Caring for 2 Million Home Health Workers-in home care providers will double by the year 2020

According to the Bureau of Labor Statistics, the demand for in home care providers will double by the year 2020. This increase in

Caring for In-Home Care Aides

demand is the product of an aging population, more people living much longer, and the changes to the healthcare industry that is aimed at moving patients away from long hospital stays to home care.

Currently, there are an estimated 2 million home health care workers, or home care aides, who are caring for elderly and infirm individuals across the country.

The profession is expected to become “the No. 1 growing occupation in the next 10 years (CNN).”

An effort has begun to help provide more support to these caregivers, with the Obama administration extending the Fair Labor Standards Act to cover home care aides and other workers. This is intended to provide these workers with the same overtime protection that other workers have received for decades, but which weren’t applied to this labor force.

The majority of the in home care providers are women and through the years, the work that they do and the care that they provide has largely been marginalized. The reasons for this marginalization may have more to do with the inherent misunderstanding about the type of care that they provide, and the level of experience and knowledge that some believe is needed to perform this work.

Caregivers are unique to the American workforce as they are individuals who support themselves by providing support to those in need. According to advocates for in home care providers, raising wages and offering more benefits, and more support, will be one way to help lift many of these providers out of poverty. It would also allow family members who are juggling raising a family and caring for elderly loved ones an opportunity to grow professionally themselves.

There are others who believe that raising wages for this level of workers would force agencies and other businesses to cut back on their workforce, effectively leaving numerous elderly and other individuals in need without the caregivers that they may require.

Care providers are an invaluable part of the healthcare industry and for many years their contributions have been downplayed. However, as more seniors age, and as people live longer than ever, it’s going to become more important to take care of the in home care workers who provide the support that elderly Americans require. Determining the best way to support them, and to give them more opportunities in the future, is at the core of today’s debate over wages, benefits, and more.

MARCH 19, 2014 BY VALERIE VANBOOVEN

7.9 million people with Medicare have saved over $9.9 billion on prescription drugs

37.2 million Medicare beneficiaries received free preventive services in 2013

On the 4th anniversary of the signing of the Affordable Care Act into law, new information released today by the Department of Health and Human Services (HHS) shows that millions of seniors and people with disabilities with Medicare continue to enjoy lower costs on prescription drugs and improved benefits in 2013 thanks to the health care law.

Since enactment of the Affordable Care Act, 7.9 million seniors and people with disabilities have saved $9.9 billion on prescription drugs, or an average of $1,265 per beneficiary. In 2013 alone, 4.3 million seniors and people with disabilities saved $3.9 billion, or an average of $911 per beneficiary. These figures are higher than in 2012, when 3.5 million beneficiaries saved $2.5 billion, for an average of $706 per beneficiary.

Use of preventive services has also expanded among people with Medicare.  In 2013, an estimated 37.2 million people with Medicare took advantage of at least one preventive service with no cost sharing, including an estimated 26.5 million people with traditional Medicare, and more than 4 million who took advantage of the Annual Wellness Visit.  This exceeds the comparable figure from 2012, when an estimated 34.1 million people with Medicare, including 26.1 million with traditional Medicare, received one or more preventive benefits with no out of pocket costs.

“Thanks to the Affordable Care Act, we saw a stronger Medicare program in 2013,” said HHS Secretary Kathleen Sebelius. “Seniors are saving billions of dollars on their needed medications and continuing to enjoy benefits that will lead to healthier lives and lower costs in the long run.”  

Closing the prescription drug “donut hole”

The Affordable Care Act makes Medicare prescription drug coverage more affordable by gradually closing the gap in coverage where beneficiaries had to pay the full cost of their prescriptions out of pocket, before catastrophic coverage for prescriptions took effect. This gap is known as the donut hole.

  

Thanks to the health care law, in 2010, anyone with a Medicare prescription drug plan who reached the prescription drug donut hole got a $250 rebate. In 2011, beneficiaries in the donut hole began receiving discounts on covered brand-name drugs and savings on generic drugs.

