Posts Tagged ‘Medicare’

  • 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.

  • 15 Reasons to Repeal Obamacare

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    Our nation faces a critical debt crisis, and once Obamacare takes its toll, things are only going to go from worse to catastrophic.  Repealing Obamacare will save our nation trillions in the long run, not to mention preserving the world’s greatest health care system.

    In February I posted Ten Reasons to Repeal Obamacare. As implementation of Obamacare marches forward, more reasons to repeal have become evident.

    We need bold leaders to take on Obamacare and end it before it’s too late. One thing such leaders can count on in this fight: The American people. Latest polls show a majority of Americans are now in favor of repeal. The longer we wait, the more damage to America is done.

    Five Additional Reasons to Repeal Obamacare:

    1.   Obamacare is leading to a shortage of medicines across America. Shortages of common drugs like pain-killers, common diuretics, heart tonics, blood pressure treatments and anti-coagulants are skyrocketing.

    2.   With the existence of an Obamacare slush fund and wildly varying cost estimates across the board, no one really knows how much money Obamacare will cost America in the long run.

    3.   Obamacare destroys our privacy by allowing private health plans to pay only those doctors who implement whatever the federal government dictates to improve “quality.”

    4.   Unaccountable “committees” such as the Independent Payment Advisory Board (IPAB) will make decisions about what care is appropriate and are beyond the oversight of Congress. The recent ruling removing Avastin as an available treatment for advanced-stage breast cancer is only the beginning.

    5.   Much of Obamacare is unconstitutional, but we cannot simply rely on the courts to declare it so.

    My original Ten Reasons to Repeal Obamacare from February:

    1.   The 1099 Rule Targets Small Businesses. Like hundreds of thousands of other Americans, I am a successful small business owner. Obamacare requires us to file a 1099 tax form for any business purchase over $600. This significant paperwork burden falls on small businesses just as many are struggling to survive the Great Recession. All so we can help “fund Obamacare.”

    2.   Skyrocketing Premiums. The insurance premiums I pay to cover my employees are increasing at well over 80%. Like the 1099 Rule, this is another way Obamacare targets small businesses. These exploding premiums are a not-so-veiled effort to get employers to drop employee health benefits and force them into the government-run insurance. I’m proud to provide my employees with these benefits and I’m appalled that the federal government is squeezing me and other small business owners this way in order to fill the ranks of public-run insurance.

    3.   Seniors Get Squeezed. Many of my clients are seniors who rely on Medicare, which was already facing cuts prior to the adoption of Obamacare. They will be hit again under Obamacare. Now Medicare faces even more cuts under the new law while the Centers for Medicare and Medicaid (CMS) is proposing a new entitlement insurance program for the “uninsured”. Some that may qualify for a “free ride”.

    4.   Legal Abuse Left Untouched. Why have health care costs been shooting through the roof over the past 20 years? A key driver is abuse of the legal system through malpractice lawsuits. Frivolous claims and outrageous awards have sent malpractice insurance premiums every doctor must pay into the stratosphere. Democrats in Congress and President Obama failed to address this obvious cost driver in Obamacare because trial lawyers are among their biggest contributors.

    5.   Doctors are Being Squeezed. Medicare keeps slashing the rate that medical doctors are reimbursed for the care they provide —  currently about 25% less than market rates. Doctors had already begun declining to take on new Medicare patients because they can’t continue to absorb the costs. Obamacare will continue to slash these reimbursement rates, further limiting the ability for seniors to find a doctor to treat them. Access will certainly be limited.

    6.   Hidden Taxes will Kill Small Businesses. Obamacare is extremely complex, and we’re just beginning to fully understand the details of its implementation. Over the next two years hidden taxes contained within Obamacare will hit many small businesses hard and drive many others under! Where will these tax revenues go? To pay for Obamacare, of course! Whether you deserve it or not! Spread the wealth.

