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  • MediCaring model – MediCaring.org
    and savings targets with PAC providers Under the terms of these negotiated agreements PAC coordinators would keep up to 70 of any savings realized with 10 or more to PAC providers 10 or more to the PAC physician and 10 or more to the discharging hospital Although unlikely to be enacted in this Congress BACPAC will probably be reintroduced in the 114 th session And while it may be financially attractive for certain providers beneficiaries would not see financial gains and the benefits from better navigation of services are not well established Nonetheless unless careful attention is paid to the implications of the bill it is even possible that some of the proposed reforms could be implemented administratively But the most interesting issue is where PAC dollars that are saved will go before any of the proposed legislative reforms culminate in a rebased PAC financing system In the IMPACT bill financing reforms are more than seven years away This provides a window of opportunity for capturing large savings in this sector now that research and private companies has established that substantial efficencies in the PAC sector are feasible This raises two related questions Are there models already in use that are capturing PAC savings and if so where are the savings going The answers are yes and to private investors More specifically evidence based proprietary protocols are now being used by some risk bearing contractors and managed care plans to significantly reduce PAC expenditures http healthaffairs org blog author jlynn Under these arrangements savings from taxpayer financed PAC services are not being reinvested in further improvements but rather are being funneled via contractual agreements directly into private pockets Business as usual you say Classic American capitalism Certainly But for policymakers and other guardians of the public purse and the public welfare the merits of this approach may best be examined in a larger framework the future of the U S health and long term care systems after 2020 when the largest generation of older adults in U S history will rapidly drive up demand for a mix of services that are aimed at controlling chronic conditions and mitigating the impact of functional disability Since evidence suggests that about 45 of the roughly 23 of total Medicare dollars that are spent on PAC services can be harvested http healthforum brandeis edu meetings materials 2014 18 march naviHealth Scully pdf this represents an important opportunity to have a robust policy discussion about whether PAC savings or a portion of them could be set aside to re engineer the health PAC and post PAC i e long term care systems into better organized integrated care systems The sheer size of the possible PAC savings that are available to possibly be captured over the next seven to 10 years roughly 10 of all Medicare spending makes this a particularly important case to debate thoroughly rather than merely standing by and letting the money quietly disappear The reality is that today we are still billions

    Original URL path: http://medicaring.org/tag/medicaring-model/ (2016-04-30)
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  • Medicare – Page 2 – MediCaring.org
    Island Quality Institute RIQI Dr Leviss provides strategic leadership across RIQIs initiatives to transform quality and efficiency of health care in Rhode Island including the RI Beacon Communities Program and the Health Information Exchange Prior to joining RIQI Dr Leviss led HIT initiatives at large and small health systems in the US and internationally He was the Vice President Chief Medical Officer at Sentillion the market leading health care identity and access management vendor acquired by Microsoft in 2010 and then served as Director of Clinical Solutions at Microsoft Health Solutions Group Dr Leviss was the first CMIO at the NYC Health and Hospitals Corp consulted at Cerner and Deloitte and was faculty at NYU and Columbia University Dr Leviss has chaired and served on several RI state wide committees on HIT and was a founding board member of Medical Informatics NY He regularly writes and presents on health information technology health care and physician leadership and was the editor of HIT or Miss lessons learned from health information technology implementations Dr Leviss is an internist at the Thundermist Health Center RI Dr Leviss received his BA in international relations from Tufts University and MD from NYU School of Medicine Event Care Transitions Learning Session webinar Date September 12 2013 Time 3 00 PM 4 00 PM ET Teleconference 866 639 0744 No pass code needed https qualitynet webex com Meeting Password community Please join us 15 minutes prior to the presentation to ensure the automatic system set up has been properly established Attendee Instructions 1 Click or Copy and Paste this to your web browser https qualitynet webex com 2 Locate the event you wish to join 3 Click on Join Now located to the right of the event title 4 Enter your name and email address as prompted 5 Enter the