The Affordable Care Act would not keep healthcare costs down, testified David Foster, chief actuary for the Centers for Medicare & Medicaid Services, before the House Budget Committee.
Foster also said that healthcare costs might actually increase if Medicare cuts to nursing homes, hospitals and home health agencies wind up being politically unpopular, the Associated Press reports. These cuts, Foster said, could push 15% of providers out of the business. Additionally, he said that the healthcare law funnels savings from Medicare to coverage for the uninsured.
White House officials have disputed Foster's analysis throughout the healthcare reform process. His assessment came last week in direct response to President Obama's State of the Union address.
Monday, January 31, 2011
Wednesday, January 26, 2011
States expanding Medicare waiver programs to include assisted living
The recession has greatly affected the elderly and those who provide for them. A new AARP report shines some much needed light on how states are changing elder care in response to the recession. Many states are using the economic downturn to restructure funding into lower cost services such as assisted living.
AARP compiled data from all 50 states and the District of Columbia in a new report on the recession’s affect on demand and funding for state programs catering to older individuals. The report found that states, in an attempt to balance the budget, have largely cut services relating to seniors, but at the same time demand for these services has grown. The demand for assisted living was one of the fasted growing, increasing in 17 states.
Recognizing the problems at hand, many states are using the economic downturn as an opportunity to restructure funding, such as expanding the assisted living waiver program, allowing more seniors on state aid to take advantage of assisted living communities.
AARP compiled data from all 50 states and the District of Columbia in a new report on the recession’s affect on demand and funding for state programs catering to older individuals. The report found that states, in an attempt to balance the budget, have largely cut services relating to seniors, but at the same time demand for these services has grown. The demand for assisted living was one of the fasted growing, increasing in 17 states.
Recognizing the problems at hand, many states are using the economic downturn as an opportunity to restructure funding, such as expanding the assisted living waiver program, allowing more seniors on state aid to take advantage of assisted living communities.
Tuesday, January 25, 2011
Aging doctors
About eight years ago, at the age of 78, a vascular surgeon in California operated on a woman who then developed a pulmonary embolism. The surgeon did not respond to urgent calls from the nurses, and the woman died.
Even after the hospital reported the doctor to the Medical Board of California, he continued to perform operations for four years until the board finally referred him for a competency assessment at the University of California, San Diego.
“We did a neuropsychological exam, and it was very abnormal,” said Dr. William Norcross, director of the physician assessment program there, who did not identify the surgeon. “This surgeon had visual-spatial abnormalities, could not do fine motor movements, could not retain information, and his verbal I.Q. was much lower than you’d expect.”
Yet “no one knew he had a cognitive deficit, and he did not think he had a problem,” Dr. Norcross continued. The surgeon was asked to surrender his medical license.
One-third of the nation’s physicians are over 65, and that proportion is expected to rise. As doctors in the baby boom generation reach 65, many are under increasing financial pressures that make them reluctant to retire.
Many doctors, of course, retain their skills and sharpness of mind into their 70s and beyond. But physicians are hardly immune to dementia, Parkinson’s disease, stroke and other ills of aging. And some experts warn that there are too few safeguards to protect patients against those who should no longer be practicing. “My guess is that John Q. Public thinks there is some fail-safe mechanism to protect him from incompetent physicians,” Dr. Norcross said. “There is not.”
Even after the hospital reported the doctor to the Medical Board of California, he continued to perform operations for four years until the board finally referred him for a competency assessment at the University of California, San Diego.
“We did a neuropsychological exam, and it was very abnormal,” said Dr. William Norcross, director of the physician assessment program there, who did not identify the surgeon. “This surgeon had visual-spatial abnormalities, could not do fine motor movements, could not retain information, and his verbal I.Q. was much lower than you’d expect.”
Yet “no one knew he had a cognitive deficit, and he did not think he had a problem,” Dr. Norcross continued. The surgeon was asked to surrender his medical license.
One-third of the nation’s physicians are over 65, and that proportion is expected to rise. As doctors in the baby boom generation reach 65, many are under increasing financial pressures that make them reluctant to retire.
