Saving Money by Bundling Care

A few months ago my a member of my family had 3 extended stays in the hospital. I had Appendicitis in graduate school, so I had a scene of how messed up the medical billing system had become. But I was not prepared for the sheer number of bills for doctors, specialists, sub contractors, hospitals, laps, other tabs that were the result of nearly a month in the hospital.

One of the things that have lead to the increased cost of medical care in the United States has been the overhead realated to record keeping and billing. A new pilot program by Department of Health and Human Services aims at streamlining this process. This program will offer "bundled" care. Patents would pay a single flat fee that would cover for an episode of treatment. From kaiserhealthnews.org

On Tuesday, the Department of Health and Human Services unveiled a Medicare pilot program that will pay participating hospitals, doctors and other health providers one, “bundled,” payment to treat a patient for a single episode of care. The program starts in 2012. To participate, providers will have to bid less, in total, than what Medicare would pay each provider separately. The traditional Medicare program pays each hospital and doctor a separate fee for its services, which critics say leads to uncoordinated care and incentives to drive up Medicare bills.

By reducing inefficiencies and waste, health care organizations will be able to reduce the cost of providing care.

Until Next Time,
Mike
Healthcare Software

Why the recession increased access to health care

The Washington Post's Sarah Kliff has an interesting post on her blog:

One unexpected side effect of the recession: Access to health care has increased. A studypublished today by the Center for Studying Health Change tracks issues related to accessing health care from 2007 through 2010. It finds that fewer Americans are experiencing unmet health needs or delaying medical care. As the above chart shows, this is true for both those with and without health insurance.

As it becomes more difficult for people to pay for treatment the demand for treatment drops and along with it the cost. This is clearly a double edged sword. The fact that people are not seeking treatment means a larger burden on the healthcare system in the short and long term. Delaying care can lead to an experimental growth health issues. In times of recession, however, healthcare organizations are able to reduce in inefficiencies that are a inevitable result in an over-stressed system. Studies by the Kaiser Family Foundation believes wasteful spending accounts for 30% of medical costs.

One way that health care organizations are cutting down on waste is by using electronic medial records and tracking tools to manage the work flow within in a doctor's office or hospital. This reduces mistakes and oversights on the part of the staff. Patients get healthy faster and fewer mistakes mean less liability for the hospital.



Until Next Time
Mike,
Healthcare software

It was only a matter of time before someone wrote this story:

Baby boomers heading into what used to be called retirement age are providing a 70 million-member strong market for legions of companies, entrepreneurs and cosmetic surgeons eager to capitalize on their "forever young" mindset, whether it's through wrinkle creams, face-lifts or workout regimens.

A study from Global Industry Analysts estimates that baby-boomers will spend $114 Billion on anti-aging products by 2015. Public health professionals are quick to disregard nearly ever aspect of the anti-aging push. They aruge that it is all marketing.  S. Jay Olshansky, a professor at the University of Illinois-Chicago's School of Public Health told the AP, "It's always the same message: 'Aging is your fault and we've got the cure. Invest in yourself, in the simple things we know work. Get a good pair of running or walking shoes and a health club membership, and eat more fruits and vegetables."

That message falls on deaf ears. Everything from plastic surgery to unregulated health supplements  are sold as quick fixes to stop aging. Because so much of the market remains unregulated, there is little protection for people negatively effected.

What is overlooked in the race to stop aging is to root cause of health problems. Someone might go right for the botox to remove wrinkles, but still spends 1000s of dollars on makeup that drys out the skin. It is easy to get plastic surgery, but harder to change ones diet. Cutting back on red meat carbs and increasing veggies and fish can go a long way to increasing health and reducing risk of long term illness.

[youtube http://www.youtube.com/watch?v=NntPPB6htxk&w=420&h=345]

Until Next Time
Mike
Chicago Home Care 

Two-Thirds of Californians Unprepared for Costs of Elder Care

A scary study out of California today:

Two-thirds of middle-aged Californians – across party lines – worry that they won’t be able to cover the enormous cost of nursing home care – now over $70,000 a year – and Latinos in particular feel vulnerable, according to a report released Tuesday.

The study was conducted by the SCAN Foundation and UCLA's Center for Health Policy Research. They asked middle aged voters how they are preparing for life after retirement. According to the report the number of people over 60 will double to 12 million during the next 25 years.

These sorts of numbers are pretty terrifying. The increase in seniors is going to put stress of any number of public and private institutions that help support older Americans. Despite the advances in health care and prevention many people will still have to use short-term nursing homes or home care.

UCLA center’s Steven P. Wallace says, "Most Californians will need it during their life, yet unfortunately, most Californians are not planning for it and the government is cutting back on affordable options that could help."

