult Protection Services Guardians, powers of attorney, discharge planners at hospitals, rehabilitation centers, assisted living communities and hospice care.

    One thing’s for certain, our healthcare system is not getting any simpler to navigate. The Geriatric Care Manager is stepping in to serve as a healthcare advocate when people need it the most.

  • Obamacare: A Man-Made Disaster

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    In the past week, Washington, DC has experienced two disasters related to nature that were beyond our control. Buildings swayed to a significant 5.8 earthquake and a category one Hurricane.

    Earthquakes, let alone an earthquake combined with a hurricane, are indeed rare events for DC.  While these natural disasters weren’t preventable, knowledge about such threats and proper preparation are key to our safety. Luck was on our side as damage and human injuries were minimal (serious flooding continues in upstate New York and Vermont).

    Before, during and after these disasters our perpetually vacationing President was almost invisible as he continues his “lead from behind” strategy.

    He appeared before a microphone today to remind America that we have just endured something. He also reminded America that, soon, he will get around to unveiling his plan to do something about our jobs crisis.

    Any “grand plan” to increase jobs in America is not something we can look forward to from President Obama. The unemployment rate is more than 9.2%, markets remain in negative territory, our national debt is multiplying out of control by the minute and the world’s economy looks more like another impending disaster. This disaster will be of the man-made variety.

    Obama: Thinking about getting around to jobs

    When Obama finally delivers his speech on how he plans to create jobs, my concern over one of the few healthy sectors of the economy, healthcare, grows by the minute.

    The healthcare sector in America has remained strong and is one of the few that boasts increasing employment opportunities. But, like the Washington Monument, cracks are appearing in healthcare because of Obamacare.

    At this point there is no question that Obamacare is a job killer, even in the healthcare sector. As government-run insurance continues to permeate the system, MD offices are closing and MD’s are retiring early leaving office staff jobless.

    Medicare cuts are a reality because of Obamacare, regardless of efforts by Democrats to blame Rep. Paul Ryan for them. Obamacare itself is causing hospitals, MD offices, home health care operations to shave off substantial Medicare dollars due to lower reimbursement rates and new meddlesome rules.

    Several of my RN friends are being laid off because of cut backs in managed care institutions that are already falling in line for the Independent Payment Advisory Board, the unelected, unaccountable committee making decisions for American’s health care.

    My observations are from my perspective as an RN and health care entrepreneur. The once-safe job-producing health care industry is the last bastion of a positive job market in the U.S., and its days as such are numbered.

    As I watch the healthcare industry and job market crumble, it reminds me of the disasters of the past week. With the earthquake and hurricane, we were lucky. With Obamacare, luck is not on our side – certainly not with Obama preparing his big “jobs” speech in the coming weeks.

  • How Obamacare Threatens Medicaid

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    The so-called “Misery Index” is back and is rivaling that of Carter Administration. Gearing up for his reelection effort, President Obama’s approval ratings are hovering near their lowest points during is presidency. Add to this the fallout from Obamacare, and things aren’t looking good for him or the country.

    As Obamacare implementation marches forward, the focus has been on Medicare. But we should not forget about Medicaid, which is another threat from Obama’s signature law.

    Let’s take a look at two scenarios for Medicaid as Obamacare rolls over the country.

    Medicaid Scenario I

    One very dismal forecast shows that by 2014 most employees will lose their private Employee Sponsored Insurance. Faced with rising costs, many of employers will have no choice but to abandon employer-based health insurance, opting instead to pay the $2,000 penalty as mandated under Obamacare.

    By choosing to pay penalties over providing benefits, employers will save thousands of dollars while unfortunately driving their employees into the welcoming arms of the government. Unable to pay the skyrocketing health insurance premiums, the only option available is the government-run health insurance, or Medicaid. Individuals will have to endure “least common denominator” health care quality while both federal and state governments will struggle to manage the growing financial strain.

    Medicaid Scenario 2

    The Democrats attacked Paul Ryan’s plan to save Medicare by privatizing it with select options. However these same Democrats are creating a scenario that threatens both Medicare and Medicaid. Key to this is the Independent Payment Advisory Board (IPAB) as mandated in Obamacare. This controversial provision, effective in 2015, creates a 15-member panel to be appointed by the President and accountable to the Department of Health and Human Services. Note that Congress abdicated their oversight role, essentially creating 15 health care Czars!

