News

Medicare has made significant changes starting in October 2019. As a benefit recipient, you may not see much difference, It is important, however, to know how some of these changes are affecting providers of healthcare services.

Medicare and Advantage programs have shifted away from 3-day qualifying hospital stays. This move can put at risk Part A coverage for skilled rehab services for elderly individuals. Many hospitals are sending patients directly home, sometimes with home health care, or into a Part B service network. Patients are generally expected to pay as much as 20 percent for co-insurance or deductibles.

Many hospitals are more frequently using the 72-hour observation window without adequately informing patients about the consequences of this practice. With observation status, you may be in a hospital’s building, but you might not have ever been admitted. This practice does not meet the 3-day hospitalization-stay to qualify for Medicare coverage in rehab or skilled nursing care center.

The new Patient-Driven Payment Model (PDPM) will change how skilled rehab centers deliver services. The PDPM concept—reimburse centers for treating more medically complex patients instead of reimbursing for minutes in rehab—is great. The harsh reality? Decreased payments to providers of rehab services. This fact may lead to rehab centers increasing their rates.

While measuring outcomes for the whole person is good. How quickly you must achieve those outcomes in rehab may accelerate.

Providers, again are caught in the middle by Medicare design changes, are

• Expected to do more with less compensation

• Achieve better outcomes

Of course, Medicare knows providers will adapt and adjust their services to accommodate this new payment model. So in the end, smaller payments will likely mean reduced services.

These changes will not happen overnight. Although you may never experience their impact, you can expect a different experience since, for instance, you had your knee replaced last year. And, now when you’re ready for surgery on your other knee you may notice several changes in your rehab regime.

Medicare Advantage programs generally have not yet adopted PDPM. They are waiting for the pioneers to navigate new territory before evaluating how to incorporate these same savings into their programs.

Just remember, savings for third-party payors is the holy grail!

No matter the circumstances, Medicare aims to reduce its overall spending on healthcare costs. It must be because the continuing escalation of costs is untenable and must be addressed.

Medicare has changed payment design models before and will do so again in the future. Let’s be thankful that nearly all healthcare systems in the USA are still focused on quality patient care and outcomes. We will find a way to absorb these compensation changes and sustain our commitment to quality healthcare.

Impact of loneliness on our brain and body

Strong social connections are fundamental to physical and mental well-being… negative health consequences of chronic isolation and loneliness, while harmful at any age, are especially so for older adults. According to a 2015 study published in Perspectives on Psychological Science, the health effects of prolonged isolation are equivalent to smoking 15 cigarettes a day.

AARP December 17, 2016

Wow! There is a difference between being alone by choice and experiencing chronic loneliness. With no sense of connection, a person can be lonely even in a crowded room. On the other hand, a person can feel quite content being alone with herself or himself.

Do you wonder if individuals who isolate themselves do so because they truly want to be alone? Or do they actually feel disconnected?

Join our Vibrant Retirement Community in Hyde Park, Chicago

Living at Montgomery Place can bring you closer to others who share common interests, economic and social status, and goals of living healthy. But simply residing here is not a tonic for loneliness. For some, initiating conversations can be challenging, especially if a person suffers from the anxiety of loneliness.

One study on interventions for loneliness found increased opportunities for social interactions had a positive impact on someone feeling lonely. While social opportunities here are plentiful, they still require effort.

So, if you find yourself feeling isolated, step out and join one of the many groups, meetings or social events at Montgomery Place. Keep trying!

And, if you notice someone, who typically doesn’t attend a gathering, extend a warm welcome. Invite them into the conversation. I joyfully witness residents doing just that every single day.