People with Medicare Part D who fall into the donut hole this year will receive discounts and savings of about 53 percent on the cost of brand name drugs and about 28 percent on the cost of generic drugs. These savings and Medicare coverage will gradually increase until 2020, when the donut hole will be closed.

For state-by-state information on discounts in the donut hole, please visit: http://downloads.cms.gov/files/Donut-Hole-by-State-2013.pdf

For more information about Medicare prescription drug benefits, please visit:

http://www.medicare.gov/part-d/.

Medicare Preventive Services

By making certain preventive services available with no cost-sharing, the Affordable Care Act is helping Americans take charge of their own health. By removing barriers to prevention, Americans and health care professionals can better prevent illness, detect problems early when treatment works best, and monitor health conditions.

For Medicare, the Affordable Care Act eliminated coinsurance and the Part B deductible for recommended preventive services, including many cancer screenings and other important benefits. For example, before the Affordable Care Act, a person with Medicare could pay as much as $160 in cost-sharing for a colorectal cancer screening. Today, this important screening and many others are covered at no cost to beneficiaries (with no deductible or co-pay). This will help many seniors to stay healthy.

For state-by-state information on utilization of preventive services at no cost sharing to beneficiaries in Medicare, please visit: http://downloads.cms.gov/files/Beneficiaries-Utilizing-Free-Preventive-Services-by-State-YTD2013.pdf

Caregiver Tips for Traveling With The Elderly

When traveling with seniors, all you need is a little extra preparation so that you and your loved ones can vacation in comfort—and worry-free.

Travel can be one of the most rewarding experiences in our lifetime, whether the goal is to see the world or to visit long-distance friends and family. However, when we travel with our elderly loved ones, we may be faced with challenges we don’t anticipate—issues that simply aren’t there when traveling on our own. Our loved one may not be mobile without a wheelchair, or they may have a specific health condition such as Alzheimer’s disease or heart problems; any of these can make vacationing much more complex, regardless of whether you’re traveling by plane, cruise ship, or your own family car.

As with any other vacation, preparation is key: plan ahead for some of the most common senior travel needs so that you and your family will be able to enjoy a hassle-free trip that’s memorable for the right reasons.

1. Consult with a doctor for travel approval and recommendations.

The all-important first step is making sure your loved one is cleared for travel by his or her primary care doctor, especially if you’re accommodating a health condition such as Alzheimer’s disease. Make sure the chosen destination is appropriate to your parent’s limitations, and ask the doctor for specific travel tips as well as any necessary vaccinations or extra medications.

2. Arrange special services ahead of time.

If your loved one needs a wheelchair at the airport, advance boarding of the airplane or train, or special seating in a disabled row or near a restroom, get in touch with the airline personnel or travel company to make sure these are available upon arrival. Remember the TSA security checkpoints, too: be aware of any surgical implants that might set off metal detectors, and wear easy-to-remove shoes. Contact the airline in advance to arrange for special screening if your loved one has disabilities or special needs, and contact hotels to check on things like shower bars and accessible rooms.

3. Research medical facilities at your destination.

Especially if you’re traveling to an unfamiliar area, make sure you know where the nearest hospitals and care centers are, in case of emergency, suggests the New York Times New Old Age blog. Bring contact details for your own doctors, too, and any necessary insurance information.

4. Prepare all necessary documentation and identification.

First, make sure travel documentation is in order: passports, if needed, as well as driver’s license, travel tickets and itineraries—and make multiple copies. You’ll also want to pack medical documentation: Medicare and insurance cards (and photocopies) as well as any prescriptions or physician’s statements. The Family Caregiver Alliance suggests wearable identification for loved ones with dementia: an ID bracelet or wearable GPS unit, for example.

5. Make sure your loved one always has a way to contact you.

Providing your loved one with a calling card or a prepaid cell phone, if they don’t already have one, is an ideal way to make sure they can get in touch with you at all times. Make sure your phone number is programmed in. If your loved one has cognitive impairment, you may want to put your name and phone number on an ID bracelet. Carry a photo of your loved one with you in case you get separated and need help to find them.