    The structure of our new health care system: Obamacare

    IPAB will be responsible for decreasing Medicare spending by slashing reimbursements to health care providers. The result will be Medicare reimbursement rates that are lower than Medicaid rates. If doctors today are turning away Medicare patients because of lower reimbursement rates, I predict that soon with the fallout from the IPAB, doctors will not take any Medicare patients.

    It is predicted that by 2015 there will be a mandatory requirement for all Nurse Practitioners to have a Doctorate/Nurse Practitioner Degree. The DNP will most likely be the sole prescriber and the one treating patients. A perfect storm is brewing to create a crisis-level health provider shortage as we shove more and more people into Medicaid while health providers run away.

    And what about “RyanCare”, Rep. Paul Ryan’s plan to save Medicare? RyanCare proposes to empower seniors to make decisions to control their Medicare dollars and save the Medicare system by controlling costs and avoiding a mass exodus to Medicaid. Democrats don’t want you to have such a say and would rather empower an unaccountable committee of 15 to apply rationing measures and drive seniors to Medicaid with almost no access to doctors.

    If this were a multiple-choice test, I would choose RyanCare over Obamacare and the Democrat’s unaccountable decision-making panels any day.

  • The Rounds: Obamacare sinks; Medicaid battles, and proud new owners of the economy

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    Real Clear Politics’ David Paul Kuhn looks at the prospects for Obamacare in the coming few years and why Obama’s definitive “achievement” is in jeopardy (court battles, legislative prospects), along with his legacy. We can only hope.

    In the New York Post, Betsy McCaughey explains how Obamacare is destroying our privacy with a new national health database:

    Section 1311 of the Obama health law says that private health plans can pay only doctors who implement whatever the federal government dictates to improve “quality.” This is the first time the federal government has asserted a broad power to control how doctors treat privately insured patients.

    In The Washington Post, George Will calls Obamacare a “travesty of constitutional lawmaking”.

    The point of [Obamacare] is cost containment. This supposedly depends on the Independent Payment Advisory Board. The IPAB, which is a perfect expression of the progressive mind, is to be composed of 15 presidential appointees empowered to reduce Medicare spending — which is 13 percent of federal spending — to certain stipulated targets. IPAB is to do this by making “proposals” or “recommendations” to limit costs by limiting reimbursements to doctors. This, inevitably, will limit available treatments — and access to care when physicians leave the Medicare system.

    Shikha Dalmia looks at the numbers to compare Obamacare with Rep. Paul Ryan’s proposal and comes to the following conclusion:

    ObamaCare is the worst thing that could happen to seniors in their old age; inaction is the next and RyanCare is the least bad. As a senior in the making, if those were my only options, I would ignore Democratic demagoguery and take RyanCare in a heartbeat. ObamaCare, however, I’d avoid like the plague.

    Obamacare continues to sink in the court of public opinion. Keith Koffler points to a new Rasmussen poll:

    The survey of likely voters finds that 54 percent at least somewhat favor repeal of the health care law while 35 percent are at least somewhat opposed. And the passion is with the opponents. Some 41 percent strongly favor appeal compared to 28 percent strongly oppose it…. Obamacare remains a political weakness for Obama, and not one he is likely to solve before Election Day.

    This week, 29 GOP governors joined together to call for relaxation of federal rules on Medicaid spending.

    Across the country, governors are concerned about the burgeoning cost of Medicaid, which in fiscal 2010 consumed nearly 22 percent of state budgets, according the National Association of State Budget Officers. That’s larger than what states spent on K-12 public schools.

    More on Medicare: Politico reports that Senate Democrats are having a tough time resisting GOP efforts to reform and save the program.

    Economist Lawrence B. Lindsey does a great job in the Weekly Standard explaining the financial straightjacket America finds itself in.

    Right now, thanks in large part to Federal Reserve policy, Uncle Sam can borrow at an average cost of just 2.5 percent. The average borrowing cost over the last three decades was 5.7 percent. Our debt is now $14 trillion and scheduled to grow to $25 trillion by the end of the decade. If interest rates normalize over that period, the added interest costs in 2021 alone will be $800 billion—more than 20 times the mere $37 billion in budget cuts that tore up Congress in March… we are stuck in a world in which the Fed must keep rates artificially low in order to prevent a budget disaster.