Resent budget cuts in the state will reduce access to esscenale services for the elderly. Transportation, health and personal services are all effected.

Until Next Time,
Mike
Chicago Home Care

Support in Co-Living

From the Old New Age Blog:

“My every need was taken care of,” said Ms. Edwards, who has lived in ElderSpirit since its inception five years ago. “That’s the kind of care you can’t get from places that are professionally run.” They see senior cohousing as a low-cost alternative that allows them to remain independent while living in a community where neighbors know one another, share weekly meals and help in times of need.

Until Next Time,
Mike
Physical Therapy Recruiting

Don't Let Incontinence Diminish Quality of Life

A Great blog post from the folks at CMSS today. In there most resent blog post, they talk about issues related to incontinence and its impact on the lives of seniors. As one grows older, the body begins to have trouble maintaining control. Something as simple as a hard belly laugh can cause leakage. At the more extreme end, the bladder and no longer function correctly or will not completely empty.

Treatment can be tricky. Many adults do not want to ware adult dipers, In the long run incontinence can cause depression and social isolation as it becomes more difficult to get out of the house.

There are other treatments. The most simple is Kegel exercises. Strengthening pelvic muscles can help prevent minor leakages and help fully empty the bladder. There are several medications on the market that help control the bladder functions. There are also electronic devices that can notify the user when badder muscles are active. Finally, there are some surgical options available. This procedure can help take pressure off the bladder.

Until Next Time,
Mike
Chicago In-Home Care

The Future of Health Care: Electronic Health Records

Innovative health care can save lives and every physician and health care provider has a stake in its success. Through the use of electronic health records (EHRs), the coordination of health care for an individual patient between various practitioner offices is more efficient and accurate, resulting in better overall patient care. With an EHR, a patient's information is always current and coordinated, helping to eliminate medical errors and duplicative paperwork. Dr. Farzad Mostashari (ONC), Dr. Donald Berwick and other health care professionals discuss how EHR technology may help reduce the cost of health care and improve health outcomes -- leading to a healthier future for all Americans. (via)

Until Next time
Mike
Healthcare Software

Getting a early start on flu shots

After several years of shortages and rationing, pharmaceutics companies are getting a headstart on flu shot vaccines. This comes after years where the people most at risk for influenza. From the WSJ:

The Centers for Disease Control and Prevention said on a media teleconference today that it expects about 166 million flu shots to be produced this year, an increase from last season’s 157 million. Nearly half of children, 6 months to 17 years old, got flu shots last season, compared to 41% of all adults, the CDC estimated.

The FDA has approved the 2011-2012 vaccine, which will cover the same strains as last year's shot. Anyone at risk should still the shot. Its effects only last about 13 months.

The increased production of the shot was promoted by new studies showing static growth in vaccination rates among health care workers and pregnant women. By producing more doses of the vaccines, healthcare organizations can ensure that as many members of their staff get the shot. This reduces absenteeism during the height of the flue season.

Doctors will also push for a higher rate of vaccination among pregnant women. the CDC has found that 71% of pregnant women get the vaccine when it is given as an option, verse 14% when it is not. By making sure there is enough to go around, doctors will be able to offer the shot to anyone who may be at risk.




Until Next Time,
mike
Healthcare Software

New PT Video Blog

Here is the first episode of a great new video blog by a group of physical therapy students at U of T.

Until Next Time
Mike
Physical Therapy Recurring

Senior Transportation Needs

A major barrior to senior care has been transportation. As we age, it becomes more dangerous for seniors to drive themselves. This can cause depression and stress as seniors lose their independence. It also creates strain on grown children who have to reshape their lives around helping their parents maintain their standard of living.

In the past, the lose of transport skills meant it was time to go into a nursing home or supportive living, even if there was no other issues.

When it comes to the standard of living and mental well being of a senior, this lose of independence can be devastating.

Increasingly there are options. National Center on Senior Transportation was created in 2007 with the express purpose of increasing senior assistance with transportation, enhancing their ability to live more independently within their communities.

Through training and grants, there are an ever increasing numbers of non-profits and small businesses dedicated to help seniors get out of the house for doctors appointments and daily shopping with out placing an additional burdon on friends and family.

Until next time,
Mike
Chicago In-Home Care

Keeping Seniors Connected: Senior Transportation Project from Jewish Community Federation on Vimeo.

Animal-Assisted Therapy Does the Trick

Therapists, both physical and occupational, have a well established bag of tricks for help seniors thrive during extended in home at care. More and more animal therapy is becoming standard practice.

Therapists report that seniors having trouble come to life with a pup walks through the door. Therapy dogs are not service dogs. They have not been trained to assist people with disabilities. Instead, they are well trained dogs comfortable in a range of social settings. In some communities, therapy dogs are approved by ad hoc volunteer groups tasked with screening dogs for behavior and personality.