6. Pack essential items in a bag that’s easily accessible.

Make sure you have essentials close at hand: an ample supply of necessary medication, important documents and phone numbers, favorite snacks or drinks, a deck of cards or other entertainment, a light sweater, a hat, sunscreen, a travel pillow. These should be kept in a carry-on bag, or a tote that’s readily available inside the car rather than locked away in the trunk.

7. Pack as lightly as possible.

This is particularly important if you are traveling with a loved one who needs special care and assistance. “Less in your hands will help give you more attention to focus on your care recipient,” says the Family Caregiver Alliance.

8. When possible, maintain a predictable daily routine.

Maintaining a routine or a predictable schedule is critical to reducing stress and anxiety in a loved one with cognitive impairment or Alzheimer’s. Keeping mealtimes, medication schedules, and rest times as consistent as possible—and planning flights and car trips accordingly—will lower the risk of agitation.

9. Plan for breaks and downtime in the schedule.

There’s nothing less relaxing during a vacation than having to rush from place to place, and quiet time is even more important if you’re a caregiver for someone with dementia symptoms. Plan to arrive for flights earlier than you normally would, to make sure your loved one has plenty of time to get settled. On road trips, plan to take plenty of breaks, whether it’s taking the time for a full meal or simply a short restroom break.

10. Plan a schedule that accommodates your loved one’s needs.

Alzheimer’s patients tend not to do well traveling in the late evening or at night because of Sundowners’ syndrome, so take this into account when making your travel plans. Travel when your loved one is mostly likely to do well, and both you and your family will get much more out of the experience.

by Sarah Stevenson

Lawmakers pile on against Medicare Advantage cut

More lawmakers are joining the effort to stop the Obama administration's proposed cuts to Medicare Advantage.

In a letter sent Wednesday, nearly 200 members of the House urged administration officials to keep Medicare Advantage rates flat to avoid harming seniors' care.

The effort was spearheaded by Rep. Bill Cassidy (R-La.), who is hoping to unseat Sen. Mary Landrieu (D-La.) in November. 

"Medicare Advantage serves our constituents well, particularly those with high rates of chronic disease," the lawmakers wrote. 

"We believe that the cuts … are inconsistent with our healthcare policy goals to promote more high quality, coordinated care for Medicare beneficiaries."

Fifty Democrats signed on to Wednesday's letter, including Blue Dog Democrat Rep. John Barrow (Ga.), highlighting the issue's political potency.

"Georgia is home to hundreds of thousands of Medicare Advantage beneficiaries who are worried about the stability of the program," Barrow said in a statement.

"Further cuts to Medicare Advantage would dramatically alter the standard of care that folks have come to rely on."

Federal health officials are proposing a reimbursement cut of roughly 2 percent on average for Medicare Advantage plans next year, and are expected to make a final decision on April 1. Outside analyses have found the cut may be as high as 6 percent based on other factors.

The reduction reflects cuts ordered by the Affordable Care Act and an annual update determined by the Medicare agency.

Obama officials and many Democrats argue that the private insurance plans under Medicare Advantage are significantly overpaid compared with traditional Medicare.

Paring back reimbursements is the fair and fiscally responsible move, they assert.

The private program receives more funding on average per beneficiary thanks to GOP-backed policies.

The insurance industry has launched a substantial lobbying campaign against the Medicare Advantage cuts.

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Congressman Walden issues letter to colleagues in Congress stressing negative consequences of deep Medicare home health cuts on seniors' access to care and home healthcare jobs.

WASHINGTON, March 12, 2014 /PRNewswire-USNewswire/ -- The Partnership for Quality Home Healthcare – a leading coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation's seniors – today thanked Congressman Greg Walden (R-OR-2) for issuing a letter to his colleagues in the U.S. Congress calling attention to the "devastating effect" deep funding cuts to the Medicare home health benefit are having on the program's most vulnerable beneficiaries and on small businesses and jobs across America.

