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Posts Tagged ‘medicare’

The Return Of The Little Black Bag In Healthcare

August 17, 2011 Leave a comment

Right around the same time some private physicians are refusing to accept new Medicare patients in fear of lower government reimbursements, another physician based concept is taking hold. The Academy of Home Care Physicians has a mission statement that promotes the art, science and practice of medicine in the home. Established in 1988, the Academy “envisions a healthcare system in which any patient who needs it can receive comprehensive primary care in their home.” Research shows that for every elderly person in a nursing home, there are three more patients equally as sick and fragile who are living at home. In a recently article published in The New England Journal of Medicine on “Why Health Care is Going Home,” Dr. Steven H. Landers stated that, “Our financing system, malpractice laws, and consumer culture all encourage utilization of costly services and have contributed to unsustainable increases in the cost of care. In home care is often less costly, and since it is highly desirable for patients, it offers a potential win–win solution.”

He added that, “The transformation of patients’ homes into central venues for health care may take years or decades, depending on how the national and institutional politics play out. New payment models are needed to cover services that haven’t previously been offered at home and to realign physicians’ incentives. Yet, ultimately, health care organizations that do not adapt to the home care imperative risk becoming irrelevant.” In today’s generation of physicians, few have been educated in medical school or continuing education to provide the kind and level of care that could be made available. Few have been educated to provide home health agencies with professional support as medical directors; fewer still have learned the advanced team techniques that allow them to work with other health professionals, nurse practitioners, physician assistants, pharmacists and others by providing continuity of care across the care continuum. Concerns over reimbursement also have been a barrier.

The American Academy of Home Care Physicians serves the needs of thousands of physicians and related professionals and agencies interested in improving care of patients in the home. Members and volunteers work to reduce barriers and enhance practice education. Notable successes include fostering increased reimbursement, sponsoring multiple educational and scientific seminars and providing the practice community with a variety of helpful publications. Academy members include home care physicians who make house calls, care for homebound patients, act as home health agency medical directors or refer patients to home care agencies. Specialties include internal medicine, family practice, pediatrics, geriatrics, psychiatry, emergency medicine and more.
Other members are directors of agencies actively planning for future home care organizations, medical directors of managed care plans, nurse practitioners who make house calls, physician assistants, and administrators of medical groups interested in home care. The services provided by home care agencies and physicians are billed under a set of codes designated by the Centers for Medicare and Medicaid. Physicians, nurse practitioners, clinical nurse specialists and physician assistants are required to oversee or directly provide progressively more sophisticated and more frequent home visits.

Beyond the licensure and certification processes, no similar evaluation mechanism exists for skills obtained through continuing education and practice experience. The Home Care Credentialing Examination fills this gap and enables home care medical providers to demonstrate their proficiency. Patients also benefit from proficiency testing and the Academy’s recognition of those who receive the credential since the exam assesses the knowledge and skills identified by respected experts as necessary to provide safe and effective medical care in the home. Upon the completion of this educational activity, the participant should be better able to:
Discuss and apply knowledge of clinical problems, effective approaches to end of life/palliative care, functionality, social services and legal/ethical concerns related to home care. Attest to his or her added competency in home care medicine by demonstrating knowledge, skills and proficiency in managing common problems faced in home care. As a public service, The American Academy of Home Care Physician’s website provides a list of its members and medical groups that provide home care.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care Chicago, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Facilities and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Skilled Nursing As A Long Term Care Option – Know the Medicare Policy

August 4, 2011 Leave a comment

A nursing home, also known as a skilled nursing facility, is a place for people who no longer need to be in a hospital but are unable to care for themselves at home and require some medical assistance. Most nursing homes have skilled nurses on hand 24 hours a day. A doctor can help patients decide if a nursing home is the best choice for their situation. Some nursing homes are set up like hospitals. The staff provides medical care as well as physical, speech and occupational therapy. There is most likely a nurses’ station on each floor. As a rule, rooms are shared by two residents but most have options for private rooms. Many residents and their families hang photos or other personal memorabilia to create a more home-like atmosphere. Other nursing homes are designed to be more like homes and the day-to-day routines are less structured. Staff and residents seek to create a neighborhood feel. Kitchens are sometimes open to residents and staff is encouraged to develop strong relationships with the residents.