    Read Lindsey’s full article, where he deftly dissects the structural issues with Medicare and Medicaid.

    Patrick Buchanan likens the Obama Administration’s position to that of France early in World War II when the Germans smashed their initial defenses and had no reserves to call upon:

    The Obama administration… has drawn and played all its cards: the $800 billion stimulus bill, three straight deficits averaging $1.4 trillion, the Federal Reserve’s mass purchases of bad paper from the world’s banks, and QE2, the monthly purchase of $100 billion in Treasury bills that ends June 30. Yet, from the numbers that came in from May, Obama looks to be holding a losing hand. The anemic growth of the first quarter of 2011 seems to have stalled, and the prospect of a double-dip recession looms.

    About one of those cards played, President Obama chuckled that “Shovel-ready was not as shovel-ready as we expected” when asked about the anemic results of all his economic stimulus initiatives.

    And when DNC chief and Florida Congresswoman Debbie Wasserman Schultz stated that the Democrats now “own the economy”, Investors Business Daily agrees, and it doesn’t look good for the President or his party.

    Let’s face it. Obama and the Democrats own this economy and the destruction of our great health care system. They own the blame. The misinformed that voted for him are “on to him”. Even his once solid base is turning on him. Is there any question why our economy isn’t improving?

  • The Rounds: Rep. Ryan Exposes Mediscare, Unconventional Wisdom and a Tale of Two States

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    As the 2012 campaign for the White House and Congress heats up, health care has moved to the forefront once again, along with the typical “Mediscare” tactics which I previously discussed. Rep. Paul Ryan, the architect of the GOP’s “Roadmap” budget, rightfully and effectively exposes the latest round of Mediscare attacks, using independent analyses from Politifact, Factcheck, and even the Washington Post’s Fact Checker blog. Read Ryan’s piece here.

    The conventional wisdom, especially after the GOP’s loss in the special election in New York’s 26th district, is that Rep. Ryan’s plan to save Medicare will be a political liability for the GOP in 2012. The Weekly Standard has a different take after looking at polling data and correctly pointing out that “Ryan’s plan would preserve Medicare’s sinking ship, keeping it afloat for future generations.”

    The fact is that Ryan and the GOP are the only ones serious about solving our nation’s looming fiscal disaster and saving Medicare. Even the Washington Post’s Chris Cillizza, while believing this may be a short term political advantage for the Democrats, points out that at least the GOP is serious about proposing plans to save Medicare.

    The problem for Democrats is, if they want to get serious about reforming the entitlement program, they are putting their own necks on the chopping block AND giving up a hugely potent political issue.

    Andrea Tantaros of the New York Daily News has another takeaway from the NY26 special election: The GOP should attack Obamacare more strongly. Rather than spend time defending Rep. Ryan’s “courageous” plan to save Medicare, the GOP must go on the offensive against Obamacare.

    The GOP has a strong case to make, and it should be out there making it. But instead of defending Ryan’s plan, they should be poking holes in Obamacare. Only then will the benefits of their alternative become clear to the American public.

    Read it here.

    On to Obamacare. Ralph R. Reiland of The American Spectator continues to expose the Obamacare waivers handed out to the politically-connected. It helps if you live in Nancy Pelosi’s district.

    I again ask the question: If Obamacare is so great, why the need for any waivers at all?

    What about the prototype for Obamacare? Heartland.org looks at the failure of Romneycare in Massachusetts.

    Taxes, costs, and political interference in medical decisions have all increased, while access to medical care has deteriorated. It’s now apparent Romney did not give Massachusetts universal private health coverage. Instead, he put the state on a glide-path to a single-payer, government monopoly health system—the same path Obamacare now follows at the national level.

    On the rising costs of health care in Massachusetts under Romneycare, Peter Suderman of Reason explores how the state’s explorations in universal, government-mandated care is working out and provides an ominous forecast:

    The Obama administration has explicitly stated on numerous occasions that RomneyCare was the model for the federal overhaul. Given the Bay State’s spiraling costs, it seems more and more likely that, thanks to ObamaCare, we can all expect higher health insurance premiums in our future.

