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.