password community 6 Dial in to the teleconference The number is 866 639 0744 or 678 302 3564 The access code is none If you have any questions or problems accessing the meeting please call the Buccaneer WebEx Helpline at 540 347 7400 x390 Presentation slides will be posted prior to the call at http www cfmc org integratingcare learning sessions htm These sessions will be held on the 2nd and 4th Thursdays of the month and are open to all please invite anyone who wants to learn along with us As a reminder these sessions are recorded and all previous Learning Sessions are available at http www cfmc org integratingcare learning sessions htm If you are not already receiving notifications about our upcoming Learning Sessions you may register or update your subscription preferences at http eepurl com jOFqb MediCaring4LIFE Making Local Improvement for Frail Elders Posted by Les Morgan on August 20 2013 No Responses Tagged with community based eldercare frail elders Medicare public policy Aug 20 2013 MediCaring is a comprehensive approach to providing medical care long term care and social support services for older adults who are living with worsening disabilities and fragile health associated with aging MediCaring4LIFE is a proposed test of MediCaring s potential to improve lives and reduce costs of the period of frailty it s a proposal to the Center for Medicare and Medicaid Innovation The following YouTube video is a presentation on the Medicaring4Life proposal sponsored by the Center for Eldercare and Advanced Illness A text summary of key points in the presentation appears below the embedded video You may also view this presentation directly on YouTube http www youtube com watch v LaeHLhqDfUw MediCaring and MediCaring4LIFE Local Improvements for Frail Elders Presented by Joanne Lynn email protected and Anne Montgomery email protected Center for Elder Care and Advanced Illness Altarum Institute What MediCaring is a comprehensive approach to providing medical care long term care and social support services for older adults who are living with worsening disabilities and fragile health associated with aging MediCaring requires individualized care plans that reflect the elderly person s strengths needs and likely future and a local service delivery system that is monitored and managed to assure that what is most needed is readily available MediCaring4LIFE is a proposed test of MediCaring s potential to improve lives and reduce costs of the period of frailty it s a proposal to the Center for Medicare and Medicaid Innovation Who People over 65 who are living with disabilities or people over 85 who simply want coherent care focused upon their priorities most often including living at home staying comfortable and preserving independence The MediCaring4LIFE proposal to the Innovation Center would build MediCaring programs in four communities and serve 14 861 elderly people over three years Where MediCaring can be implemented in any community where there is local leadership and commitment The MediCaring4LIFE proposal will support reforms in four communities Akron Ohio northeastern Queens N Y Milwaukie Ore and Williamsburg Va One of the projects is led by a social services provider and the others are led by health care providers All involve Medicare clinical leaders community based organizations state Medicaid offices local managed care entities including the new managed long term care companies and community leaders By the end of the three year grant period each community will have established local coalitions and a leadership structure capable of monitoring and managing health and social services for older adults in the area into the future and able to start taking on responsibility for shared savings as part of the strategy for sustaining and continuing the gains Altarum Institute s Center for Elder Care and Advanced Illness will coordinate the MediCaring4LIFE initiative providing organization and project management coaching and collaboration with the Institute for Healthcare Improvement quality measurement and monitoring with the National Committee for Quality Assurance clinical and ethical standards development American Geriatrics Society financial monitoring and modeling Dobson DaVanzo legal analysis EpsteinBeckerGreen support for information technology Growth House Inc support for community building Community Catalyst and support for enabling involvement by frail elders and their families in transformation and governance Consumer Voice How The MediCaring4LIFE initiative will implement a set of evidence based improvement activities that assure comprehensive assessment and individualized planning ready availability of critical services at home including medical nursing home modifications transportation caregiver support and nutrition and reliable services organized by an individually negotiated care plan that guides care across all settings Financing of services will be through existing programs where appropriate primarily Medicare and Medicaid accompanied by adjustments of certain rules to permit more flexibility as well as coverage for currently non covered services