    Finally, last week I looked at California as an example of where America is headed under Obama. Walter Russell Mead has an excellent piece in The American Interest where he concludes California is now a failed state.

    Let there be no mistake: when you produce so many criminals that you can’t afford to lock them up, you are a failed state.  Virtually every important civil institution in society has to fail to get you to this point.  Your homes and houses of worship are failing to build law abiding citizens, much less responsible and informed voters.  Your schools aren’t educating enough of your kids to make an honest living.  Your taxes and policies are so bad that you are driving thousands of businesses away… California used to be the glory of this country, the dream by the sea, the magic state.  Now it produces so many criminals it can’t pay to keep them locked up.

  • Mediscare Tactics and Unchecked Entitlements Threaten our Country

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    The Medicare issue and its requisite scare tactics are not going away any time soon. Like past election years, Medicare is set to play a leading role in the 2012 race to occupy the White House and control Congress. With Democrat Kathy Hochul’s victory this week in the special election to fill New York’s vacant 26th Congressional district, Democrats think they’ve got their winning issue for 2012. Unfortunately for all of us, it boils down to a broad misunderstanding of Medicare and the GOP’s plan to save it.

    Scott Stantis, Chicago Tribune

    The scare tactics and demagoguery over Medicare have to stop. As the creator of the GOP’s “Roadmap” budget and proposals to save Medicare, Representative Paul Ryan is rightfully concerned about the skewed picture many Americans hold about Medicare and efforts to save it.

    To set the record straight, Ryan’s proposed reforms don’t change any Medicare provisions for Americans 55 and older, and any statement to the contrary is at best willfully misleading. For Americans younger than 55, Medicare must change in order to ensure its survival for future generations.

    » Read the rest of the entry..

  • Down and Out on the GOP Trail

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    The 2012 GOP field has shifted considerably in the past few days. Although I was pleased with his connection to the issues facing the GOP, I thought we would get more of the positive side of Newt Gingrich before he “stepped in it” — but after his statements to David Gregory on Sunday’s Meet the Press that Paul Ryan’s Plan for Medicare was “radical engineering from the right” there may be no recovery phase for the former Speaker.  Back circa 2004 Gingrich had created a health care initiative and I spoke with him as he was out promoting it. Both he and his plan seemed to lack focus and I was not impressed with his understanding of the healthcare industry in America. His comments Sunday only reinforce the fact that he doesn’t understand healthcare. Newt’s campaign may be done before it really begins. It’s done with me.

    Mitt Romney has the most cash (he just raised $10 million in one day), the best organization and decent polls — all things pointing to a campaign that’s in really good shape. That was until he doubled down last week on his signature law from his stint as governor of Massachusetts, Romneycare, the blueprint for Obamacare. Rather than admit the state-wide universal healthcare mandate has become a costly failure pockmarked by growing wait lists for care, he said he’d do it all over again. He won’t be able to square his defense of Romneycare when Obamacare ranks as one of the biggest objections to Obama by the American public. I believe Romney will have to exit the field as he faces an increasing backlash from GOP primary base on his seemingly irreconcilable healthcare positions.

    Donald Trump yesterday announced that he will not run for the Presidency because he has more passion for “business”.  Is it not ironic that NBC made a deal with him that he could not refuse (and may have threatened to replace him with a new business leader at the helm of Celebrity Apprentice).

    Mike Huckabee was in a good position to continue harnessing the strong support that he enjoyed during the 2008  presidential campaign. Some early straw polls placed him in the lead. Instead, his “heart says no” to another run. This isn’t surprising, as he was doing little to prepare and many surmised that he is having a great time and making money for the first time with his popular show on Fox News.

    Now we have a very open field and it’s anyone’s guess as to who will break out of the pack. Will safer, more conventional candidates like Gov. Mitch Daniels or Gov Tim Pawlenty fit the bill? Or will we have the opportunity to support two of my favorites: Congressman Paul Ryan and Governor Chris Christie? Will a draft movement get them in the game? I certainly hope so. After all, we must beat Obama in 2012!

    Update 5/22: Mitch Daniels is also out.

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