Many doctors, of course, retain their skills and sharpness of mind into their 70s and beyond. But physicians are hardly immune to dementia, Parkinson’s disease, stroke and other ills of aging. And some experts warn that there are too few safeguards to protect patients against those who should no longer be practicing. “My guess is that John Q. Public thinks there is some fail-safe mechanism to protect him from incompetent physicians,” Dr. Norcross said. “There is not.”
Moving an Elderly Loved One
This second article on moving an elderly loved one overs valuable tips and tools to ease the stress of a later life transition.
By KAREN STABINER
A middle-aged son and his mother — she in her late 80s, eager for life but tired of driving and cooking and feeling isolated — find a sun-drenched studio unit in a beautiful, service-laden independent- and assisted-living facility. They’re both thrilled and relieved, until a couple of weeks before move-in day, at which point the mother suddenly balks.
She doesn’t want to move. She so adamantly doesn’t want to move that she stays in her old apartment for a month after the new lease is signed, visiting her eventual home for the occasional meal, taking her time. Read the full article on the NYT New Old Age Blog
By KAREN STABINER
A middle-aged son and his mother — she in her late 80s, eager for life but tired of driving and cooking and feeling isolated — find a sun-drenched studio unit in a beautiful, service-laden independent- and assisted-living facility. They’re both thrilled and relieved, until a couple of weeks before move-in day, at which point the mother suddenly balks.
She doesn’t want to move. She so adamantly doesn’t want to move that she stays in her old apartment for a month after the new lease is signed, visiting her eventual home for the occasional meal, taking her time. Read the full article on the NYT New Old Age Blog
Monday, January 24, 2011
More hospices providing alternative therapies
Approximately 42% of U.S. hospices are offering alternative therapies such as massages or pet therapy, which are considered “complementary and alternative” therapies that don't fall under the rubric of standard care.
Almost 72% of American hospices that offer alternative therapies now offer massages, while 69% provide support group therapy and 62% offer music therapy, according to data compiled by the Centers for Disease Control and Prevention.
Researchers point out that while these alternative therapies aren't usually covered by insurance, they significantly contribute to the patient's quality of life while calming their anxieties and improving their moods. The CDC study was published in Wednesday's edition of National Health Statistics Report.
Almost 72% of American hospices that offer alternative therapies now offer massages, while 69% provide support group therapy and 62% offer music therapy, according to data compiled by the Centers for Disease Control and Prevention.
Researchers point out that while these alternative therapies aren't usually covered by insurance, they significantly contribute to the patient's quality of life while calming their anxieties and improving their moods. The CDC study was published in Wednesday's edition of National Health Statistics Report.
Will 2011 be a better year for the reverse mortgage?
Reverse mortgages took it on the chin in 2011. During the year, reverse mortgages volumes have suffered as a result of the continuation of declining home prices, regulatory changes and headline risk associated with high costs and stories where seniors have been taken advantage of as part of the process.
Final numbers released from Reverse Market Insight show that volumes 35% during 2010, with 72,748 units being endorsed in 2010.
The data for 2010 shows a significant drop in active lenders leading to increasing market share and volumes for lenders who have survived during the last few years. Volumes in December show that Wells Fargo remained the top lender by unit volume followed by Bank of America and MetLife rounding out the top 3.
Read full report...
Final numbers released from Reverse Market Insight show that volumes 35% during 2010, with 72,748 units being endorsed in 2010.
The data for 2010 shows a significant drop in active lenders leading to increasing market share and volumes for lenders who have survived during the last few years. Volumes in December show that Wells Fargo remained the top lender by unit volume followed by Bank of America and MetLife rounding out the top 3.
Read full report...
Wednesday, January 19, 2011
Do I need Medicare Part B?
Need Medicare Part B? If you’re eligible, now is the time to sign up. The general enrollment period for Medicare Part B runs from January 1 through March 31. Before you make a decision about general enrollment, let us fill you in on some general information.
Medicare is a medical insurance program for retired and disabled people. Some people are covered only by one type of Medicare; others opt to pay extra for more coverage. Understanding Medicare can save you money; here are the facts.
There are four parts to Medicare: Parts A, B, C and D. Part A helps pay for inpatient hospital care, skilled nursing care, hospice care, and other services. Part B helps pay for doctors' fees, outpatient hospital visits, and other medical services and supplies not covered by Part A. Part C allows you to choose to receive all of your health care services through a provider organization. These plans, known as Medicare Advantage Plans, may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C. And Part D is the Medicare Prescription Drug Program.