Research has shown proximity to pets can reduce stress levels. Other studies have show that having dogs in the home can reduce panic attacks, and the effects of post-traumatic stress disorder, or manic depression.

Competitive Bidding savings Money, but loses Experience

The ongonig debate about the United State's budget has continued deep into the summer. Much of the debate has centered around medicare and the government's role in health care funding. One compromise plan proposed has is called "Competitive Bidding." Simply put: 

All plans in a market (e.g., a county), fee-for-service included, offer bids for the cost above the standard Part B premium of provision of a standardized set of benefits (e.g., the current Medicare benefit) for an average beneficiary. The lowest bid in a market — whether from a private plan or from fee-for-service Medicare — establishes the subsidy (premium support) offered for enrollment into any plan in the market. This amount would then be risk-adjusted according to beneficiary health status. Beneficiaries opting for plans with higher costs (bids) or additional benefits would pay the additional cost. Means testing or a low-income subsidy program, as exists in today’s Medicare, could be incorporated to protect poorer beneficiaries from high residual out-of-pocket costs.

This sort of plan could satisfying both sides of the ideological debate. 


There is, however, a problem. By basing all pricing on a bid process, small, locally focused  home healthcare providers might be pushed out of the market by large national companies. According to one study, lowball bids from large providers could introduce inefficiencies and accounted expenses to the current system.


It also pushes more expenses providers out of the market. By undercutting smaller companies, large providers will be able to place inexperienced nurses and medical techs into homes without a free of medical backlash.  


Chicago Home Care

“It Begins with Education”: Five Questions for a Fellow with Jillian Heck and Melissa Warriner

 A Great Q&A with some medical students from the Philly area talking about the after school HIV/AIDS prevention program they founded.

A 2008 article in the Philadelphia Inquirer stated that HIV/AIDS infection rates are “more than five times the national average” in the Greater Philadelphia area. Furthermore, another study states that 34% of adolescents have had sex by the time they are in 9th grade. These two facts astounded us and served as the main motivation for our project, which targets middle-school aged adolescents and provides them with HIV/AIDS education through the use of physical activity.

New Medicare rules tighten screening for home health care services

This month a new Medicare rule takes effect regarding screenings home healthcare workings. The goal of this new rule, part of last years healthcare reform bill, is the reduce fraud and increase the safety and working conditions of health care workers.

Research shows that patients who are seen in the weeks after being hospitalized are less likely to be back in the hospital," said Ratner, also an associate professor of medicine at the University of Minnesota. "The idea that a patient needs skilled services, nursing or physical therapy but doesn't need a physician visit isn't even logical.

This rule is a positive thing for nurses or physical therapy. This reduces not only the stress levels of home health care workers, but their liability. By requiring patients to have regular visits with a physician, prescriptions remain up-to-date and health issues are monitored. An at home nurse or physical therapist's job is assist in the day-to-day life not diagnosis and outline treatment.

Communicating with a loved one with Dementia

I came across this post today with great information about communicating with a loved with with dementia:

If your father is asking the same question over and over - "Where are we going?" Answer his question, but also write it down on a notepad and give it to him. When he asks again, tell him the answer is on the notepad. This will help him retain the answer and keep him from asking again.

For more information about memory supported living, visit CMSSChicago.org

New Essay on the Advantages of Electronic Medical Records

Yesterday, while doing some research on ways to increase patient safety, I came across this essay and I though you might it useful: Electronic Medical Records and Patient Safety.

How To Find a Physical Therapy Job in the United States

In previous posts we talked about the steps nurses must take in order to work in the United States. This post will look at some additional steps Physical therapists must take in order to be awarded work permits.

Physical therapists are required to take and pass the Foreign Credentialing Commission on Physical Therapy (FCCPT) exam. The TCCPT exam was designed to assist the U.S. Citizenship and Immigration Services verify the credentials of international candidates.  

The first step is to decide where in the United States you want to work. PT licensing is done at a state level. So once you have picked a location, you will then need to seek out the specific requires for that state. Each state has its own rules, they can be similar, but little differences can make a big difference. Once you have figured out where you want to work, it is time apply. Each state is going to require you ti fill out an application, and prove that you have met their educational requirements. Than you will receive authorization to take the National Physical Therapy Examination (NPTE).

The next step is getting approval to immigrate to the US to work. You will need to get a H1B visa. This requires sponsor and an employer prior to show that you have a job and an in person interview.

You will also need a healthcare work Certificate. This will show that you have met the education al requirements and have the necessary English skills to work in the United States.

