Archive for the 'Campaign for Better Care' Category

Setting the Record Straight: Best Kept Secrets about Health Reform

Published on February 24, 2010 in Campaign for Better Care, Christine Monahan, Health Care, Quality and Reform. 0 Comments
Christine Monahan, Health Program Assistant

Christine Monahan, Health Program Assistant

Between President Obama issuing a new proposal on health insurance reform on Monday and the White House Health Care Summit Thursday, the beat marches on around this debate in Washington.

But people around the country are wondering how health reform will help them.  I think you’ll agree that the amount of misinformation and scare tactics spread by opponents over the past several months has confused just about everyone about what the health bills in Congress would really accomplish.

It’s time to set the record straight.

The National Partnership for Women & Families created a list of the top 10 best kept secrets about health reform, because people across the country need to know how meaningful reform will benefit them and their families.  That, after all, is the most important question to answer in this debate.

Here’s a look at some of the things opponents don’t want you to know about the legislation Congress has passed.

  • Better Benefits – women and families will be guaranteed coverage for the care they need, from the doctors they need.
  • Better Care – finally we will invest in innovative new ways to provide health care that will support better communication and coordination among health care providers – and between doctors and patients (and their families) – to prevent errors and duplication that disrupt your care.
  • Free Preventive Care – both private health plans and Medicare will cover the full costs of a range of preventive services and immunizations, so women and families can stay healthy without worrying about the expensive co-payments or deductibles that now often keep them from getting the care they need.
  • Coverage for Young Adults – recent high school and college graduates won’t be left without coverage as they struggle to find work and start their careers. The new legislation will let young adults stay on their parents’ insurance plans until they are 26 years old.

There’s more too.

Women and families are counting on lawmakers to get health care reform done and done right. We can’t let anyone stand in the way, or mislead the public about meaningful reform. Check out the full list: The Top Ten Best Kept Secrets about Health Insurance Reform and Why Congress Should Pass It Without Delay.

Health Care Reform Matters to Older Women

Published on December 7, 2009 in Campaign for Better Care, Debra Ness, Health Care and Reform. 0 Comments
Debra Ness

Debra Ness

Let’s be clear. As both caregivers and patients, women bear the brunt of shortcomings in our health care system – high costs, poor quality, and fragmented, uncoordinated care. 

That’s because women are the primary users of health care, and we continue to use more health services as we age.

It’s also because, in most cases, we are primary caregivers for our families.  We coordinate care for our spouses, parents and children, and often, at great cost to ourselves, we fill in the gaps when the system fails and care is poor quality or uncoordinated.

With the finish line in sight on health reform, everyone needs to take a close look at what the House and Senate bills will do, not only to expand coverage and contain costs but also to improve the way care is delivered.  We should look particularly closely at whether these bills will provide higher quality care for older women, who are more than half of Medicare beneficiaries and 70 percent of those aged 85 and older.

The good news is that the House and Senate bills both contain a number of measures that will improve the way we pay for and deliver health care.  These quality improvement measures are vital to preserving and protecting programs like Medicare for the long term, and containing costs and improving efficiencies overall.

For example, both bills move us toward a system that links payment to better quality and better coordinated care.  This means we can start paying for health care based on value and better health outcomes, rather than paying based on the number of services or tests performed. This is good news for anyone who has a loved one struggling with illness or health problems. People who navigate the health system know that their loved one needs the right test or treatment at the right time – not an abundance of repeat or erroneous services that don’t provide answers or make them better.

Earlier this year, we talked to caregivers around the country about their concerns with our health care system.  Poor care coordination and a lack of communication among doctors were foremost on their minds.  That’s because they’ve seen first-hand how these problems lead to dangers and waste from bad drug interactions, repeat tests, misdiagnoses, and more.

Both the Senate and House bills also introduce new models of delivering health care that are specifically designed to improve coordination and reduce events like preventable hospitalizations and readmissions, which are all too common now.

Because passing legislation only begins the work to fix our broken health care system, these bills allow us to test new models over time so we can find out what works best and continuously build on our success.

Recently a distinguished group of consumer advocates, economists and analysts issued a letter praising the Senate’s Patient Protection and Affordable Care Act for its payment and delivery reforms.  I was proud to coordinate and sign that letter.

Older women have a huge stake in turning our health care system around, and ensuring that it serves them and other vulnerable populations better.  If we can make the system work for them, we can make it work for everyone.

We’re closer than ever to the reforms we need, but victory is not assured.  We need to be certain the final legislation includes the key provisions that will improve care coordination and put patients first.  

Balancing the need for change with ensuring that we do change right is the key to sustainable reform.  As the Senate debates the specifics of reform, we must all fight for policies that will provide higher quality, better coordinated, and more affordable care for everyone.

The Evidence is There: Better Coordinated Care Makes Sense and Saves Money. Duh.

Published on October 14, 2009 in Campaign for Better Care, Christine Bechtel and Health Care. 0 Comments
Christine Bechtel

Christine Bechtel

This just in.  What health care experts have suspected for some time has been demonstrated by a new study published in the American Journal of Managed Care: patients who can rely on a coordinated system where their providers talk to each other, their medical information is available electronically, and they have improved access to doctors and nurses – have better health outcomes.