Most people first become eligible for Medicare at age 65, and there is a monthly premium for Medicare Part B. In 2011, the standard premium is $115.40. Some high-income individuals pay more than the standard premium. Your Part B premium also can be higher if you do not enroll during your initial enrollment period, or when you first become eligible.
There are exceptions to this rule. For example, you can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. If this situation applies to you, you can sign up for Medicare Part B without paying higher premiums:
• Any month you are under a group health plan based on your own current employment or the current employment of any family member; or
• Within eight months after your employment or group health plan coverage ends, whichever comes first.
If you are disabled and working (or you have coverage from a working family member), the same rules apply.
Remember: Most people are automatically enrolled in Medicare Part B when they become eligible. If you don’t enroll in Medicare Part B when you first become eligible to apply and you don’t fit into one of the above categories, you'll have to wait until the general enrollment period, which is January 1 through March 31 of each year. At that time, you may have to pay a higher Medicare Part B premium.
For more information about Medicare Parts A, B, C, and D, visit the Centers for Medicare & Medicaid Services (CMS) website at www.medicare.gov. Or read our publication on Medicare at www.socialsecurity.gov/pubs/10043.html.
Medicare is a medical insurance program for retired and disabled people. Some people are covered only by one type of Medicare; others opt to pay extra for more coverage. Understanding Medicare can save you money; here are the facts.
There are four parts to Medicare: Parts A, B, C and D. Part A helps pay for inpatient hospital care, skilled nursing care, hospice care, and other services. Part B helps pay for doctors' fees, outpatient hospital visits, and other medical services and supplies not covered by Part A. Part C allows you to choose to receive all of your health care services through a provider organization. These plans, known as Medicare Advantage Plans, may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C. And Part D is the Medicare Prescription Drug Program.
Most people first become eligible for Medicare at age 65, and there is a monthly premium for Medicare Part B. In 2011, the standard premium is $115.40. Some high-income individuals pay more than the standard premium. Your Part B premium also can be higher if you do not enroll during your initial enrollment period, or when you first become eligible.
There are exceptions to this rule. For example, you can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. If this situation applies to you, you can sign up for Medicare Part B without paying higher premiums:
• Any month you are under a group health plan based on your own current employment or the current employment of any family member; or
• Within eight months after your employment or group health plan coverage ends, whichever comes first.
If you are disabled and working (or you have coverage from a working family member), the same rules apply.
Remember: Most people are automatically enrolled in Medicare Part B when they become eligible. If you don’t enroll in Medicare Part B when you first become eligible to apply and you don’t fit into one of the above categories, you'll have to wait until the general enrollment period, which is January 1 through March 31 of each year. At that time, you may have to pay a higher Medicare Part B premium.
For more information about Medicare Parts A, B, C, and D, visit the Centers for Medicare & Medicaid Services (CMS) website at www.medicare.gov. Or read our publication on Medicare at www.socialsecurity.gov/pubs/10043.html.
Saturday, January 15, 2011
The Gracious Mindset of Seasoned Citizens
by Garry Harper, author & theologian
There’s nothing like a lifetime when it comes to putting mistakes into context. Who among us can’t recall a poor decision here or there that seemed to change the vector of our lives? And yet, when one reaches the age of “real” enlightenment – say 55 – looking back brings far more smiles than frowns of disappointment.
Could it be that grace moves like an arc over the span of our lives? While we’re traveling on the straight line of time, grace moves over and above us at a somewhat quicker pace. It is most distant from us – almost out of our reach – when we’re raising our own children. In our late 20’s and early 30’s we’re tempted to indulge ourselves in sophomoric self-righteousness. Somehow, the mistakes we made in our youth seem so large that we try to extinguish the fires of “creativity” out of our own similarly exuberant children.
Is there a grandparent among us who doesn’t secretly smile at the predictable naughtiness of our grandchildren or even laugh (behind the door of the guest room) at Christmas?