with the supplemental award funding In the third year the project s financial experience and evidence will anchor specification of a shared savings model for the targeted population frail elderly people in a particular geographic area using a modified Accountable Care Organization model as the financing design for serving the needs of elders living in the four communities The MediCaring approach aims to save at least 20 from medical costs and 5 from long term care costs in the first three years By providing much more coherent care planning that is accessible to all service providers and which reflects strong input from elders and family members the choices afforded to frail elderly people with serious disabilities and coming to the end of life will expand to allow those who wish to do so to forego aggressive and burdensome medical treatments that have little chance of meaningful gains Many may instead choose services that allow them to live as well as possible in the time remaining buoyed with good symptom relief strategies that limit the effects of disabilities support for caregivers and fewer disruptions To achieve this the supportive services must be reliable and prompt so that elderly persons and their families feel confident that they can stay at home rather than resorting to the hospital at the first sign of trouble This also means that the care system must provide around the clock back up by phone and have the capability to have the appropriate service or expert go to the home promptly Both routine and urgent medical care and social supports must be available in the elderly person s residence e g home nursing home assisted living facility Frailty is a very high cost part of our lives the per person per month costs regularly top 5 000 for an average of three years before death Yet the home based primary care program for veterans has cut hospitalization by more than half and nursing home use by more than 80 If MediCaring4LIFE reduces hospital use by just 25 and reduces net long term care costs by 5 the investment of about 1 000 per person per year will yield returns of more than twice the investment Average costs per person per month will come down by about 20 and these are conservative estimates We have recorded a webinar to provide an overview of the spreadsheet calculations behind these estimates on YouTube http www youtube com watch v LaeHLhqDfUw The potential for improving life experience while saving money is feasible but it requires breaking down conventional boundaries between medical care and social supports informing affected people honestly about what they face and explaining their options helping elderly persons and their families develop care plans that are centered around their goals and preferences and developing a community focused system that can help manage the local delivery system to organize care so that the services that are most readily available are those that are most needed Why Until recently frail elderly people have been largely unrecognized in our health care system That will change with the aging of the largest single generational cohort in American history the baby boomers Millions of Americans will live into a fragile old age during the first half of the 21st century with most needing personal care assistance for three years or more The average lifetime costs of long term services in old age exceed 5 000 per month making this the most expensive part of the lifespan For the economy to thrive while so many of us are living with worsening disabilities the per capita costs of health care during the final phase of life must come down For people to live well throughout their lives the last part of life must offer opportunities for meaningfulness and must be lived with comfort and confidence MediCaring aims to make dramatic improvements in reliability trustworthiness individualization and efficiency of health and long term care by deliberate design ongoing monitoring and improvement local management and honest and well supported care plans for each individual Reducing Readmissions From the Experts Webinar Thursday August 8 3 pm ET Posted by Janice Lynch Schuster on August 7 2013 No Responses Tagged with best practices care transitions CCTP CMS community based discharge planning eldercare frail elders hospital readmissions Medicare quality improvement Aug 07 2013 As part of its ongoing series on reducing readmissions the Integrating Care for Communities project from the Colorado Foundation for Medical Care hosts a webinar on Thursday August 8 at 3 ET Details about the program can be found here with information provided by CFMC During this session we will hear from ARC Avoiding Readmissions through Collaboration California Community Based Care Transitions Program CCTP Awardee Learning Objectives Participants will Identify the structure and tactics used by the collaborative to drive readmission reduction in participating hospitals Trace the collaborative s efforts to develop a Patient Advisory Council Examine how to develop and deploy a successful relationship between a hospital and their SNFs to optimize care transitions Presented