Future of Healthcare: Medical Home Model

With the advent of healthcare reform and the need to treat the aging population who have chronic medical conditions without bankrupting the payment system, new ideas to treat all Americans are coming to the forefront.

One such strategy which hopes to close the gap in the nation’s healthcare is called the medical home care model.

This is a patient centered approach which treats individuals from one central medical practice. The medical practice includes all health professionals a person would need to access to treat their health conditions.

If care is needed by providers outside of the medical home, it would be coordinated with other caregivers through the medical home. All treatment is tracked by the medical home so that this information would be self contained and accessible to the healthcare provider.

Electronic medical record data linked to various healthcare arenas, email communication with health professionals, open scheduling, and monitoring of health outcomes are advantages of this approach.

This idea could mean a higher level of care for you with great improvements in preventative care. Potentially, the risks of chronic complications can be reduced with closer contact to your team of healthcare providers who are informed about your specific medical needs and a team who is striving to help you prevent complications.

Ideally it would fit well within the healthcare reform plan with fee for service payments and coordination of fees when providers are needed outside the medical home.

The medical home would also gain monetary advantages for maintaining quality standards and positive outcomes.

The patient will be the center of attention in the medical home model.

This means that you must be an active participant in your care, your treatment plan and your lifestyle changes.  You will be engaged in your own health and medical outcomes.

What are your thoughts about this new approach to healthcare?

We would love to hear your ideas about how this model will meet your needs.

Blue Zones: How to Live 100 Years

People have searched for the fountain of youth for centuries.  We still look for a way to live not only for a long time, but to live healthfully.

Pills, potions and serums to beat “old age” are a million (perhaps even billion) dollar a year industry.

It seems that there are four places in the world where people have successfully aged up to 90-100 years.

These are known as blue zones. Dan Buettner, a writer for National Geographic, has documented common factors among the people who inhabit these blue zones.

In Okinawa, Japan; Sardinia, Italy; Loma Linda, Calif.; and Nicoya Peninsula, Costa Rica people live longer and healthier without taking pills and supplements.

Their secrets include:

  • Stay physically active
  • Limit caloric intake to meet needs
  • Avoid meat and processed foods
  • Drink in moderation and choose red wine containing antioxidants
  • Surround yourself with family
  • Manage your stress
  • Be part of a community and stay engaged
  • Keep a positive attitude
  • Interact with like minded people who help support your achieving the previous goals

You don’t have to move around the world to take advantage.

You can incorporate their “secrets” into your life and achieve the desired goal.

Our lifestyle choices are the primary determinant of how we will age not our genetics.

How will you age?

Elder & Driving: Still Safe to Get Behind the Wheel

A car means freedom and independence.  We all love the feeling of driving down the road on our way anyplace for an adventure.

Unfortunately, as we age several roadblocks can pop up to force us to examine if this freedom is worth the price for not only the driver but everyone else on the road as well.

There are many causes of impaired ability to drive safely which can affect judgment, decision making, reflexes, memory or focus on the task.

  1. Dementia-any form not just Alzheimer’s disease
  2. Poor vision-glaucoma, cataracts, macular degeneration
  3. Motor impairment-Parkinson’s disease, muscular or neurological degenerative diseases, arthritis, weakness
  4. Impaired mental function-illness, infection, seizures, uncontrolled blood sugar
  5. Polypharmacy-use of multiple medications
  6. Impaired mental function-dehydration, brain disorders, loss of memory, stroke

There is no one disorder or reason that should automatically result in taking the keys away but rather each person should be evaluated individually.

A new screening tool to help professionals assess whether an older person is fit to drive has recently been used in Canada.

The SIMARD test (Screen for the Identification of Cognitively Impaired Medically At-Risk Drivers) developed in Alberta is a paper and pen test consisting of four tasks which takes about 5 minutes and is then scored. Depending on the score one can be identified as safe, unsafe or in need of a road test to determine safety.

Doctors in Canada are mandated to report unsafe drivers and this tool will help give older adults a fair way to show their abilities.

Your family, friends and even you worry about driving a car without incident as aging sets in.

We have all heard the news reports when an unsafe driver causes an accident and pray it won’t happen to us.

We should all ask ourselves if our individual freedom is worth the risk of another person’s well being.

As long as you are able to drive safely, stay focused, and respond appropriately, keep on driving.

When that is not the case, recognize it and ask a professional for help to determine if you are still safe.

Do you have any tips or stories to share to help others?

Fraud Alert: Info on Part D Rebate

The Center for Medicare/Medicaid Services, HHS and the Administration on Aging have sent a press release to provide information and increase awareness for the nation’s seniors.

The following is directly from the press release:

“The more we can work together to educate the American people about ways to protect themselves and the health care system from fraud and scams, the better chance we have to protect taxpayer dollars and the Medicare Trust Funds,” said Secretary Sebelius.

“In addition to this outreach and education media campaign, we are working with organizations across the country to ensure seniors know where to turn to get information about the new law and their Medicare benefits.”

“Since early April, we have learned of seniors across the country who are being asked for personal information to help them get a rebate check,” said CMS Acting Administrator Marilynn Tavenner. “Beneficiaries who reach the donut hole will get a check mailed to the same address Medicare uses to send them information now without doing anything special.”

Seniors should be on the look-out for scams where people they don’t know ask them for their personal information in order to get their checks.

This is not how the process will work.

Checks will come directly to beneficiaries who qualify for this benefit under the Affordable Care Act. Seniors or family members should contact us at 1-800-MEDICARE to report any of these types of calls or go to www.stopmedicarefraud.gov to learn more about efforts to fight scams like these.

The first $250 checks are being mailed June 10 to those Medicare beneficiaries who entered the Medicare Part D donut hole, also known as the coverage gap, in the first quarter of 2010 and are not eligible for Medicare Extra Help (also known as the low-income subsidy or LIS).