It would seem that the arc of grace finally reconnects with all of us in our golden years. We see things so clearly because we have finally learned that God has a way of teaching everyone what they really need to know just in time to enjoy the human condition. Then, graciously, we’re allowed to graduate into his presence. Theologians define “grace” as unmerited favor. It is only when we reach our full maturity that we finally give in and admit there is such a thing as “the human condition.” Imperfections quietly become evidence of character and we learn to appreciate the characters in our lives. We forgive because we have experienced forgiveness.
I recall my own grandfather. He had a funny way of looking up and off to the right, shaking his head, smiling and making a shhh sound whenever I was caught in the act of some mild misbehavior. Now I know why. I think he was, as I do now, merely having a silent conversation with God as both he and the Supreme Father of us all mused over the predictability of juvenile behavior.
Now that we’re older – and clearly wiser – let’s enjoy the full power of grace. We’re living in a time of uncertainty and we’re watching the next generation struggle through a poor economy and a crisis of confidence in our government. Emotions are high and anger seems to emerge far more often than necessary. From our vantage point the “children” of our nation are fighting over what they believe are limited resources. If they only knew what we know – that God has always provided exactly what we need when we need it – they might relax for just a moment and look upward. There, just out of their reach but still visible, they would see the arc of grace.
by Garry Harper, author & theologian
There’s nothing like a lifetime when it comes to putting mistakes into context. Who among us can’t recall a poor decision here or there that seemed to change the vector of our lives? And yet, when one reaches the age of “real” enlightenment – say 55 – looking back brings far more smiles than frowns of disappointment.
Could it be that grace moves like an arc over the span of our lives? While we’re traveling on the straight line of time, grace moves over and above us at a somewhat quicker pace. It is most distant from us – almost out of our reach – when we’re raising our own children. In our late 20’s and early 30’s we’re tempted to indulge ourselves in sophomoric self-righteousness. Somehow, the mistakes we made in our youth seem so large that we try to extinguish the fires of “creativity” out of our own similarly exuberant children.
Is there a grandparent among us who doesn’t secretly smile at the predictable naughtiness of our grandchildren or even laugh (behind the door of the guest room) at Christmas?
It would seem that the arc of grace finally reconnects with all of us in our golden years. We see things so clearly because we have finally learned that God has a way of teaching everyone what they really need to know just in time to enjoy the human condition. Then, graciously, we’re allowed to graduate into his presence. Theologians define “grace” as unmerited favor. It is only when we reach our full maturity that we finally give in and admit there is such a thing as “the human condition.” Imperfections quietly become evidence of character and we learn to appreciate the characters in our lives. We forgive because we have experienced forgiveness.
I recall my own grandfather. He had a funny way of looking up and off to the right, shaking his head, smiling and making a shhh sound whenever I was caught in the act of some mild misbehavior. Now I know why. I think he was, as I do now, merely having a silent conversation with God as both he and the Supreme Father of us all mused over the predictability of juvenile behavior.
Now that we’re older – and clearly wiser – let’s enjoy the full power of grace. We’re living in a time of uncertainty and we’re watching the next generation struggle through a poor economy and a crisis of confidence in our government. Emotions are high and anger seems to emerge far more often than necessary. From our vantage point the “children” of our nation are fighting over what they believe are limited resources. If they only knew what we know – that God has always provided exactly what we need when we need it – they might relax for just a moment and look upward. There, just out of their reach but still visible, they would see the arc of grace.
Thursday, January 13, 2011
Boomers and seniors digging into savings for housing
Baby Boomers and seniors in the United States are taking a more pragmatic approach to their housing choices as an effect of the economic downturn according to a new study released today. A joint study by the 50+ Housing Council of the National Association of Home Builders (NAHB) and the MetLife Mature Market Institute reveals that home design considerations have taken a back seat as financial matters have been more prominent in home purchase process for 55+ buyers.
The new study, "Housing Trends Update for the 55+ Market,", explores households living in active adult communities, either age-qualified active adult communities where at least one resident must be age 55+, other non-age-qualified 55+ owner-occupied communities (not explicitly restricted to 55+ households but nevertheless occupied primarily by people age 55+), or age-restricted rental communities.
"By the year 2020, as Baby Boomers move into this age bracket, almost 45 percent of all U.S. households will include someone at least 55 years old," said David Crowe, NAHB’s chief economist. "The number of those households seeking housing better suited to their changing needs will therefore rise dramatically."