by Cheryl Reinking RN MS Interim Chief Nursing Officer El Camino Hospital Cheryl Reinking RN MS has served 25 years at El Camino Hospital in progressive nursing leadership roles her most recent being as Interim Chief Nursing Officer which she assumed in July 2013 Cheryl has led a number of hospital wide initiatives and was key to the hospital s implementation of the nationally recognized Nurses Improving Care for Healthsystem Elders NICHE program which was designed to create increased patient centric care for hospitalized older patients She developed the hospital s site specific program Pat Teske RN MHA Cynosure Health Pat Teske RN MHA is the implementation officer for Cynosure Health In her role she strives to implement the company s vision through strategic planning and execution of projects on time and within budget that yield successful outcomes Previously she held the position of vice president of Quality Improvement and Care Management for Catholic Healthcare West Pasadena CA where she lead the regions chief nursing officers quality directors case managers and medical staff directors to accomplish their annual goals As an independent contractor Pat supported BEACON the Bay Area Patient Safety Collaborative as well as other state and local collaboratives She is currently leading the Avoid Readmissions through Collaboration ARC effort in CA and working nationally with HRET on the Partnership for Patients HEN A requested public speaker at national state and local conferences including IHI NPSF and TJC Ms Teske has developed and offered numerous educational programs designed to support performance improvement and system reliability Pat received her MHA from the University of LaVern and her BS in Nursing from the University of Virginia Lisa Ehle MPH Program Manager Cynosure Health Lisa Ehle MPH is a Program Manager at Cynosure Health and currently oversees the Avoid Readmissions Through Collaboration ARC program and the ARC Patient Advisory Council Before joining Cynosure Health Lisa served as the State Director of Program Services with the March of Dimes Massachusetts Chapter where she co founded the MA Perinatal Quality Collaborative and directed a Program Services Committee charged with addressing the perinatal needs of the state She has been an advocate for maternal and child health issues including preterm birth prevention routine HIV screening smoking cessation and improving hospital discharge practices Lisa has worked at the state level for the MA Department for Public Health creating policies and guidelines for infectious disease prevention and screening programs Lisa received her Bachelor of Science in Physical and Psychiatric Rehabilitation Counseling from Boston University Sargent College and a Masters of Public Health from Boston University School of Public Health specializing in Social and Behavioral Sciences Event Care Transitions Learning Session webinar Date August 8 2013 Time 3 00 PM 4 00 PM ET Teleconference 866 639 0744 No pass code needed https qualitynet webex com Meeting Password community Please join us 15 minutes prior to the presentation to ensure the automatic system set up has been properly established Attendee Instructions 1 Click or Copy and Paste this to your web browser https qualitynet webex com 2 Locate the event you wish to join 3 Click on Join Now located to the right of the event title 4 Enter your name and email address as prompted 5 Enter the password community 6 Dial in to the teleconference The number is 866 639 0744 or 678 302 3564 The access code is none If you have any questions or problems accessing the meeting please call the Buccaneer WebEx Helpline at 540 347 7400 x390 Presentation slides will be posted prior to the call at http www cfmc org integratingcare learning sessions htm key words readmissions rehospitalizations care transitions quality improvement organizations CMS CFMC Making the Case for a Refreshed Medi Care Posted by Janice Lynch Schuster on August 6 2013 No Responses Tagged with eldercare frail elders Medicare public policy Aug 06 2013 This summer doctoral candidate and Somers Intern in Aging and Long term Care Policy has joined us at Altarum Institute Center for Elder Care and Advanced Illness Altarum featured her post Making the Case for a Refreshed Medi Care on July 23 for the Health Policy Forum A recent article featured on The New Old Age blog Walking Away from Medicare describes one geriatrician s decision to switch gears She resigned her position as the medical director of a Federally Qualified Health Center and launched her own patient centered outpatient geriatric practice The features incorporated by Dr Leslie Kernisan include making house calls developing comprehensive care plans that incorporate both medical services and personal aspirations and goals and using every modern tool to communicate with patients To read her entire article http altarum org health policy blog making the case for a refreshed medicare Key Words New Old Age Medicare reform geriatric care frail elders costs CCTP Success Will We Know It When We See It Posted by Janice Lynch Schuster on July 3 2013 No Responses Tagged