Some nursing homes have visiting doctors who see their patients on site. Other nursing homes provide transportation for residents to visit their doctor’s office. Nursing homes sometimes have separate areas called Special Care Units for people with conditions such as Alzheimer’s and other dementias. When considering a nursing home for yourself or a loved one, it is important for families to think about any special needs that are present or may be anticipated in the future. Look. What choices are in your area? Is there a place close to family and friends? What’s important to you—nursing care, meals, a religious connection, hospice care, or Special Care Units for dementia care?
Ask. Talk with friends, relatives, social workers and religious groups to find out what places they suggest. Ask doctors which nursing homes they feel provide good care. Call. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Inquire about waiting lists. Visit. Make plans to meet with the facility director and the nursing director.

Important things to look for:
Medicare and Medicaid certification
Handicap access
Strong odors (either bad or good)
Food choice options
Residents who look well cared for
Staff to patient ratio

Talk. Don’t be afraid to ask questions. Ask how long the director and department heads such as nursing, food and social services have worked at the facility. If key staff members change frequently, there may a problem. Visit again. Make a second visit without calling ahead. Try another day of the week or time of day so you will meet other staff members and see other activities. Stop by at mealtime and observe if residents seem to be enjoying their food. Understand. Once you choose, carefully read the contract. Check with your State Ombudsman for help if the contract is not fully understood.

Do Nursing Homes Have to Meet Standards?
The Centers for Medicare and Medicaid Services (CMS) requires each State to inspect any nursing home that receives money from the government. Homes that do not pass inspection cannot be certified. Ask to see the current inspection report and certification of homes you are considering. A good website to check for certification policies is Medicare.gov.

Payment Options for Nursing Home Care
Medicare. Many people mistakenly believe Medicare will pay for long term stays in a nursing home, but it does not. For example, Medicare will only cover all or portions of the first 100 days in a skilled nursing home for someone who needs special care or rehabilitation after leaving the hospital. State/Federal Medicaid programs may pay for long term nursing home care, but there are many stipulations for qualifying. It is important to check with Medicare, Medicaid, and any private insurance company to find out the current rules.

In order for Medicare to pay for care in a skilled nursing facility the patient must have been in the hospital for three consecutive days. Then, no later than thirty days after discharge from the hospital, be admitted to a Medicare certified nursing facility. If these criteria are met, then days 1 through 20 in a skilled nursing facility are paid 100% by Medicare.  For days 21 through 100, Medicare pays all except your co pay which is currently $137.00 per day. The rate changes yearly and in 2008 was $128.00 per day. From days 101 and beyond, regardless of your condition, you are responsible for all of the facility costs. Medicaid. This State/Federal program provides health benefits to some people with low incomes and lack of resources to pay. According to Medicare.gov, if your income and resources are limited, you may be able to get help to pay for skilled nursing and other health care costs. If you qualify for both Medicare and Medicaid, most health care costs are covered. You may also qualify for the Medicaid nursing home benefit or the Programs of All-inclusive Care for the Elderly. Call your State Medical Assistance (Medicaid) Office for more information.

Once you have met the requirements of your state’s Medicaid program, keep in mind it can take up to 90 days to be approved. Private pay. Some people pay for long term care with their own savings for as long as possible. When that is no longer feasible, they may be eligible for Medicaid benefits. If you think you may need to apply for Medicaid in the future, ask the facility to make sure they accept that type of funding and if they are Medicare/Medicaid certified. Long-term care insurance. Some people buy private long term care insurance. It can pay part of the costs for a nursing home or other long term care such as an assisted living residence. Long term care insurance is sold by many different companies and benefits vary widely. Look carefully at several policies before making a choice.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing Los Angeles, Hospice Care, Medical Supplies, as well as a variety of Assisted Living and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

