Category: Seniors

GPS Tracker for Grandma

walkawayI was perusing a health news website and ran across an advertisement for SmartSole, a GPS insole tracking device. It’s developed for Alzheimer’s patients and those with cognitive impairment who make be at risk of wondering away from their caregivers.

This is an example of the way technology can be harnessed to lower cost. Some nursing homes refuse to accept patients who are at high risk of running or wondering away. The alternative is locked-down, secure facilities that are more expensive and less convenient for family members. This type of technology could even be used in the future to help mom and dad could live independently while being monitored remotely.

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2015 Medicare Trustees Report: No Pot O’ Gold in Medicare’s Future

The Trustees for Social Security and Medicare released their 2015 Trustees’ Report. Liberal stalwart, Mother Jones, proclaimed how wonderful it was. Political blogger Kevin Drum had an interesting argument showing how long-term medical cost projections were down from a decade ago. However, he also conceded that others think the current slowdown is temporary. Yet, if you look at the report itself the news isn’t very reassuring. In 2000, Medicare spending as a percentage of GDP was just above 2 percent. It’s now about 3.5 percent and will be four percent by 2023.

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Seniors: ObamaCare Will Harm Us

Seniors are Feeling the Pinch of ObamaCare

A7TNAT_2180031bUnitedHealthcare, is terminating contracts with up to 2,100 doctors serving 8,000 Medicare Advantage patients in the New York metro region.

There are 2.6 million elderly New Yorkers who receive Medicare, the public health insurance program for the elderly. But one in three patients — nearly 900,000 — are enrolled in Advantage, Medicare HMOs run by private insurers.

Dr. Jonathan Leibowitz, who serves 30 patients under Medicare Advantage at his Brooklyn practice, said he was blindsided by UnitedHealthcare’s decision to give him the boot.

“A patient can’t see his doctor? What are they doing!” he asked.

UnitedHealthcare told Leibowitz that because of “significant changes and pressures in the health-care environment,” he’d be getting the ax on Jan. 1.

From the New York Post.

Is Medicaid for Seniors Regressive?

The old age provisions of the Medicaid program were designed to insure poor retirees against medical expenses. However, it is the rich who are most likely to live long and face expensive medical conditions when very old…We find that retirees with high lifetime incomes can end up on Medicaid, and often value Medicaid’s insurance features the most, as they face a larger risk of catastrophic medical needs at old ages, and face the greatest consumption risk.

Source: Medicaid Insurance in Old Age from NBER by Mariacristina De Nardi (et al).

More Evidence that Incentives Matter

“We saw it happen almost overnight,” [State Senator Diane J. Savino] said, describing programs that sprang up in sites like former auto-shops and part-time banquet halls in neighborhoods like Brighton Beach and Manhattan’s Chinatown, siphoning off low-income immigrant seniors from regular senior centers, “and basically stealing Medicaid dollars to do it.”

“We’re dealing with the unintended consequences of a very good initiative,” she added, referring to the Cuomo administration’s Medicaid redesign, which has rapidly transferred tens of thousands of elderly and disabled people from a fee-for-service system to managed care, in an attempt to reduce Medicaid spending and nursing home use.

Under the new system, managed care plans get roughly $3,800 a month for each eligible person they enroll in New York City, regardless of what services are provided. The plans contract with the social adult day care centers to provide services to their members. But advocates for the elderly and for people with disabilities have warned state officials that some plans were “cherry-picking” healthy seniors by using the new day care centers as marketing tools, while shunning the people who needed hours of costlier home care.

Joan Pastore, director of Amico, a city senior center in Dyker Heights, Brooklyn, said members of the center told her that they were not only signed up by new centers with enticements like $100 in cash and $50 for bringing a friend, but “coached on how to lie to qualify for home care.” (NYT)

Solution for Elder Care: Robots

Researchers at the Georgia Institute of Technology have developed Cody, a robotic nurse the university says is “gentle enough to bathe elderly patients.” There is also HERB, which is short for Home Exploring Robot Butler. Made by researchers at Carnegie Mellon, it is designed to fetch household objects like cups and can even clean a kitchen. Hector, a robot that is being developed by the University of Reading in England, can remind patients to take their medicine, keep track of their eyeglasses and assist in the event of a fall.

The technology is nearly there. But some researchers worry that we are not asking a fundamental question: Should we entrust the care of people in their 70s and older to artificial assistants rather than doing it ourselves? (NYT)

Fee-For-Service Would Have Cost Less

In Bensonhurst, Brooklyn, at the new R&G Social Adult Day Care Center, known locally among elderly immigrants for luring clients with cash and grocery vouchers, most people there for lunch did not stay to eat. Instead, many walked briskly toward the subway carrying bags stuffed with takeout containers, and two elderly men rode away on bicycles with the free food.

Not a wheelchair or walker was in sight at these so-called social adult day care centers. Yet the cost of attendance was indirectly being paid by Medicaid, under Gov. Andrew M. Cuomo‘s sweeping redesign of $2 billion in spending on long-term care meant for the impaired elderly and those with disabilities.

Such centers have mushroomed, from storefronts and basements to a new development in the Bronx that recently figured in a corruption scandal. With little regulation and less oversight, they grew in two years from eight tiny programs for people with dementia to at least 192 businesses across the city.

Next time you hear someone say how we need to replace fee-for-service payment with bundled payments plus managed care, pull out this article from the NYT. Matt Yglesias comments.

Working Longer

An increase in the average retirement age from 64 to 68 would save about 20 percent in social security payments since the average number of years in retirement would be cut by about 20%. Similarly, an increase in retirement age to 70 would save about 25 percent in social security retirement benefits. Either change would also add significantly to revenue from social security taxes since workers would be employed for several additional years. Therefore, such increases in age of eligibility for social security benefits would go a long way toward solving the looming social security financial “crisis.”

More on this issue in The Becker-Posner Blog.

Ah, the Bureaucracy

Of the 1.1 billion claims submitted to Medicare in 2010 for hospitalizations, nursing home care, doctor’s visits, tests and physical therapy, 117 million were denied. Of those, only 2 percent were appealed.

More from Susan Jaffe from the Kaiser Health News.