with care transitions CCTP CMS Coleman Model community based frail elders hospital readmissions Medicare quality improvement rehospitalization Section 3026 Jul 03 2013 By Carol Castillon Defining success in work that focuses on people who are very sick can be a challenge The usual metrics just aren t always applicable With that in mind how will we know success in our community based care transitions work CCTP Like everyone else involved in this endeavor San Diego faces the challenge of reaching a 20 reduction in Medicare fee for service readmissions We are avidly monitoring our progress But is that really success To some extent of course it is and it would be fabulous to get there If and when we do though I think there would still be a void Perhaps I m naïve or perhaps I have what we lovingly call a social worker s heart but my definition of success is something a little different The only way to convey this is by telling the story of patient X A day after admitting patient X to a partnering hospital our Inpatient Transition Coach assessed the patient for meeting our high risk criteria That same day the patient was assigned to the Care Transitions Intervention CTI coach The coach saw the patient and enrolled him into CTI as well as into our Care Enhancement program which could address the need for social services Throughout the hospital stay the partnering hospital provided the patient with assistance in communicating his needs to his healthcare team From this interaction the team

    Original URL path: http://medicaring.org/tag/medicare/page/2/ (2016-04-30)
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  • MediCaring Communities Webinar – MediCaring.org
    abbr title acronym title b blockquote cite cite code del datetime em i q cite s strike strong Name required E mail required URI Identifying Communities with Potential for Pioneering MediCaring Suggest Yours Petition the White House for a MediCaringCommunities demo MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on M A Bloomberg April 29 2016 Aspen Valley Hospital reaps awards for patient experience Aspen Times April 29 2016 Optimizing care transitions the role of the community pharmacist Dove Medical Press April 26 2016 3 lessons to improve patient care transitions FierceHealthcare April 21 2016 Dave Alfano Launches Caring Transitions of Central Connecticut PR Web press release April 19 2016 Older adults with dementia face increased mortality risk due to care transitions Bel Marra Health April 14 2016 Central Wyoming

    Original URL path: http://medicaring.org/2015/06/02/medicaring-communities-webinar/ (2016-04-30)
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  • The Very, Very Old: The Challenges of Increased Longevity – MediCaring.org
    old age the predictable but often unexpected result of better health care and improved public health Quite simply most Americans now face a long slow decline rather than a short course to death For the most part we will endure this period because life even when we live with significant health problems is sweet But in our current medical and social services environment enduring will be a real challenge one that will require significant levels of direct personal help medical care and financial resources We will find that thriving in advanced older age requires major rearrangements of assumptions about relationships meaningfulness and life in general And many of us will find the task made even more difficult by our collective failure to address what lies ahead Such simple things will throw us off course One bad fall and we often cannot live alone in the family home again A little more loss of sight and we cannot drive to get food or to visit friends The margin between living as we wish and being in serious trouble becomes quite thin Physiologically people in their eighties and beyond have very little reserve in most organ systems so a challenge to the heart or lungs or kidneys or any other organ system leads to evident and serious illness Unlike younger people what was once a minor setback that is behind us within a few days can now lead to death The rate of cognitive failure increases dramatically with age those who make it to age 85 have a 50 50 chance of having serious memory loss as a major part of their life course 1 Many will have Alzheimer s type dementia but some will have strokes dementia associated with Parkinson s disease or another etiology And those who evade chronic failures of the mind are still at risk of distorted thinking from delirium with a fever a change in medication or even dehydration The rate of disability for self care often called functional disability or dependency in activities of daily living also increases dramatically with age Most older adults eventually have some problems walking and moving about Many have challenges with communication incontinence tooth loss arthritis and other troublesome body malfunctions These problems continue and generally worsen for several sometimes many years through to the end of life To live well in late old age we really have to depend on one another more than we do at any other time in life except perhaps for infancy and early childhood Sometimes devices medications or simplifying one s daily routine helps a great deal But even then another person usually must be on call in case something goes wrong For most of us there comes a time when we depend on other adults to help us with the most routine acts of daily life from getting out of bed to getting to the bathroom from surviving from dawn to dusk And yet we do not now have the structures in place that