The Shrinking Supply of Primary Care Physicians

July 6, 2011 1 comment

Primary care physicians are already in short supply in many parts of the country. The passing of the landmark Health Care Reform bill will bring them millions more newly insured patients in the next few years and promises even more of a strain. The new law goes beyond offering coverage to the uninsured, with steps to improve the quality of care for the average person and help keep us well instead of today’s seek-care-after-you’re-sick culture. However, to take advantage, you will need a regular primary care physician. Recently published reports predict a shortfall of roughly 40,000 primary care doctors over the next decade, a profession losing out to the better pay, better hours and higher profile of many other specialties. Provisions in the new law aim to start reversing that tide, from bonus payments for certain physicians to expanded community health centers that will pick up some of the slack.

The law offers incentives to encourage more people to enter medical professions, and a 10% Medicare pay boost for primary care doctors. Also at issue, is the need for affordable education for would be primary care physicians. To cope with the growing shortage, federal officials are considering several proposals. One would increase affordable enrollment in medical schools and residency training programs. Another would encourage greater use of nurse practitioners and physician assistants. A third would expand the National Health Service Corps, which deploys doctors and nurses in rural areas and poor neighborhoods. The U.S. has 352,908 primary care doctors now, and the college association estimates that 45,000 more will be needed by 2020. However, the number of medical school students entering family medicine fell more than a quarter between 2002 and 2007. Senator Max Baucus, a Montana Democrat and chairperson of the Finance Committee, said, “Medicare payments were skewed against primary care doctors, the very ones needed to coordinate the care of older people with chronic conditions such as congestive heart failure, diabetes and Alzheimer’s disease.”

Physician 2 by *stitchxwitch on deviantART

A number of new medical schools have opened around the country recently. As of last October, four new schools enrolled about 190 students, and 12 medical schools raised the enrollment of first year students by a total of about 150 slots, according to the AAMC. Some 18,000 students entered U.S. medical schools in the fall of 2009, the AAMC says. Medicare pays $9.1 billion a year to teaching hospitals, which goes toward resident salaries and direct teaching costs, as well as the higher operating costs associated with teaching hospitals, which tend to see the sickest and most costly patients. Doctors’ groups and medical schools had hoped that the new health care law passed in March, would increase the number of funded residency slots, but such a provision did not make it into the final bill. The residency is the minimum three year period when medical school graduates train in hospitals and clinics. There are about 110,000 resident positions in the U.S., according to the AAMC. Teaching hospitals rely heavily on Medicare funding to pay for these slots. In 1997, Congress imposed a cap on funding for medical residencies, which hospitals say has increasingly hurt their ability to expand the number of positions.

One provision in the Health Care Reform bill attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary care or general surgery residencies. The slot redistribution will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services. It will probably take 10 years to even make a dent into the number of doctors that we need out there,” said Atul Grover, the AAMC’s chief advocacy officer.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Chicago and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Wii Video Game Rehabilitation For Seniors In Assisted Living

July 6, 2011 Leave a comment

It is not an accident that Nintendo’s original name for their video game Revolution, evolved into simply and officially being, “Wii.” Nintendo of America’s President, Reggie Fils-Aime, put it this way when he said, “Revolution as a name is not ideal; it’s long, and in some cultures, it’s hard to pronounce. So we wanted something that was short, to the point, easy to pronounce, and distinctive. That’s how ‘Wii,’ as a console name, was created.” The company has given many reasons for this choice of name since the announcement, however, the best known is:

“Wii sounds like ‘we’, which emphasizes that the console is for everyone. Wii can easily be remembered by people around the world, no matter what language they speak, no confusion, no need to abbreviate, just Wii.” Nintendo’s spelling of “Wii” with two lower case “i” characters is meant to symbolize two people standing side by side, representing players gathering together. Playing Wii Sports and Fitness games has indeed become popular for everyone, including seniors in assisted living facilities.