NAHB predicts that 54,000 housing starts are projected in 55+ communities this year, a 30 percent rise from estimated 2010 levels and that number is expected to increase another 46 percent to roughly 79,000 housing units in 2012. The average price of homes in the active adult segment were $319,000 in 2010 with buyers having an average income of more than $80,000 per year.
The survey finds that 55% of new age-restricted adult home buyers used the proceeds from the sale of their previous home as down payment where 45% used cash or savings as their down payment on their new home in 2009. This represents a significant change in prior years when over 90% of buyers in 2005 and 2007 used proceeds from the sale of their homes for down payments. The survey still finds that seniors want to be close to friends and family as well close to work.
Monday, January 10, 2011
More trouble at the Border…
Boomers, are you aware that Medicare stops at the Border? The exposure to financial harm is high for anyone traveling outside the United States, especially for seniors who are on Medicare, since Medicare stops at the border except for limited circumstances. If you have a Medicare Supplement, there is some relief for emergency medical care, but that too has limits – you can very easily exceed the limit causing you to dip into your retirement savings.
The lifetime maximum for foreign travel coverage outside the United States on Medicare Supplement policies is $50,000. This amount can be easily exceed when traveling. Without Travel Medical Insurance, you are required to pay for services at the time you receive them. However, if you have travel medical insurance, those issues are handled by the travel insurance company, not you. A call to the customer service line of your insurance company you selected is all that is necessary to begin the payment process.
When people think of travel insurance, they’re typically thinking of travel delays and baggage problems. Admittedly, cancelled flights and lost baggage are a few travel inconveniences that travelers have no control over, but one thing you can control is having the security of knowing that if you need medical care outside the country, you can be properly covered.
Here are some questions that need to be answered. Who should I buy it from; the tour operator, the travel agent or a travel insurance specialist? What type of travel insurance coverage should I buy; Medical Evacuation, Travel Medical or Trip Cancellation? When is the best time to buy travel insurance?
Buying Travel Insurance
Most, but not all, tour operators and travel agents do not hold the proper insurance licenses to offer all types of travel insurance, so they are limited in their offerings. Keep that point in mind when you are being asked to purchase travel insurance.
When booking any travel, ask if travel insurance is already included in the rate. Ask for an outline of coverage and certainly ask about the medical insurance portion of the policy, if any. If it’s not what you want, then you must opt out of the program.
What type of travel insurance is right for Medicare Recipients?
We have done analysis’ on many travel insurance programs and with our twenty years of insurance experience our recommendation for traveling seniors is to purchase an International Medical Travel Insurance policy with a trip cancellation/interruption rider. This type of policy will give you the protection on both sides of the potential problem areas which are international medical care, travel delays, interruptions, lost luggage, etc.
When to purchase travel insurance?
The best time to buy travel insurance is between 1 to 14 days of putting down the initial deposit on your trip. This will normally qualify for coverage for any pre-existing medical conditions, especially for Medicare Recipients.
The lifetime maximum for foreign travel coverage outside the United States on Medicare Supplement policies is $50,000. This amount can be easily exceed when traveling. Without Travel Medical Insurance, you are required to pay for services at the time you receive them. However, if you have travel medical insurance, those issues are handled by the travel insurance company, not you. A call to the customer service line of your insurance company you selected is all that is necessary to begin the payment process.
When people think of travel insurance, they’re typically thinking of travel delays and baggage problems. Admittedly, cancelled flights and lost baggage are a few travel inconveniences that travelers have no control over, but one thing you can control is having the security of knowing that if you need medical care outside the country, you can be properly covered.
Here are some questions that need to be answered. Who should I buy it from; the tour operator, the travel agent or a travel insurance specialist? What type of travel insurance coverage should I buy; Medical Evacuation, Travel Medical or Trip Cancellation? When is the best time to buy travel insurance?
Buying Travel Insurance
Most, but not all, tour operators and travel agents do not hold the proper insurance licenses to offer all types of travel insurance, so they are limited in their offerings. Keep that point in mind when you are being asked to purchase travel insurance.