If this seems overwhelming, do not worry. There are physical therapy recruitment organizations throughout the US that will help you organize your information and work with you to obtain approval to work with in the united states. Once you get your visa they will help you find a place to live and organize transportation to get your too and from your new job while you adjust to living in the united states.  

Preparing for an International Nursing Job

Traveling abroad to pursue a career in nursing can be both an amazing adventure and a great opportunity to hone your skills. But it is not a discussion to make lightly. This article will look at the things that one should keep in mind when making the decision to apply for an international nursing job.

TOEFL and TSE Exams

1Employers and recruiters in the United States require potential recruits to pass the TOEFL and TSE exams. TOELF (Test of English as a Foreign Language) tests a person's ablity to undersatand on English in an academic setting. These scores good for two years since an individual's grasp of a language can change drastically in a short time. In some cases, agencies in the US will refund or cover the cost of English Qualification exams. For those interested in an international nursing job a mastery of English is just as important as a mastery of nursing.

VisaScreen

A VisaScreen certificate is required by the United States for all individuals seeking temporary or permanent residents while working internationally as a nurse. In order to receive a VisaScreen certificate one must achieve minimum scores as a series of standardized language exams as well as show proof that one has successfully graduated from a government accredited nursing program. VisaScreen also requires a minimum number of classroom hours and clinical hours.

Picking the Correct Program

With exams and tests out of the way, what does one looking for an international nursing job need to look for when seeking a placement agency or recruiter? Start by picking a location in which you would like to work. Many recruitment and placing agencies focus on placing nurses on a city or geographic region. Once you have settled on a location, look at the benefits that the agency offers. It is best to look for an agency that provides housing assistance, vacation days and health insurance. Housing assistance is very important. For someone new to a country, navigating an unfamiliar city while looking for a place to live can be very stressful. A recruitment agency can work with you to find a place to live and secure a lease. This can make the transition far less stressful.

Things to think about when searching for Nursing care

The search for a nursing home can be a difficult time for most. It indicates that a loved one is reaching a point in their life where living on their own has become difficult if not impossible. This difficulty is increased by the older generations' negative perception of how nursing homes used to be. Much has changed since those days. Reform and regulations as well as changes in education have improved the care that one received while living in a nursing home. With this article I hope we hope in give you an outline things to look for when searching for nursing homes in Chicago.

What to look for in a Facility

This set of the process is going to be the easiest.Skilled care facilities need to have a few things. Does the building proved basic the safety features important to seniors? Are there hand rails along the walls? Are the floors kept clean and dry? Would the building be easy to clear in the case of an emergency? Is nursing home clean? Is there a lingering odor?

Staff and Care

Getting a sense of the quality of care can be more difficult. It can be hard to get a sense of how a nursing home is run in the short time you are their taking a tour. Watch how the staff interacts with residents. Are they respectful? Does the staff engage with residents? Think about what sort of activities are available and a daily and weekly basis. How is the food? Is it hot, attractive, and tasty? How do they deal with special dietary needs or special requests?

Finding Nursing Jobs in the United States

Finding Nursing Jobs in the United States

Finding a nursing job in the United States can be very difficult. There is a large need for nurses but not enough people to find the jobs. This makes it a very competitive job market. Some organizations, home healthcare specifically, are turning towards international candidates to fill the need.

Finding Nursing Jobs in the United States 

If you are living outside the United States, finding and securing employment can be daunting. Many people are turning to nursing recruitment agencies.

These nursing recruitment agencies are able to help candidates match thier skills with recruitment, placement, and staffing agency who in turn will place qualified candidates in the United States.

Nursing recruitment agencies will also help candidates find housing and potentally provide transportation. This makes the the transition to working in United States less stressful.

Things to think about when searching for Nursing care

The search for a nursing home can be a difficult time for most. It indicates that a loved one is reaching a point in their life where living on their own has become difficult if not impossible. This difficulty is increased by the older generations' negative perception of how nursing homes used to be. Much has changed since those days. Reform and regulations as well as changes in education have improved the care that one received while living in a nursing home. With this article I hope we hope in give you an outline things to look for when searching for nursing homes in Chicago.

What to look for in a Facility

This set of the process is going to be the easiest.Skilled care facilities need to have a few things. Does the building proved basic the safety features important to seniors? Are there hand rails along the walls? Are the floors kept clean and dry? Would the building be easy to clear in the case of an emergency? Is nursing home clean? Is there a lingering odor?

Staff and Care

Getting a sense of the quality of care can be more difficult. It can be hard to get a sense of how a nursing home is run in the short time you are their taking a tour. Watch how the staff interacts with residents. Are they respectful? Does the staff engage with residents? Think about what sort of activities are available and a daily and weekly basis. How is the food? Is it hot, attractive, and tasty? How do they deal with special dietary needs or special requests?