/PRNewswire/ -- As October 1, 2009 signals the beginning of the new fiscal year 2010, the American Health Care Association (AHCA) said cuts of up to $16 billion over ten years to Medicare funded nursing home care being put into effect today by the Centers for Medicare and Medicaid Services (CMS) must be taken into account by U.S. Senate and House leaders as they continue to refine the financing details of their respective health care reform bills.
"By any standard, the $16 billion ten-year cuts to Medicare funded nursing home care going into effect today represent an enormous blow to the stability our sector requires to ensure the ongoing provision of quality nursing home care," said Bruce Yarwood, President and CEO of AHCA. "As health reform deliberations continue, we respectfully urge lawmakers to keep in mind that any additional Medicare cuts will be on top of this $16 billion ten year regulatory cut implemented today. Without a doubt, the care and well being of the nation's most vulnerable seniors will clearly be at stake if any new cuts are excessive."
Yarwood said it is critical to keep in mind the nature as well as the structural fragility of America's nursing home patient-base and workforce. America's nursing homes provide care and services to 1.6 million patients annually. 52% are over age 85, 73% are women, 14% are non-white, and 54% have annual incomes of less than $10,000 annually. The AHCA leader noted nursing homes and other long-term care facilities employ over 2.1 million caregivers - 86% of whom are women, and 30% of whom are non-white. The average worker is a single, low income mother between the ages of 25 and 54.
"Arguments being made by some that seniors' benefits will not be reduced by cuts now contemplated ignore the fact that when Medicare cuts provider reimbursement, providers, in turn, are forced to cut staff because labor expenses comprise 70 percent of facility costs. Cutting staff within a facility, has a direct, immediate, negative impact on patients and their care - and that is what we fear most in terms of how the eventual final reform bill may be crafted."
Yarwood also urged lawmakers to take into account the fact the Medicaid program already under funds the cost of providing care by at least $4.2 billion annually, according to Eljay, LLC, thereby already placing enormous stress on facilities and staff before federal Medicare cuts even enter the picture.
The National Governors' Association (NGA), National Council of State Legislators (NCSL), and other independent policy analysts and organizations, he said, have already sounded the alarm that state Medicaid funding cuts coupled with poor economic conditions are already threatening vulnerable populations. "As independent research has corroborated time and again, Medicare and Medicaid funding must be viewed together - not in isolation," Yarwood continued. "The combination of cuts to both programs present a clear and present danger to every aspect of facility operations - and ultimately to patient care itself."
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Showing posts with label seniors. Show all posts
Showing posts with label seniors. Show all posts
Thursday, October 01, 2009
Tuesday, September 15, 2009
Seniors in Medicare Advantage Receive Higher Quality Care, New Reports Show
TT Note: And this is the plan the current health care reform bill will cut? What's wrong with this picture?
/PRNewswire/ -- Seniors in Medicare Advantage spent fewer days in a hospital, were subject to fewer hospital re-admissions, and were less likely to have "potentially avoidable" admissions, for common conditions ranging from uncontrolled diabetes to dehydration, according to a new analysis of publicly available AHRQ data released today by America's Health Insurance Plans (AHIP).
The new study echoes the findings of an earlier analysis of AHIP member data showing that seniors in Medicare health plans can receive higher quality care compared to fee-for-service (FFS) Medicare.
"Medicare Advantage plans coordinate care, help seniors manage chronic conditions, and focus on prevention to help seniors stay healthy in the first place," said Karen Ignagni, President and CEO of AHIP.
Instead of focusing almost exclusively on treating beneficiaries when they are sick, Medicare Advantage plans place a strong emphasis on preventive health care services that detect diseases at an early stage and disease management programs for seniors with chronic illnesses to help them keep their conditions under control. These programs are working to help keep patients out of the hospital and avoid potentially harmful complications.
The new study analyzed statewide datasets on hospital admissions in California and Nevada compiled by the Agency for Healthcare Research and Quality (AHRQ). The unique data in these states allows for direct comparisons of utilization rates among enrollees in Medicare Advantage plans and in FFS Medicare. These comparisons were adjusted for health status using the Medicare risk score process for age, sex, and 70 Hierarchical Condition Categories that are used as a basis for Medicare risk adjustment. Key findings from the report include:
-- Medicare Advantage beneficiaries in California spent 30 percent fewer
days in the hospitals than patients with FFS Medicare, and in Nevada,
seniors in Medicare Advantage plans spent 23 percent fewer days in the
hospital.
-- Medicare Advantage enrollees were re-admitted to the hospital in the
same quarter for the same condition 15 percent less often in
California and 33 percent less often in Nevada compared to FFS
Medicare.
-- In both California and Nevada, seniors in Medicare Advantage were 6
percent less likely than seniors in FFS Medicare to be admitted to the
hospital for conditions described by AHRQ as "potentially avoidable,"
such as dehydration, urinary tract infection, or uncontrolled
diabetes.