    Original URL path: http://medicaring.org/2014/04/21/the-very-very-old-the-challenges-of-increased-longevity/ (2016-04-30)
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  • New Year’s Agenda for Frail Elder Care – MediCaring.org
    issue for U S health care You can download it here Testified before the congressionally appointed Long Term Care Commission and the Office of the National Coordinator for Health Information Technology Policy Committee We have also given dozens of talks all over the country With the Centers for Medicare Medicaid Services offering shared savings for acountable care organizations bundled payments and other demonstrations we see ways to use a portion of those savings to enhance social supports and to monitor and manage local care systems Intrigued Want to help us craft the proposals and get them onto the policy and reform platforms of dozens of organizations Be in touch Share your ideas and describe your opportunities and we will stay in touch as this movement builds We wish our friends and colleagues a rewarding year in 2014 We resolve to make the most of every day creating the systems and structures that support the last phase of long lives Tweet Pin It Leave a Reply Cancel reply Your Comment You may use these HTML tags and attributes a href title abbr title acronym title b blockquote cite cite code del datetime em i q cite s strike strong Name required E mail required URI Goodreads Start Here Articles and Books about Improving Care for Frail Elders Innovation Requires Shedding Established Patterns MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on

    Original URL path: http://medicaring.org/2014/01/12/new-years-agenda-for-frail-elder-care/ (2016-04-30)
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  • Learn More About MediCaring in a Webinar with Dr. Joanne Lynn – MediCaring.org
    the CMS Innovation Center MediCaring offers a comprehensive approach to medical care long term care and social support services ACOs would be organized locally by geography Dr Lynn authored an opinion piece published on November 13 2013 in the Journal of the American Medical Association on Reliable and Sustainable Comprehensive Care for Frail Elderly People The PDF can be downloaded here To join the Webinar 1 Visit http fuze me 22240239 and select launch in web browser 2 Use the following dial in to participate in the audio conference Call 201 479 4595 Enter Room Number 22240239 Tweet Pin It Leave a Reply Cancel reply Your Comment You may use these HTML tags and attributes a href title abbr title acronym title b blockquote cite cite code del datetime em i q cite s strike strong Name required E mail required URI Listen Up One Geriatrician Describes What She Learned from Patient Advocates Update on End of Improvement Standard New Medicare Policy Manuals Released MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on M A Bloomberg April 29 2016 Aspen Valley Hospital reaps awards for patient experience Aspen Times April 29 2016 Optimizing care transitions the role of the community pharmacist Dove Medical Press April 26 2016 3 lessons to improve patient care transitions FierceHealthcare April 21 2016 Dave Alfano Launches Caring Transitions of Central Connecticut PR Web press release

    Original URL path: http://medicaring.org/2013/12/04/learn-more-about-medicaring-in-a-webinar-with-dr-joanne-lynn/ (2016-04-30)
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  • Medicaring – Page 2 – MediCaring.org
    this future and it is our turn to shape it Or we will endure the frustrations and suffering that the current arrangements engender key words caregivers National Family Caregiver Month Joanne Lynn Altarum Institute Improving Life for the Oldest Among Us Altarum Roundtable Highlights Options Posted by Janice Lynch Schuster on October 17 2013 No Responses Tagged with aging Altarum Institute elder care Joanne Lynn Medicaring Oct 17 2013 Nearly 300 people participated in a September Altarum Roundtable Advanced Old Age in America What Can We Count On For now it seems very little beyond the urgent need to improve the current fragmented and costly system which fails to meet the diverse needs of older adults their families and their communities Panelists who included congressional representatives journalists thought leaders and community organizers addressed the intertwined issues of medical services long term care and social supports providing a deeper perspective on the current sorry state of affairs and exploring new strategies to make our collective future a better place for aging people Susan Dentzer a senior health policy advisor at the Robert Wood Johnson Foundation