Guinness World Records confirms a record was set in Houston, Texas at the largest ever, senior citizen Wii Bowling Tournament. The event was put on by TexanPlus, Houston’s largest Medicare HMO. The event drew more than 1,500 supporters and 600 senior bowlers determined to  break the record and also have fun while dishing out a bit of Texas style competition and a side helping of health information. The extravaganza included a health fair and immunization clinic. “I’m in it to win it,” one man at the event said as he rolled his walker up to the foul line.

Wii Wallpaper by *vinh291 on deviantART

According to a sponsor, one booty shakin’ grandma even showed off her victory dance after she “Wii bowled” a strike. Aside from the “seniors gone wild” moments, the event served a very important purpose: to encourage seniors to get stronger and more physically fit, possibly saving them from life altering injuries such as broken hips resulting from a falls. According to the Centers for Disease Control and Prevention, falls are the leading cause of injury related death in seniors.

Assisted living facilities staff knows that a fall, or worse, a broken bone can limit a resident’s mobility and can be the downward spiral that can end up taking a life. The healthcare workers in assisted living facilities take steps to make sure their senior residents have a reduced risk of falling. They make sure their residents have regular vision checkups for changes that may impair depth perception. Sometimes medications can cause dizziness or disorientation and the resident’s doctor may recommend the use of a cane or walker to help prevent falls.

In assisted living facilities, objects that get in the way of walking are removed and handrails and night lights are installed in bathrooms. Assisted living facilities have regular exercise programs designed to help keep their residents mobile, flexible and healthy. A daily walk around the courtyard and garden area is a common activity of residents who choose assisted living facilities as a safe, comfortable place to spend their senior years. As for the Wii bowlers in Houston, all the participants, winners and runners up reported that they were happy they went to the event and found the video game system a fun and healthy way to get exercise.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Houston and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

Poor Urban Communities Hit The Hardest With Skilled Nursing Facility Closures

July 5, 2011 Leave a comment

New research reveals poor, urban neighborhoods are taking the hardest hit from the widespread closure of skilled nursing facilities across the nation over the last decade, representing a 5 percent drop. “The country’s minority population is aging at a steeper rate compared with the white population,” said study lead author Zhanlian Feng, an assistant professor at Brown University in Providence, R.I.  “And so the potential need for long term care is rising fastest in minority communities, as skilled nursing home closures are happening more often in their areas,” he added.

This disproportionate impact of skilled nursing home closings on minority and low income communities “will have all sorts of implications in terms of access and quality of care issues,” Feng added. To explore skilled nursing facility trends, Feng and colleagues analyzed information drawn from the National Online Survey Certification and Reporting database on closings of Medicare and Medicaid certified facilities between 1999 and 2008. During that time, the research team found that 11 percent of stand alone skilled nursing facilities, approximately 1,776, and nearly half of all 1,126 hospital based skilled nursing facilities in the country shut their doors. Together, they represent a loss of 16 percent of the 97,000 Medicare/Medicaid certified skilled nursing homes, more than 5 percent of nursing home beds. Based on 2000 U. S. Census figures,  the study authors further noted that overall closure rates were about twice as high in zip codes that are in low income and minority communities than in the richest zip codes.

Skilled Nursing homes in zip codes comprised primarily of Hispanic or African American residents were 37 and 38 percent more likely, respectively, to close than those in areas with the fewest Hispanics or African America. While distances to the nearest operating skilled nursing facilities increased “significantly” in all areas that experienced closures, the researchers found the travel increases greatest for those living in poor and minority localities.The team concluded that nursing homes in minority and low income communities are bearing a greater share of financial pressures and closures, which raises valid concerns about rapidly diminishing senior care options and the quality of care in the remaining facilities in those areas.

An Old Tale by *gilad on deviantART

“There are times when placement in a nursing home is unavoidable,” said Dr. Mitchell H. Katz, director of the Los Angeles County Department of Health Services, who wrote an accompanying editorial. “And then what we should want is a high quality nursing home that is near where a person has lived all their life and where their family and friends are. Moreover, what’s disturbing about this investigation is that it shows that nursing home closures are not random. And that they are more likely to occur in low income neighborhoods.” Katz said more of the people in low income neighborhoods who use nursing homes are Medicaid recipients, whose reimbursement rates are lower than the fees of private pay patients. “So the result is that those places that care for these patients are more likely to close,” he said. More than 27 million Americans will need long term care by 2050, nearly twice as many as in 2000, Katz noted. Either the federal government will have to increase the reimbursement rate for nursing home services, or state and federal policies will have to fund less expensive and perhaps more preferable lifestyle options, such as assisted living, he concluded.