The donut hole is the period in the prescription drug benefit in which the beneficiary pays 100 percent of the cost of their drugs until they hit the catastrophic coverage. People in the Extra Help program already have assistance with the cost of prescription drugs. Beneficiaries should contact the Social Security Administration at www.ssa.gov for information about Extra Help.

“Empowering consumers to prevent fraud is essential in preserving the integrity of the Medicare and Medicaid programs,” said Assistant Secretary Kathy Greenlee. “This joint education and outreach campaign will not only protect seniors from fraud and scams but will help protect the Medicare trust fund as well.”

Fight Elder Abuse

Elder abuse either in the form of exploitation; neglect; physical, sexual or emotional harm or abandonment by trusted caregivers can happen to any elder including your own loved one.

Most believe one in ten seniors is affected but due to limited reporting of abuse, which is thought to be only one in five cases, no one is sure exactly how widespread the problem is.

Risk factors include dementia, substance abuse by both victims and caregivers and isolation. More women are affected than men at this time.

The fifth annual World Elder Abuse Awareness day is June 15, 2010.

Agencies across the nation will be scheduling events to make more people aware of signs to look for, ways to report suspected abuse and what to do to prevent abuse.

Movie theaters across the nation will show a trailer called the NCEA Elder Abuse Piece which highlights elder abuse.

According to the National Center for Elder Abuse (NCEA), abuse warning signs include:

  • Physical Abuse ‐ Slap marks, unexplained bruises, most pressure marks, and certain types of burns or blisters, such as cigarette burns
  • Neglect Pressure ulcers, filth, lack of medical care, malnutrition or dehydration
  • Emotional Abuse Withdrawal from normal activities, unexplained changes in alertness, or other unusual behavioral changes
  • Sexual Abuse Bruises around the breasts or genital area and unexplained sexually transmitted diseases
  • Financial Abuse/Exploitation Sudden change in finances and accounts, altered wills and trusts, unusual bank withdrawals, checks written as “loans” or “gifts,” and loss of property

For more information, visit  www.ncea.aoa.gov

Have you seen abuse? Do you suspect someone you know has been abused?

Take action now and learn more.

Assistive Technology – Can You Benefit?

Do you need a little more help to do some of the many things you used to do easily?

Are there tasks that you still want to accomplish on your own but just can’t quite do them?

Help is on the way in the form of assistive technology.

A variety of adaptive devices can help you maintain your independence for as long as possible allowing you to “age in place” without moving to the next level of care too quickly.

There are several different categories of assistive devices that can make a difference from a simple walker to an amplification system for the phone.

  • Home-construction in your home such as building ramps; installing grab bars or reconfiguring doorways to help overcome barriers or recover from an injury, anything to allow you to remain independent in your home
  • Daily activity-devices that help with tasks of daily living such as bathing, eating, grooming, holding, reaching, or toileting. The goal is to remain independent for as long as possible.
  • Mobility-electric wheelchair, walker, cane, wheelchair lift or stair elevator and any device/equipment that allows you to move about safely and independently
  • Communication-telephone amplifiers, hearing aids, auditory receivers, computer devices, alert systems and any device that allows you to send or receive information
  • Sensory enhancements for those with vision or hearing impairments-devices that allow you to engage in your environment such as television captioning, large print documents/books, voice activated devices, bed shaking alarms, magnification, time, travel, writing and reading in Braille and lighted doorbells
  • Therapy-access to all types of therapists to help you recover or regain optimum physical functioning as well as orthotic devices to help you control limbs and joints or amputation sites
  • Switches-allow you to turn on, off or adjust equipment such as air conditioners, computers, lights or answering machines; these can be voice activated or mouth activated

Carefully determine what you need before you purchase any device as most insurance companies and Medicare will not cover these devices unless they are determined to be durable medical equipment (necessary only for those who have an illness or injury and serve a medical purpose).

If you are a veteran, you may be able to receive adaptive devices from VA services. Another source of help is your local area agency for aging services that can often assist you with low-cost equipment.

Ask yourself if this device will help you continue to be independent. Seek the advice of your doctor, medical team, therapist, audiologist or family members. As more older Americans and their families try to remain in their home setting as long as possible, the use of assistive technology can make all the difference.

Health Care Reform Highlights

President Obama has signed into law a healthcare reform bill that created both controversy and confusion among lawmakers and citizens.

It promises to provide healthcare to all citizens by 2014 as well as a myriad of other amendments.

Many seniors worry what the outcome of this legislation will be on their current Medicare coverage as well as how this might raise the cost of their out of pocket expenses for healthcare on fixed incomes.


  1. Close the hole in Medicare prescription drug plan by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
  2. Government funding to Medicare Advantage private insurers will be cut $132 billion over 10 years which might mean the loss of additional services from these policyholders not available through current Medicare coverage.
  3. Medicare will begin covering annual Wellness visits not currently included.
  4. Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.
  5. The creation of a national insurance trust for long-term care insurance, known as the Community Living Assistance Services and Supports (CLASS) Act.
  6. Eliminates insurance companies’ ability to refuse coverage for pre-existing medical conditions.
  7. Provide access to insurance coverage for all uninsured Americans estimated at 32 million currently.  It will fine anyone not opting to enroll in a healthcare plan $695.
  8. Fine large companies $2,000 per employee for not providing healthcare coverage.
  9. Mandate that restaurants or vending machine operations with 20 or more locations provide nutrition information on menu boards, drive through lanes and printed menus and any other nutrition information requested by consumers.
  10. Adult children up to age 26 can remain on their parents’ insurance policy.

 We will all have to wait and see what these sweeping changes will mean to our health, well being and pocketbooks.