    7.   Research and Development Takes a Hit. Medical device and pharmaceutical companies take huge risks every year to develop the innovative products and medicines that improve and extend the lives of millions of Americans. Obamacare allows politicians to dictate what medical products and treatments should cost, setting up a situation where companies cannot recoup their development costs and will not have the resources to continue taking such risks.

    8.   Cancer Treatments Rationed. Under Obamacare, many cancer-treating medications will be rationed and may not be available at all. It’s already begun. Let’s hope you can continue to afford private insurance or maintain your treatments under Medicare.

    9.   Obamacare is a Job-Killer. How are entrepreneurs and small business owners going to swing all of the new taxes and regulatory burdens imposed on them and pay the high costs of health insurance? It will be more difficult to bring on the types of skilled employees that I need for my business. It will place a strain on my ability to continue providing the premier private and skilled services that I am now able to provide. Just when we need more jobs, Obamacare goes for the kill.

    10.   Obamacare is a Business-Killer. Obamacare will cut me off at my knees. In 2013 I will likely need to sell real estate to generate capital to reinvest in my business. I need to hire more employees and treat more patients at home that need personal care, skilled nursing and physical therapy. But wait a minute! Under Obamacare I now face an additional tax on the capital gains from real estate sales. Now after all of the hard work to save, buy, maintain and hope to gain some equity in real estate, I must to fork over another 3.8% to fund Obamacare and not my business! Obamacare will kill businesses.

    Obamacare’s 2,700 pages is set to transform many aspects of American life, business and society. It is a law far too sprawling in scope to warrant specific fixes. It must be fully repealed and defunded soon, before permanent damage to our nation occurs.

  • 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: 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..

  • The GOP Stood Firm on the Budget

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    As the terms of the Budget deal were tossed around last week, many things stood out. First, kudos to the Republicans who stood their ground and hit a home run. Speaker John Boehner was determined to get the budget through even if it meant shutting the government down. He was loyal to the constituents who voted in 87 house members in November demanding our inflated federal government stop spending money at the rate that it had been for the past two years.

    Rep. Paul Ryan (R-WI)

    President Obama was no where to be found all day Friday as Boehner and a weakened Harry Reid duked it out. It is important to note that the original Democratic budget plan included ZERO budget cuts. Harry Reid bowed to the Republican push and agreed to allow issues surrounding funding for Planned Parenthood and NPR voted on in the Senate. These programs may not get defunded, but we will get our elected officials on the record regarding these non-deserving drains on our budget and the American taxpayer’s wallet.

    While Obama, who’s now focused on 2012, wants to take credit for passing a budget and avoiding a shutdown, the kudos go to the Republicans and Speaker Boehner for driving these cuts home. There’s much more to do, but this is a solid start.

    Congressman Paul Ryan, Chairman of the House Budget Committee, is getting the attention he deserves as the only Member of Congress putting together realistic plans to cut federal spending. He is a problem solver and has the facts and numbers to back things up.

    Under his plan, Medicare will stay the same as it is now for those currently 55 and older. For those under the age of 55, Medicare and Social security will change, and for the better. You will still receive Medicare but it will be managed by private insurance companies to reduce the drain on government coffers.

    For Social Security, we may have the opportunity to direct some of your funds in investments just as you manage your portfolio. I believe that both Social Security and Medicare need to be privatized to allow free enterprise to market, sell and create the actuarial tables. This not only would draw out efficiencies via a capitalist model, but if managed correctly it could make money for our economy and not drain it. In my role as a Registered Nurse and owner/operator of a home health care company, I deal with Medicare provisions each and every day. The current Medicare model is broken. These changes are absolutely necessary.

    I believe that Paul Ryan’s plan, even though it may not make it through the Senate, will have a lasting impact on our economy, spending and certainly healthcare. It shows that the recklessness of Obama’s spending and Obamacare will bankrupt our nation and destroy our free market system. Paul Ryan and John Boehner have made great strides in seeing that this doesn’t happen.

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