The new analysis follows a previous AHIP study comparing utilization rates among patients in eight Medicare health plans compared to seniors in FFS Medicare. This study among seniors with certain chronic conditions in California and Nevada also found that:
-- Medicare Advantage beneficiaries spent an average of 18 percent fewer
days in the hospital than seniors in FFS Medicare.
-- Seniors in Medicare Advantage had an average of 27 percent fewer
visits to the emergency room than those seniors in traditional
Medicare.
-- Seniors enrolled in Medicare Advantage health plans also experienced a
42 percent lower rate of hospital re-admissions than those seniors in
FFS Medicare.
-- Avoidable admissions to the hospital were 13 percent lower among
seniors in Medicare Advantage plans than those in traditional
Medicare.
Policymakers and stakeholders recognize that reducing preventable hospital admissions and readmissions are important steps towards improving the quality and safety of patient care and helping to put our health care system on a more sustainable path. These studies demonstrate that the programs Medicare Advantage plans have implemented provide a model for how this can be accomplished.
The health care reform proposals currently being considered in Congress include significant cuts to the Medicare Advantage program that would risk the health security of millions of seniors across the country. Seniors would face higher premiums, reduced benefits, and, in some parts of the country, would lose access to their Medicare Advantage plan altogether.
"The entire Medicare program, including Medicare Advantage, should be carefully evaluated as part of comprehensive health care reform. However, seniors in Medicare Advantage should not be forced to fund a disproportionate share of the costs to reform the health care system," said Ignagni.
-----
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/PRNewswire/ -- Seniors in Medicare Advantage spent fewer days in a hospital, were subject to fewer hospital re-admissions, and were less likely to have "potentially avoidable" admissions, for common conditions ranging from uncontrolled diabetes to dehydration, according to a new analysis of publicly available AHRQ data released today by America's Health Insurance Plans (AHIP).
The new study echoes the findings of an earlier analysis of AHIP member data showing that seniors in Medicare health plans can receive higher quality care compared to fee-for-service (FFS) Medicare.
"Medicare Advantage plans coordinate care, help seniors manage chronic conditions, and focus on prevention to help seniors stay healthy in the first place," said Karen Ignagni, President and CEO of AHIP.
Instead of focusing almost exclusively on treating beneficiaries when they are sick, Medicare Advantage plans place a strong emphasis on preventive health care services that detect diseases at an early stage and disease management programs for seniors with chronic illnesses to help them keep their conditions under control. These programs are working to help keep patients out of the hospital and avoid potentially harmful complications.
The new study analyzed statewide datasets on hospital admissions in California and Nevada compiled by the Agency for Healthcare Research and Quality (AHRQ). The unique data in these states allows for direct comparisons of utilization rates among enrollees in Medicare Advantage plans and in FFS Medicare. These comparisons were adjusted for health status using the Medicare risk score process for age, sex, and 70 Hierarchical Condition Categories that are used as a basis for Medicare risk adjustment. Key findings from the report include:
-- Medicare Advantage beneficiaries in California spent 30 percent fewer
days in the hospitals than patients with FFS Medicare, and in Nevada,
seniors in Medicare Advantage plans spent 23 percent fewer days in the
hospital.
-- Medicare Advantage enrollees were re-admitted to the hospital in the
same quarter for the same condition 15 percent less often in
California and 33 percent less often in Nevada compared to FFS
Medicare.
-- In both California and Nevada, seniors in Medicare Advantage were 6
percent less likely than seniors in FFS Medicare to be admitted to the
hospital for conditions described by AHRQ as "potentially avoidable,"
such as dehydration, urinary tract infection, or uncontrolled
diabetes.
The new analysis follows a previous AHIP study comparing utilization rates among patients in eight Medicare health plans compared to seniors in FFS Medicare. This study among seniors with certain chronic conditions in California and Nevada also found that:
-- Medicare Advantage beneficiaries spent an average of 18 percent fewer
days in the hospital than seniors in FFS Medicare.
-- Seniors in Medicare Advantage had an average of 27 percent fewer
visits to the emergency room than those seniors in traditional
Medicare.
-- Seniors enrolled in Medicare Advantage health plans also experienced a
42 percent lower rate of hospital re-admissions than those seniors in
FFS Medicare.
-- Avoidable admissions to the hospital were 13 percent lower among
seniors in Medicare Advantage plans than those in traditional
Medicare.
Policymakers and stakeholders recognize that reducing preventable hospital admissions and readmissions are important steps towards improving the quality and safety of patient care and helping to put our health care system on a more sustainable path. These studies demonstrate that the programs Medicare Advantage plans have implemented provide a model for how this can be accomplished.
The health care reform proposals currently being considered in Congress include significant cuts to the Medicare Advantage program that would risk the health security of millions of seniors across the country. Seniors would face higher premiums, reduced benefits, and, in some parts of the country, would lose access to their Medicare Advantage plan altogether.
"The entire Medicare program, including Medicare Advantage, should be carefully evaluated as part of comprehensive health care reform. However, seniors in Medicare Advantage should not be forced to fund a disproportionate share of the costs to reform the health care system," said Ignagni.
-----
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