“That would be sensible, and should not cost more, but it requires a more far seeing policy approach than what we have now,” he said. Otherwise, only the wealthy will have access to nursing homes, the authors said. In a separate study published in Archives of Internal Medicine, investigators from the Institute for Aging Research, which is affiliated with Harvard Medical School, found that a significant amount of Medicare money directed toward the care of nursing home residents with advanced terminal dementia may be wasted on aggressive therapies that offer little practical benefit. For patients who stand to gain little from rehabilitative services, for example, the researchers suggested redirecting resources toward high quality palliative care that could provide a more comfortable end of life experience. The findings of the studies are published in the Jan. 10 online edition and the May 9 print issue of the Archives of Internal Medicine.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing New York, Hospice Care, Medical Supplies, as well as a variety of Assisted Living and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

The Elder Care Justice Act – A Part Of Health Care Reform You May Have Missed

June 22, 2011 1 comment

While health care reform captured the national headlines, the Elder Care Justice Act, which is part of the overall reform, deserves our attention as well. When Health and Human Services Secretary, Kathleen Sebelius, was asked about provisions in health care reform that received little fanfare, she pointed to the EJA. This part of the legislation that was signed into law on March 23, gives our nation a solid framework to protect seniors from being beaten, neglected and exploited.

The reason this is an important step forward is because the EJA is the most comprehensive federal legislation ever enacted to combat elder abuse. The EJA authorizes increased federal resources and leadership to support state and community efforts to prevent, detect, treat, understand, intervene in and, where appropriate, prosecute elder abuse. It also authorizes funding for broad-based education and awareness efforts.
This is a critical victory for today’s seniors and each of the 76 million boomers that have a one in ten chance of facing elder abuse as our society ages.
Where the funding will go:

Adult Protective Services

Provides $400 million ($100 million per year) in first‐time dedicated funding for adult protective services.
Provides $100 million ($25 million annually) for state demonstration grants
to test a variety of methods to improve adult protective services.
Provides $32.5 million (over 4 years) in grants to support the LongTerm
Care Ombudsman Program and an additional $40 million ($10 million
annually) in training programs for national organizations and State long‐term
care ombudsman programs.

John Severn by *janesey on deviantART

Elder Justice Coordinating Council

Makes recommendations to the Secretary of Health and Human Services on the coordination of activities of federal, state, local and private agencies and entities relating to elder abuse, neglect and exploitation. Recommendations contained in report are due in 2 years.

The Patient Safety and Abuse Prevention Act

Creates a national program of criminal background checks for persons seeking employment in nursing homes and other long‐term care facilities.

CLASS Act

Creates a voluntary payroll deduction plan for long-term care workers. Employees who pay into the program for at least five years will be entitled to a daily cash benefit of at least $50 that they can use for long-term care at home or in a community-based setting. Medicaid beneficiaries in nursing homes would retain 5 percent of their cash benefit; and Medicaid beneficiaries receiving home and community-based services would keep 50 percent.

Home and Community-Based Services

Creates a state Medicaid option to provide community-based attendant services and supports for people who meet their state’s nursing home eligibility standards.
Gives states the option to provide home and community-based services through a state plan amendment, rather than a waiver. Requires the plan to be statewide; prohibits caps on the number served; and enables targeting of individuals with specific conditions.
Creates incentives for states to move Medicaid beneficiaries out of nursing homes into home and community-based services. Extends the Money Follows the Person program for six years.
Extends spousal impoverishment protections to spouses of Medicaid beneficiaries receiving home and community-based services.
Eliminates Medicare Part D cost-sharing requirements for people who are receiving long-term care under a home and community-based waiver.
Provides for grants and demonstration programs to train workers in geriatrics and long-term care.