As part of the Affordable Care Act (ACA), funding for the Medicare home health benefit was cut by an unprecedented 14 percent cut over four years (2014-2017) - the maximum allowable by law.  Such a deep funding cut, according to the Centers for Medicare and Medicaid Services (CMS), will drive "approximately 40 percent" of providers to net losses by 2017.  Avalere Health's analysis of the ACA cut reveals that nearly two-thirds (72%) of Oregon's home health agencies will suffer net operating losses by 2017.

Recent analyses, as pointed out by Congressman Walden, demonstrate that every state will experience job loss and business closures and consolidations due to the rebasing cut. As a result, the Medicare program's most vulnerable patients could lose access to quality skilled home healthcare.

"Congressman Walden has long been a steadfast advocate for seniors' access to quality home healthcare services.  He has strongly opposed funding cuts that threaten seniors, rural communities, and hardworking home healthcare professionals, and we applaud him for his compassion and leadership," said Eric Berger, CEO of the Partnership for Quality Home Healthcare. "In the Congressman's home state of Oregon, more than 15,000 homebound seniors and nearly 3,000 home healthcare professionals are directly impacted by the ACA cut, demonstrating the critical need for relief to protect these vulnerable patients and healthcare jobs."

In the month of February alone, the home health community lost 3,800 jobs according to the Bureau of Labor Statistics (BLS), the largest cut seen in home health in more than a decade.  Since this job loss occurred in just the second of the 48 months in which the Obamacare cut is being implemented, home health leaders are warning that – unless corrected – the Obamacare cut will cause thousands of additional jobs to be lost.

"Thanks to Congressman Walden and other lawmakers' leadership, Congress is recognizing the devastating effect this cut is having on seniors nationwide.  We applaud them for considering much-needed relief to the Medicare program's frailest patients and home healthcare professionals across our nation," added Berger.

Across Oregon, 21,161 seniors receive the Medicare home health benefit, which is widely recognized as clinically advanced, cost effective and patient preferred.

The Partnership for Quality Home Healthcare was established to assist government officials in ensuring access to skilled home healthcare services for seniors and disabled Americans. Representing community- and hospital-based home healthcare agencies across the United States, the Partnership is dedicated to developing innovative reforms to improve the quality, efficiency and integrity of home healthcare. To learn more, visit www.homehealth4america.org. To join the home healthcare policy conversation, connect with us on Facebook, Twitter and our blog.

SOURCE Partnership for Quality Home Healthcare

Is it Too Dangerous for your loved one to Live Alone?

Is it Too Dangerous to Live Alone?

Children of elderly parents face tough choices.  One of the hardest things that a child will ever do is determine whether or not their parent should live alone. As children we find that it is devastating to watch the people who cared for us become unable to perform their day to day care alone.  The once strong hands tremble, the same hands that held us steady while we learned to walk, ride a bike, or swing.

As upsetting as it may be to watch a parent become unsteady, it is even more heartbreaking to receive a phone call from authorities or a local hospital that a loved one has been admitted to an emergency room for an injury.  Especially, an injury that could have been prevented by having an in-home nurse or aide.  Home care may be preferable to assisted living or a nursing home.

When thinking about an assistance choice, answer these questions:

•  Has your parent or loved one become confused lately? Do they repeat the same questions or tell the same things to you repeatedly?

•  Are bills behind?  If memory loss is a problem, bills can be left unpaid which will result in loss of utilities or even loss of the home.

•   Do you notice mood swings in your loved one?

•  Have your parent(s) been forgetting to go to appointments?

•   Do you notice bruises? Does your parent seem to bump into objects that they would normally avoid?

•   Do stairs and chairs seem to give your loved one a problem to get out of or up?

•   Normally clean homes are increasingly unclean.

•  You may notice that your parent’s hygiene is not the same as before, even a few weeks before starting this assessment.  It may be hard for them to get in and out of a shower or tub.

Any or all of these things combined can point to a need for in-home care. Approaching your elderly parents about setting up in-home health care can be stressful on both you and them.  Bring up your concerns, address the issues you have noticed, and explain that you are only concerned for their well being.  When discussing home health care as an option, be sure to point out that your parent will be able to remain at home.  Your parent will also be in control of who goes where in their home, will participate in a care plan development, and will be able to remain home as long as possible by choosing home health care.