Tuesday, November 30, 2010

Largest Health Insurer Forecasts Growth in Medicare Advantage Plans for Elderly

Today, Reuters reported that United Health Group (UNH.N) expects health insurance plan enrollments to increase over the next year. The Group is the largest health insurer in the U.S and expects the growth to result at least in part, from increased Medicare Advantage plans for the elderly. You can view the original article here. Click here for information on UNH.N.

Specifically, the insurer noted at an annual investor conference that it  expects it will add around 800,000 members. Although this increase in membership comes as a welcomed reception, yesterday (Monday, November 29) the company noted that it expects “earnings per share” to drop of around 8%. This number, however, was not more than Wall Street expected.

Monday, November 29, 2010

Over 4 Million Children Not Receiving Medicaid or CHIP, Despite Eligibility

Image Courtesy of jscreationzs/ FreeDigitalPhotos.net
In March, numerous healthcare initiatives were signed into law. In September, a report was published that examined “the average day in 2008,” with regard to American children and the widespread lack of medical insurance. This issue is one that is going to take serious efforts by Americans and lawmakers alike to fix.

According to Medical News Today, citing a report published in Health Affairs, a startling 4.7 million children were uninsured but eligible for Medicaid or Children’s Health Insurance Program (CHIP) in 2008. The estimated number of uninsured American children was around 7.3 million, and unfortunately, almost two-thirds (65%) were eligible.

What policies should U.S. lawmakers explore to combat this trend? One solution may be an “auto-enrollment.” The authors note that it may be feasible to use income tax information to automatically enroll kids.

Of the 4.7 million eligible but non-enrolled children, most are from families barely above the federal poverty level. Experts must figure out the reason for the state-to-state disparities. By region, the percentage rates of enrolled children are given below.
  • Northeast 87.7%
  • Midwest 85.3%
  • West 78.8%
  • South 79.8%
The authors of the study state that more research is needed to determine why some states are lagging behind others, in terms of enrollments. Some factors that need to be assessed include political cultures, income per capita, and population density.

Wednesday, November 24, 2010

Seniors can reduce frequency of falls by exercising to music, study finds

Image Courtesy of Pixomar / FreeDigitalPhotos.net
Music-based exercise programs may help Seniors improve balance and reduce frequency of falls, according to a report online that is expected to be published March 28, in Archives of Internal Medicine. Read the Senior Journal article which references the report here.

The study was organized by University Hospitals, and Faculty of Medicine of Geneva, Switzerland. For six months, music-based exercises were tested in a controlled environment involving just over 130 elderly men and women. It should be noted though, that 96% of the participants were women.

Participants were assigned at random to two groups; the first group of adults was immediately immersed in the music-based exercise program, whereas the second group of adults participated in the program six months following the first group. The first group returned to normal exercise activities after their six month period. When measured, the first group only showed a rate of .7 falls per year per person, compared to 1.6 for the second, delayed group.

According to the authors, "that participation in music-based multitask exercise classes once a week over a 6-month period can improve gait performance under single and cognitive-motor, dual-task conditions, as well as improve balance, and reduce both the rate of falls and the risk of falling in at-risk elderly community-dwelling adults.”

Tuesday, November 23, 2010

Physicians and social media: AMA weighs in

Recently, the American Medical Association (AMA) adopted a policy aimed at educating physicians on the use of social media. Many industries use social media to gain attention, but the AMA is taking steps so that the integrity of the medical profession remains intact, and so that the patient-physician relationship is not undermined.

The AMA issued a press release, available here. The press release focuses on the use of privacy settings, encourages internet monitoring, and more. For example, here is an excerpt from the press release:

"[P]hysicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate."
 Just as impacting,

"[p]hysicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession."
 The AMA appears to be concerned with both the patients and the professionals. Likewise, protection of the industry as a whole is also an obvious objective.

Monday, November 22, 2010

Bride-to-be paralyzed after prank gone wrong: Forced to choose marriage or Medicaid

Although this tragic story does not involve "elder law" per se, it does highlight the strict eligibility rules that Medicaid recipients must adhere to. Moreover, it perhaps calls into question some of the policies that may bring about unintended restraints. In this case, tragically the restriction is the ability to get married. 

In just an instant, a bride-to-be was paralyzed by a bachelorette party prank gone awry. Some of the best friends of the 25-year-old fitness instructor shoved her into a pool, just as they had numerous times before. On this occasion, the result was not hilarity. Bride-to-be Rachelle knew at the instant she hit the concrete that she was paralyzed. 

The spinal cord injury Rachelle suffered prevents her from feeling below the collarbone. She is unable to walk, and doctors believe she may never again do so.

Just as tragic as the injury is one of the consequences following that fateful night. Rachelle relies on Medicaid to pay for her enormous medical bills. If not for Medicaid, Rachelle would be buried in debt for life. But the Medicaid she does receive comes at a huge price. The benefits she receives are contingent on her level of income. If she marries her would-be husband, their combined incomes would lead to forfeiture of her benefits.
Is it time to look at new Medicaid rules regarding disabled young couples? Certainly, the goal of medicaid is not to prevent couples from marrying. Check back for more updates related to this story.

Read the CNN and Daily Mail article for more.

Friday, November 19, 2010

Power to the Patients! New Rules Forbid Discrimination in Medicare Facilities

Patient advocates have commented by the thousands in an effort to end any real or perceived discrimination. In April, 2010, President Obama echoed these pleas...as of this week, new rules have been established and will go into full effect very soon. 

In a press release released yesterday by The Centers for Medicare & Medicaid Services (CMS), it appears as if new rules will give more rights to patients. The gist of the press release being that patients, under the new rules, can select their own visitors.

These new rules will come in the form of an update to the Conditions of Participation (CoPs), standards that apply to all facilities under the Medicare/Medicaid system. It also pertains to patients in such hospitals.

The focus of the press release was on same-sex domestic partners. HHS Secretary Kathleen Sebelius stated that “basic human rights” and “equal rights” support the new rules.

How did these new rules come about? This past April, President Obama made it clear that the HHS was to develop new standards and guidelines related to anti-discrimination. The hospitals affected will be required to implement these new policies in a written, formalized document.