Side Note: The Senate Special Committee on Aging estimates that there may be as many as 5 million elder victims of abuse every year.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Dallas and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

The Medical Home Concept: A Solution For The Healthcare Conundrum?

November 12, 2010 Leave a comment

The current monetary number for healthcare spending in the US is 2 trillion dollars, a topic that has created a lot of frustration in our country. At times it seems all we have to show for it is patient confusion over navigating the system, employer and patient agitation over rising costs, and government resistance and aggravation trying to provide affordable access to all. In the last few years, there has been a growing interest in the concept of a Patient Centered Medical Home as a way to combat the ills of the U.S. healthcare system. Proponents of this approach believe the way out of our healthcare conundrum is to make the primary care physician the hub of a patient’s disease prevention and care coordination.

In a medical home model, the primary care doctors and clinicians serve as advocates for patients, helping to avert unnecessary tests and procedures, hospital admissions and avoidable complications. Instead of a payment system that rewards procedures and volume, it would shift to one based on patient satisfaction and clinical outcomes. While few argue with the goals of a patient centered approach to the delivery of healthcare, most agree that transforming the current system would not be easy. Nor is the financial viability of this concept so readily clear.

History of The Medical Home Concept

The origin of the medical home concept goes all the way back to 1967, when The American Academy of Pediatrics used the term to describe a central location for archiving a child’s medical records. In the following decades, medical homes focused primarily on families with children of special needs, helping to coordinate care and information across multiple specialists and services. By the 1990’s, as the delivery of healthcare was becoming more complex, the role of the medical home expanded to include the provision of comprehensive primary care for adults. Associations such as the American College of Physicians and the American Academy of Family Physicians also embraced the medical home concept and issued a joint statement of principles with the AAP in 2007.


Healthcare by ~sciophobik on deviantART

Today, the term “medical home” has become somewhat misleading, as it refers not to a location but to a model based on integrated care across all elements of the healthcare system including hospitals, Nursing Homes, subspecialty care, Home Healthcare agencies, public and private community services and family members. Interest in implementing a Patient Centered Medical Home has been gaining interest among hospitals and physician groups over the last few years based on the summary of several factors. In 2008, Harris Interactive conducted a survey of over 1,000 adults that revealed the current healthcare delivery system does not serve the public well. 8 of 10 respondents said it needs to be fundamentally changed or completely rebuilt.

Specifically, common frustrations voiced by participants in the survey included:

  • Nearly 73% of those surveyed had difficulty making timely doctors’ appointments, getting phone advice or receiving afterhours care without having to visit an emergency room.
  • Approximately 30% reported difficulties getting same or next day appointments with their doctor when they are sick. An even larger share, 41% said they had difficulties getting advice from their doctor by phone during regular office hours.
  • 6 out of 10 said it was difficult to get care on nights, weekends, or holidays without going to the emergency room.
  • Nearly half of all adults reported at least 1 failure of coordination of care. More than half, 56% of those seeing 3 or more doctors experienced poorly coordinated care.
  • 32% of adults and 40% of those in fair or poor health thought they received either duplicate tests or unnecessary care.

In 2002, the American Association of Pediatrics expanded its definition of a Medical Home Model to include its operational characteristics. “The medical home offers accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective care.” Since then, the American Academy of Family Physicians and the American College of Physicians have developed models referred to as “advanced medical homes” and the “medical home.”  Both entities build upon the AAP model by integrating care coordination features with pay for coordination and performance as outlined in Wagner’s Chronic Care Model described below.

This model identifies the essential components of high quality chronic disease care: the community, the health system, self management support, delivery system design, decision support and clinical information. The goal is healthier patients and more satisfied providers which results in medical cost savings. Enactment of health care reform legislation will accelerate the adoption of the patient centered medical home in the public and private sectors by making key investments in the nation’s primary care infrastructure. The legislation will give the Centers for Medicare & Medicaid Services greater latitude in launching and sustaining innovative models, which may then be implemented by the private sector.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Philadelphia and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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