• Tom Boyd

An Industry Thrives

Chartbook Provides Comprehensive Look at Women’s Health Care in the U.S.

Kaiser Family Foundation, May 6, 2011

 The Kaiser Family Foundation has released a new Women’s Health Care Chartbook, which includes the findings from a national survey of women ages 18 to 64 and provides a look at the experiences of women in the health care system.  The chartbook presents a wide range of data on women’s health issues, including insurance coverage, affordability of and access to care, use of health care services, prevention and family health.  The survey was conducted in 2008 and builds on data collected during previous women’s health surveys conducted by the Foundation in 2001 and 2004.

The National Small Business Association released its 2011 Small Business Taxation Survey which reveals exactly what small business owners are concerned about.  Their top worries are ranked here. (4/11/11 excerpt)

Economic uncertainty66 percentDecline in customer spending39 percentCost of health benefits35 percentRegulatory burdens35 percentFederal taxes29 percentState and local taxes18 percentLack of available capital17 percentLack of qualified workers12 percentCost of employee salaries12 percent

Overmedication of Nursing Home Patients Troubling

Inspector General, Department of Health and Human Services

A government report this week ( has documented a problem regarding the use of antipsychotic drugs in nursing homes.  Too many of these institutions fail to comply with federal regulations designed to prevent overmedication, giving nursing home patients antipsychotic drugs in ways that violate federal standards for unnecessary drug use.

The report also found that these powerful, at times dangerous drugs were often prescribed for uses that are not approved by the Food and Drug Administration and do not qualify as medically accepted for Medicare coverage.  Potentially most alarming, 88 percent of the time these drugs were prescribed for elderly patients with dementia, a population the FDA has warned faces an increased risk of death from this class of drugs.

Medicare trustees release annual report

AHA News Now, May 13, 2011

The Medicare Board of Trustees today estimated the program’s Hospital Insurance trust fund will expire in 2024, five years earlier than projected last year.  Although the fund was “substantially improved” by the lower expenditures and additional tax revenues instituted by the Patient Protection and Affordable Care Act, the slowdown in the national economy resulted in a decline in tax revenues and higher real projected expenditures, according to the board’s 2011 annual report.  The Supplementary Medical Insurance trust fund, which consists of Medicare Parts B and D, is adequately financed over the next 10 years and beyond because Parts B and D premiums and general revenue income are reset each year to match expected costs, the report states.  Actual Part B expenditure growth in 2010 was lower than expected, the report notes.

Study: Cost of establishing an ACO significant

AHA News Now, May 13, 2011

The estimated start-up and first-year costs to establish and sustain the core competencies necessary to manage the care of a defined population through an accountable care organization are considerably higher – $11.6 to $26.1 million – than the $1.8 million estimate made by the Centers for Medicare & Medicaid Services in its proposed rule, according to a new study prepared for the AHA by McManis Consulting.  Based on four case studies of organizations that have taken steps to manage the care of a defined population in a manner similar to an ACO, the study creates two hypothetical examples to estimate the start-up and ongoing costs of establishing an ACO.  The study was completed prior to the release of the ACO proposed rule and therefore does not include estimates of the costs of meeting the rule’s specific requirements.  However, it identifies 23 different capabilities that must be developed across four categories to achieve the desired transformation in care delivery: network development and management; care coordination, quality improvement and utilization management; clinical information systems; and data analytics.  “CMS’ estimate falls short of the mark,” said AHA President and CEO Rich Umbdenstock.  “The shared savings rate with ACOs s hould be adjusted to reflect these costs in order to encourage and enable participation in this important program.”

Aging In Place Technology Watch

An industry thrives – the worker, not so much

May 24, 2011

The sound of one hand clapping.  We’re apparently headed into a wave of hiring of home care workers, according to a new Senior Helpers study.  Yay, I guess, for the job ‘opportunities’ for 100,000 additional in-home senior care workers in 2011.  It’s a good thing that the article offered up an observation by one franchise owner who said “many of the caregivers employed were middle-aged women who were in the job because they wanted to help, rather than for the money.”  Yes, of course.  They can’t be in it for the money.  Note the Bureau of Labor Statistics about the fasted growing job occupations.  Note the only one with an annual average wage below $20k – yup, that’s the personal care worker, one of the few on the list with only ‘on-the-job training’.  One in three have no health insurance, which for a single individual (healthy) under the age of 65 requires an average premium cost of nearly $3000.  And sure enough, the industry is lobbying to be exempt from requirements to insure their workers, also admitting that for those who are currently insured, that the coverage “is probably not up to what will be required.”

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