moderated the three panels The first kicked off by U S Senator Johnny Isakson R GA and Elizabeth Falcone from the office of U S Senator Mark Warner D VA included an in depth look at The Care Planning Act of 2013 That bill would reimburse interdisciplinary teams to help Medicare and Medicaid beneficiaries map out options for living with advanced illness and document a care plan geared to their own values and preferences and guide the course of their treatment Other panelists included Shannon Brownlee a writer who shared her family s story of the fragmented care her mother received and how such experiences have become the norm for many aging Americans Jennie Chin Hansen CEO of the American Geriatrics Society described how we might affect the forces that influence the current system She suggested that we must address the space in between the years in late life that are often characterized by increasing dependency disability and frailty A second panel discussed economic trends as well as national strategies that could help to create a framework for improving care in advanced old age This session highlighted ideas by health economist Joseph Antos from the American Enterprise Institute and John Rother of the National Coalition on Health Care A third panel examined trends at the community level with remarks from Mimi Toomey of the Administration for Community Living Suzanne Burke of the Council on Aging of Southwestern Ohio John Feather CEO of Grantmakers in Aging and Joanne Lynn Director of the Center for Elder Care and Advanced Illness at Altarum Institute Roundtable cosponsors included Grantmakers In Aging Grantmakers In Health LeadingAge National Alliance for Caregiving National Coalition on Health Care National Consumer Voice for Quality Long Term Care and OWL The Voice of Midlife and Older Women key words Altarum Institute public policy aging elder care Joanne Lynn Advanced Old Age in America What Can We

    Original URL path: http://medicaring.org/tag/medicaring/page/2/ (2016-04-30)
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  • High and Worsening Symptom Prevalence in the Last Year of Life – MediCaring.org
    life 2 3 4 The fact that pain remains common is particularly troubling as this symptom is highly visible well studied relatively reliably ameliorated and has a large impact on health related quality of life 5 On the other hand it is encouraging that trends in symptom prevalence in cancer may have stabilized While there have been many positive developments in end of life care since 1997 the Annals study shows that much more effort is needed to ensure that policy and organizational change translate to improvements in actual patient outcomes Along these lines there are many reasons why end of life symptom prevalence may not have improved since the IOM report Intensity of treatment has been increasing near the end of life and even though hospice use doubled from 2000 to 2009 the median stay is under three weeks 6 7 Tacking on hospice to otherwise intense late life care may leave patients suffering in the meantime and simply may not provide enough time for hospice to help alleviate symptoms Palliative care services are more common in hospitals where palliative care programs have tripled since 2000 8 but most of the course of a terminal illness takes place outside of the hospital Many patients may not have consistent access to palliative services known to be effective in promoting symptomatic relief Effective treatments exist for many end of life symptoms but there are significant gaps in their delivery 9 10 Interventions may not be reaching the right patients in the right ways In summary the prevalence of many end of life symptoms remains unacceptably and disappointingly high in light of active efforts to improve end of life care Some best practices simply are not being followed Some choices are not being adequately explained and offered to patients and the family caregivers supporting them Aligning current care with best practices represents a promising way to harvest low hanging fruit in order to reverse these negative trends and reduce end of life symptom burden for millions of Americans But beyond that the trends characterized in the Annals study must be parsed further in order to identify better and more coordinated ways to organize and deliver high quality end of life symptom management Footnotes References 1 Approaching death Improving care at the end of life Washington D C Institute of Medicine 1997 2 Walling A M Asch S M Lorenz K A et al The quality of care provided to hospitalized patients at the end of life Arch Intern Med 2010 170 12 1057 1063 3 Dy S M Asch S M Lorenz K A et al Quality of end of life care for patients with advanced cancer in an academic medical center J Palliat Med 2011 14 4 451 457 4 Malin J L O Neill S M Asch S M et al Quality of supportive care for patients with advanced cancer in a VA medical center J Palliat Med 2011 14 5 573 577 5 Relieving pain in America A blueprint

    Original URL path: http://medicaring.org/2015/02/02/symptom-prevalence/ (2016-04-30)
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