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News Roundup: April 7, 2014

Health Care's Future Is in the Home

Published by San Diego Scoop
April 1, 2014

Home health care is an essential part of the nation's health care system.

Rapid advances in technology and new ways health care is provided to patients have created new opportunities to receive care at home. The health care community is constantly evolving and understanding that not only does home health care reduce the overall cost of treatment, it also improves the quality of life of patients and their families. In fact, a recent study by the U.S. Government Accountability Office revealed that people receiving home care tend to live longer and have a better quality of life.

Home health care providers include medical professionals like physicians, nurses, physical therapists, occupational therapists and speech therapists, as well as medical social services providers and skilled home health aides. It's the best way to ensure ill, elderly or disabled people receive high-quality health care in the privacy and comfort of their own homes. In addition, home health nurses serve as the eyes and ears of physicians, keeping them up-to-date on recovery and alerting them to potential health concerns.

As home health agencies coordinate a plan of care with your physician, there are dozens of administrative and operational tasks that go on "behind the scenes" concerning scheduling and planning patient care. That's where companies, like Axxess, a technology company that integrates home health care software to promote quality health care services, come in.

The Axxess software is a complete, end-to-end solution for home health care agencies to manage and efficiently run their businesses. It allows an agency to deliver the best tools possible to their health care providers for excellence in patient care.

Axxess puts all care and administrative aspects of a home health care agency at the fingertips of managers and providers: care plans, patient data, medication management, assessments, clinical progress notes, scheduling and billing. This type of software is user-friendly, cost-effective and secure and with ongoing customer training and support available at no additional cost, Axxess has quickly become the industry's fastest-growing home health software.

A Cost-Effective Way to Care for an Aging Population

Published by Governing
Christopher Kelly & Jerome Deichert
March 31, 2014

The aging of the U.S. population, driven by the postwar baby boom generation, is upon us. As is true across the country, in our state of Nebraska baby boomers represent the largest birth cohort, projected to grow the state's 65-and-older population to nearly 420,000 by 2030. The proportion of older Nebraskans within the state's overall population is also growing because other demographic changes, such as birth rates and immigration, are not projected to keep pace with the aging of the state's residents. Consequently, legislators and other policy-makers are becoming increasingly concerned about the fiscal consequences of population aging.

Some of the impacts are already well known. In the United States, baby boomers are becoming eligible for Social Security and Medicare and will produce unprecedented strains on these programs, particularly over the next two decades. Additionally, since Medicare does not meet all health-care expenses, particularly long-term care costs, older Americans will pay higher out-of-pocket costs for these services and will increasingly rely upon Medicaid when they can no longer meet these expenses. In a state like Nebraska with an already large older population, the specter of future Medicaid long-term care costs looms quite large. These expenses totaled $742.5 million in fiscal year 2013 -- nearly 40 percent of the state's total Medicaid spending.

Nonetheless, the continued upward spiraling of Medicaid long-term care costs is not inevitable. Today, the highest Medicaid costs for long-term care derive from care provided by skilled-nursing facilities. The annual cost of nursing-home care in Nebraska averages more than $75,000 per person. However, nursing-home placement, while necessary for some individuals who require skilled nursing assistance 24 hours a day, seven days a week, is not needed by everyone who receives long-term care. The most effective way to save Medicaid costs is to delay or prevent unnecessary nursing-home placement.

Assisted living has long been marketed as a residential alternative to nursing homes, but these settings are limited in their capacity to meet the long-term-care needs of older adults. Assisted-living facilities are not required to provide the professional staffing needed by residents with clinical diagnoses such as dementia; in addition, most do not provide personal-care assistance for activities of daily living such as bathing, dressing, feeding and toileting. Further, the supply of assisted-living facilities in rural states like Nebraska is limited. And assisted living is expensive to families, since most of these facilities do not accept Medicaid.

For these reasons, the most effective way to lower long-term care costs, and to delay or prevent nursing-home placement, is through home and community based services (HCBS). In-home services such as home health and personal care cost roughly half of the $230 average per day for a skilled nursing facility in the United States. Community-based services, such as adult day care, cost one-quarter of the expenses for nursing home care. For many older Nebraskans, HCBS are already available, particularly for those in metropolitan areas who can afford to pay for services out-of-pocket. However, the affordability and the availability of private-sector HCBS providers for low-income and/or rural elders is limited. The best option for lowering long-term-care costs is to expand lower-cost HCBS in the public sector. This includes working in continued partnership with Area Agencies on Aging, which receive federal funding under the Older Americans Act to provide services such as nutrition, transportation and care management.

Although the demand for long-term-care services among older Americans will continue to increase over the next two decades, this does not necessarily require a corresponding increase in costs to states. The key lies in the ability of state policy-makers, working with providers in both the public and private sectors, to delay or prevent unnecessary nursing-home placement through the expansion of more affordable alternatives, specifically HCBS. The greater availability of these options will enable states to meet their long-term care challenges in a way that provides more choices for our seniors and is economically sustainable.

Christopher M. Kelly is an associate professor in the Department of Gerontology at the University of Nebraska at Omaha. Jerome Deichert is director of the Center for Public Affairs Research at the University of Nebraska at Omaha. This commentary is based on a policy brief prepared in December 2013 by the authors for the Nebraska Legislative Planning Committee.

Advances in telemedicine means doctors can make house calls

Published by KPLC TV
March 25, 2014

Whether it's an exam via laptop or swipe of a smartphone, many people are finding they don't have to go too far out of their way to talk to a doctor.

Telemedicine is extending the reach of doctors beyond the walls of their office or hospital.

"A lot of times a lot of those resources are trapped in one large facility in a metro area, so extending that off into the community maybe 50, 60 miles into a rural population - that's a very big deal," says Steve Cashman.

Cashman founded HealthSpot, Inc. - kiosks stationed around communities that allow patients to see doctors through video connections.

The Cleveland Clinic is experimenting with another program that uses a local cable company to access patients through televisions in their living rooms.

"We have connected into the home via the television, so we can actually see the patient at home and talk to them, and they can see us at the same time," Cleveland Clinic Chief Executive Officer Dr. Toby Cosgrove said.

Others are turning to their smartphones, using apps like HealthTap.

It doesn't replace an office visit, but gives users basic health information.

"Millions of people are using HealthTap right now and are asking our more than 50,000 physicians questions literally every second," says HealthTap founder Ron Gutman.

Telemedicine visits are usually reserved for minor illnesses like ear infections and strep throat, but could also be used for follow-up appointments with specialists.