When booking any travel, ask if travel insurance is already included in the rate. Ask for an outline of coverage and certainly ask about the medical insurance portion of the policy, if any. If it’s not what you want, then you must opt out of the program.
What type of travel insurance is right for Medicare Recipients?
We have done analysis’ on many travel insurance programs and with our twenty years of insurance experience our recommendation for traveling seniors is to purchase an International Medical Travel Insurance policy with a trip cancellation/interruption rider. This type of policy will give you the protection on both sides of the potential problem areas which are international medical care, travel delays, interruptions, lost luggage, etc.
When to purchase travel insurance?
The best time to buy travel insurance is between 1 to 14 days of putting down the initial deposit on your trip. This will normally qualify for coverage for any pre-existing medical conditions, especially for Medicare Recipients.
Splitting pills can be dangerous
The practice of splitting tablet forms of medications is a risky technique, Medical News Today reported.
Researchers found that nearly one-third of split tablet fragments varied from the recommended dosage by 15% or more, according to a study which was published in the January issue of the Journal of Advanced Nursing. Medical experts are concerned because with some medications, there is a narrow margin between therapeutic and toxic doses. They say the practice is widespread in all healthcare sectors.
"It is done for a number of reasons: to increase dose flexibility, to make tablets easier to swallow and to save money for both patients and healthcare providers,” the study's lead author, Dr. Charlotte Verrue, told Medical News Today. “However, the split tablets are often unequal sizes and a substantial amount of the tablet can be lost during splitting."
Researchers found that nearly one-third of split tablet fragments varied from the recommended dosage by 15% or more, according to a study which was published in the January issue of the Journal of Advanced Nursing. Medical experts are concerned because with some medications, there is a narrow margin between therapeutic and toxic doses. They say the practice is widespread in all healthcare sectors.
"It is done for a number of reasons: to increase dose flexibility, to make tablets easier to swallow and to save money for both patients and healthcare providers,” the study's lead author, Dr. Charlotte Verrue, told Medical News Today. “However, the split tablets are often unequal sizes and a substantial amount of the tablet can be lost during splitting."
Tuesday, January 04, 2011
Bullies with Gray Hair
Having worked for several years in assisted living I witnessed many episodes of bullying between residents. The first time I encountered it I was stunned that mature individuals would treat each other with such disrespect...Patricia Grace, Aging with Grace
Bullying may be a concern for teenagers in schools and through Facebook, but young people online are not the only targets of verbal abuse and social ostracism. Residential facilities for the elderly are not immune to abuse either.
Doris Lor, a retired secretary living in a retirement community in Chandler, Ariz., said she has been the victim of intimidation from other residents since she bought her home in 2003.
Lor, 76, lives in Solera Chandler Active Adult Retirement Community, which has more than 1,100 residents 55 years and older. She said a group of about a dozen elderly residents have not allowed her to use the community "clubhouse," where residents gather for luncheons and to play card games like canasta. "They have a clique that's meaner than mean. They don't allow you to take part in anything," Lor said. "I know another resident who still goes to play, and she just keeps her mouth shut, plays the game and leaves."
Lor said she has complained to Solera's staff, even recording a confrontation with a resident who refused to allow her to sit at a card table, but the intimidation continued. Lor said the situation became so "humiliating" that she no longer visits the communal spaces.
Read full story...
Bullying may be a concern for teenagers in schools and through Facebook, but young people online are not the only targets of verbal abuse and social ostracism. Residential facilities for the elderly are not immune to abuse either.
Doris Lor, a retired secretary living in a retirement community in Chandler, Ariz., said she has been the victim of intimidation from other residents since she bought her home in 2003.
Lor, 76, lives in Solera Chandler Active Adult Retirement Community, which has more than 1,100 residents 55 years and older. She said a group of about a dozen elderly residents have not allowed her to use the community "clubhouse," where residents gather for luncheons and to play card games like canasta. "They have a clique that's meaner than mean. They don't allow you to take part in anything," Lor said. "I know another resident who still goes to play, and she just keeps her mouth shut, plays the game and leaves."
Lor said she has complained to Solera's staff, even recording a confrontation with a resident who refused to allow her to sit at a card table, but the intimidation continued. Lor said the situation became so "humiliating" that she no longer visits the communal spaces.
Read full story...
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