Quick Fact: What is a Patient-Centered Medical Home?

A “medical home” — aka: “patient-centered medical home”— is a medical office or clinic where a team of health professionals work together to provide a new, expanded type of care to patients. It’s not an institution or nursing home, but a medical office or clinic that offers coordinated, comprehensive primary care that is personal and focused on making sure the patient’s health care needs are met.

The study compared four components – patient experience, quality of care, costs, and staff burnout – at a pilot patient-centered medical home (PCMH) in Seattle.  The outcome is compelling. 

Patients at the PCMH fared far better than patients at control sites in some significant ways.  After 12 months, patients at the PCMH had 29 percent fewer visits to the emergency room and 11 percent fewer hospitalizations.   These patients reported higher levels of satisfaction with their care and took a more active role in their own health care through regular communications with doctors and more participation in patient groups and self-management workshops.  These outcomes are good for patients, good for providers, and good for our nation’s pocket book. 

Another reason the medical home model is so promising?  Staff burnout (a long-time problem for primary care clinics that threatens the important role they play in preventing disease and keeping people healthy) was significantly less after one year at the PCMH.  Only 10%  of staff reported high burnout compared to 30% at the control sites.

And– because we love it when higher quality of care makes financial sense too – even though the PCMH had some significant initial start-up costs, those costs were recouped quickly (after one year).  The study estimates this is because of savings from fewer emergency visits and hospitalizations.   From the patient’s perspective, there was no detectable difference in cost between the PCMH and the control sites; meaning the PCMH was providing better care and patients were getting better outcomes and it didn’t cost them more.

But of course there’s bad news – there always is.  The problem is that all those savings generated by the PCMH didn’t actually accrue to the same people who made the wise investment in the first place.  For example, reduced hospitalizations are a worthy outcome, but those savings don’t benefit the PCMH directly; they really save health plans money.  That’s a function of the way we currently pay for health care, which promotes fragmentation over coordination and leaves patients feeling as though they’re a collection of body parts instead of the whole person they really are.

Evidence like this should play a central role in re-organizing health care payment and delivery systems in this country.  As Congress debates the future of health care, we must make sure that the way we pay for and deliver care helps every patient receives the high quality, coordinated care they deserve. 

For more information about the Patient-Centered Medical Home and how you can help advance this exciting new model of care in your area, click here.

The Costs of Family Caregiving in an Aging Society: What Is Your Experience?

Published on October 5, 2009 in Campaign for Better Care, Health Care and Lynn Feinberg. 2 Comments
Lynn Feinberg

Lynn Feinberg

Everyone I know has at least one personal story about the overwhelming stress and frustration in trying to arrange, coordinate or provide the best possible care for an aging parent, spouse, grandparent, other older relative or friend, not to mention the spiraling costs of health care.

More than three decades of research clearly show that family caregiving is a public health issue — that family members who provide care to older adults with chronic or disabling health conditions are themselves at risk — emotionally, physically and financially — particularly when the care is for a loved one with Alzheimer’s disease or another form of dementia.

Given our current economic recession, the financial aspects of family caregiving can be particularly distressing for the estimated 34 million Americans — most of whom are women — who provide care for an older (50+) family member or friend. The financial strain on this group, as they try to manage work, family, and caregiving responsibilities, was highlighted in a recent article in the New York Times. “Taking Care of Parents Also Means Taking Care of Finances” describes the growing numbers of Americans who are facing the “financial squeeze that can come from caring for elderly parents.”

The costs can be significant. Caregivers to persons age 50 and older spent an average of $5,531 per year out-of-pocket in 2007 for expenses ranging from household goods, food and meals, travel and transportation costs, to medical care co-pays and prescription medications.

According to a recent study by the National Alliance for Caregiving and Evercare, family caregivers have experienced the economic downturn in major ways. Consider these sobering statistics:

  • 50% of working caregivers (that is, those who have worked at some point while providing care in the past 12 months) said they were less comfortable taking time off from work to provide care;
  • One in three working caregivers said they had to work more hours or get another job;
  • One in six (15%) said that the economic downturn has caused them to lose their job or be laid off;
  • Six out of 10 caregivers who reported increasing their out-of-pocket spending for caregiving also reported having difficulty paying for their own basic care needs; and
  • 63% say they are saving less for their own retirement.

When it happens to you, when it becomes a personal issue in your own family, you are more likely to act.

For years at the National Partnership, we have talked about helping Americans meet the dual demands of work and family. A lot of people think about working parents when they hear those words, but millions of working people in this country are caring for frail, older relatives. The time has come to organize family caregivers as a strong and powerful force for meaningful and lasting change.

Stories about the real-life experiences of older adults and their family caregivers can help increase attention to the urgent need for better and more affordable, coordinated care.

Please take a moment to share your personal story about your caregiving experiences for an aging relative or friend.

Your story can make a difference!