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News Roundup: October 21, 2013

Elderly Will Need Help as They Age at Home

Published by The New York Times
Henry Cisneros
October 17, 2013

As baby boomers, some 78 million strong and our nation’s largest demographic group, head into their retirement years, they will present enormous challenges for housing providers and policy makers.

The overwhelming majority will seek to “age in place” in their own homes and communities, foregoing long-term institutional care. The potential savings to our health care system are great.

Most baby boomers want to avoid institutions, but millions will have a hard time affording the changes needed to make their homes accessible.
But many homes and communities lack the structures and services that make aging in place safe and affordable. For millions of older Americans who spend more than half their income just to cover housing costs, financing options will be more limited.

Nonprofit organizations like Stewards of Affordable Housing for the Future and LeadingAge have done pioneering work to develop strategies that link low-income senior housing with health care and supportive services. The federal government should help by encouraging housing and health care providers to more fully integrate their services.

Today, the federal government provides vital support for more than 1.5 million elderly households through its rental-housing programs. These programs, however, meet only a fraction of the need. In addition, many of the rental properties that receive federal subsidies and serve the low-income senior population desperately require modernization. Those properties often lack essential features like hand rails, barrier-free entrances, and roll-in showers.

Efforts to address the capital backlog and ongoing accrual needs of the existing public housing stock, as well as to preserve the Low Income Housing Tax Credit program would go a long way toward improving housing quality for senior residents. These improvements will require a sustained commitment of additional funds, but will yield substantial savings to the health care system over time as more seniors are able to age in place.

While some states and localities are beginning to measure these cross-sector savings, the Office of Management and Budget, in evaluating the costs of housing programs, should account for any savings to the health care system made possible by safer, more accessible housing linked to essential supportive services.

In a report in February, the Bipartisan Policy Center Housing Commission proposed how federal agencies could work together to meet the housing needs of our nation’s burgeoning senior population. That's crucial as the nation's seniors grow.

U.S. News: Telehealth Makes Strides Toward Future of Health Care

Published by Home Health Care News
Elizabeth Ecker
October 16, 2013

Telehealth services are becoming more prevalent, more thorough and more affordable, writes U.S. News in an article about the growing reliance on technology to improve health care. Timed with the implementation of the Affordable Care Act and a host of new standards and practices, it it becoming more and more so, U.S. News writes.

It’s “based on patient convenience rather than patient schedules,” writes U.S. News, “—whether insured or uninsured, and whether they have a primary care physician or haven’t seen a doctor in years. Anyone can download an app at americanwell.com, enroll, choose from a panel of physicians and talk to a doctor nearly immediately.”

The availability of telehealth services is providing a new alternative to emergency room care and doctor visits for advice on chronic conditions and needs that are lower-priority than urgent care.

“The most common alternatives to a scheduled doctor’s office visit include urgent care in free-standing clinics staffed by physicians, employer-based clinics offering a range of care from diagnosing infections to full primary care, and retail clinics within drug stores or big box stores like Walmart, usually staffed by nurse practitioners or physician assistants and often limited to common conditions like colds, flu and urinary tract infections,” U.S. News reports. “This direct-to-consumer app adds one more possibility to the growing field of convenience medical care.”

Visits to those retail clinics grew fourfold between 2007 and 2009, indicating consumers like the alternatives that are emerging.

Effort connects medical homes with 'essential' IT tools

Published by Modern Healthcare
Andis Robeznieks
October 14, 2013

While the patient-centered medical home has been touted as the foundation for a better coordinated and more efficient healthcare system, experts now say medical home practices need to be connected to other parts of the healthcare system. To this end, the Patient-Centered Primary Care Collaborative has released a report (PDF available for download here) listing 10 “essential” health information technology tools needed to make these population health connections.

“Health IT offers an essential infrastructure and solutions for population health management that can be adopted incrementally over time and help providers continue on a path of quality improvement and primary-care transformation,” Dr. David Nash, founding dean of Thomas Jefferson University's Jefferson School of Population Health and a member of the PCPCC report review committee, said in a news release.

The 10 essential population health IT tools identified by the PCPCC are:

-Electronic health records, to document diagnosis, vital signs and other data needed for advanced analytics;
-Patient registries, to serve as central databanks to identify care gaps and report quality measures;
-Health information exchange, to coordinate care and share data between care team members;
-Risk stratification, to classify patients by their current health status and identify who may need interventions to prevent hospitalization;
-Automated outreach, to generate automatic messages to patients who need preventive care or chronic disease management;
-Referral tracking, to ensure that providers receive results of consultations from specialists patients were referred to;
-Patient portals, to share records with patients and encourage self management;
-Telehealth/telemedicine, to allow remote examination and treatment;
Remote patient monitoring, to track vital signs of patients with chronic conditions and to alert providers when intervention is needed; and
-Advanced population analytics, to evaluate how different segments of patient populations are faring and assess the performance of individual clinicians and provider organizations as a whole.

“Improving population health presents a major cultural, operational and financial shift across a broad range of stakeholders,” according to the report. “While our current system is designed to respond to the acute needs of individual patients, it must transition to one that anticipates and shapes patterns of care for populations, and addresses the environmental and social determinants of health.”

The report cites a 2011 study by HHS' Agency for Healthcare Research and Quality as evidence of why such tracking and communication tools are needed. According to the AHRQ study, only 62% of primary-care physicians report getting consultation results from specialists, even though 81% of specialist reports are sending them. Also, 69% of primary-care providers report sending patient histories to specialists, but only 35% of specialists report getting them.

The report is scheduled to be the focus of an Oct. 15 panel discussion at the PCPCC annual conference in Bethesda, Md.