Archive for the ‘Uncategorized’ Category

Supreme Court Rescues Obamacare, Again

Friday, June 26th, 2015

Obamacare. For the past several years, you haven’t been able to go anywhere in our country without hearing about it, and it just got a whole lot more attention. Yesterday, the Supreme Court, in a 6-3 decision, ruled in favor of President Obama’s health care reform. Obamacare, also known as the Affordable Care Act, was designed to increase the quality and affordability of public healthcare in the United States. It established new minimum standards for insurance companies to uphold in order to cover all of their applicants and provide equal rates, regardless of pre-existing conditions of sex. The law has been one of the most controversial legislations in recent memory, as is threatened to further wedge the philosophical gap between Republicans and Democrats.

The Supreme Court ruling came after a discrepancy among the interpretation of particular clauses within the law, which was hastily crafted by Congress and had not been granted the opportunity to make adjustments in the messy language. The case was meant to determine if states that do not have their own insurance exchange and rely on the federal insurance exchange would be eligible for federal subsidies. If the law had not been upheld, it would have left approximately 6.4 million Americans without government subsidies to afford their healthcare. American citizens must learn to adapt to these healthcare reforms, as they are here to stay. The Supreme Court’s ruling means that it will take an Act of Congress and a future President’s signature to overrule Obamacare.

Republican officials had no fear of voicing their disapproval with the ruling. Florida Senator Marco Rubio denounced the law in its entirety, “I disagree with the Court’s ruling and believe they have once again erred in trying to correct the mistakes made by President Obama and Congress in forcing Obamacare on the American people.” He even alluded to his own proposed health care system, “I remain committed to repealing this bad law and replacing it with my consumer-centered plan that puts patients and families back in control of their health care decisions.” Several Republican states have neglected to create their own insurance exchanges simply because they do not wish to support President Obama’s reforms in any way.

Hospitals Struggle to Boost Patient Satisfaction Ratings

Monday, March 30th, 2015

More and more, the level of satisfaction that patients get from their experience of a visit or stay at a hospital directly affects how successful the institution can be.

As the world of healthcare continues to go through a metamorphosis, patient feedback continues to take a bigger and bigger role in shaping the reputation of hospitals. A bad reputation will cost the hospital future patients, and even more severely, will determine how much money it is allotted from the government and from private insurers.

There are now a multitude of venues for critique and criticism that carry a great deal of weight with the public—Facebook has even been proven to be a surprisingly accurate indicator of a hospital’s approval rating, according to Health IT Outcomes. Positive Facebook reviews have a remarkably tight correlation with hospitals’ low-readmission levels, meaning that the hospitals that do not make mistakes (and thus do not require the patient to return), and are hence getting their credit on the world’s largest social media database.

In short, accurate reviews of healthcare institutions are everywhere, and are accessible to anybody. It is no wonder, then, that hospitals and clinics across the country have begun adamantly making reforms to their policies, hoping to add some compassion to their care.

Hundreds of hospitals, though, are finding it quite challenging to reel-in positive patient reviews. Kaiser Health News reported the story of Rowan Medical Center of North Carolina, which is among the lowest rated healthcare institutions in the country.

Hospitals that have a history of malpractice or poor bedside manner, such as Rowan, often find it difficult to escape their previous reputations, despite any improvements that they may have made since their previous errors. Additionally, the Medicare method of assessing hospitals from the patient’s perspective (a survey that has the patient rank the hospital on a scale of 1-10, among other examinations) is very tough, as they only reward hospitals if patients give them a 9 or a 10 on their scale. Thus, it is hard for poorly-rated hospitals to receive the funding that is necessary to training their staff or improving infrastructure.

In April, though, the government intends to kick-off a new system for ranking hospitals, which will entail a five-star scale. Officials hope that this will be easier for the consumer to understand, and will hopefully help improving hospitals avoid the stigmas of the past.

There are many ways that a hospital can improve their quality of care. According to a survey conducted by the Schwartz Center, the most successful and highly-rated hospitals in the country:

  • Place a high priority on their staff, so as to avoid physician and nurse burnout
  • Involve and interact closely with the families of patients.
  • Emphasize quality care and compassion when training their staff.
  • Have a set-in-stone schedule for their staff, so no patients are left unattended.
  • Keep procedures as simple as possible for their patients.

Patients clearly crave a strong interpersonal relationship with their healthcare providers. Bedside manner is everything.

With luck, hospitals with poor satisfaction ratings will take advantage of the new government-implemented scale come April, and will continue to employ the aforementioned tactics in order to boost their overall patient-friendliness.

Many Americans Forgo Health Insurance, Despite Large Subsidies

Friday, March 27th, 2015

There has been much ado about the stiff penalties that come with remaining uninsured under the Affordable Care Act. Those who spent 2014 without a coverage plan are about to be slammed with either a $95 penalty or be subjected to confiscation of 1% of their income, whichever sum is higher. While Obamacare in itself is a remarkably famous piece of legislation, and nearly every American has heard of it, many speculate that the bulk of those who are still uninsured (and consequently facing penalties) are so due to simple ignorance of the mandate portion of the law.

A study by Avalere Health reveals that there is a major demographic of low-income Americans that, while being eligible for hefty government subsidies on the federal exchange, still have not purchased a healthcare plan.

An analysis by Kaiser Health News (KHN) interpreted the data, and concluded that while 76% of people with incomes between 100 and 150 percent of the official poverty level (between $11,670 and $17,505 for an individual) had enrolled for coverage last year, only 41% from the next demographic (between 151 and 200 percent of the federal poverty line) had 2014 coverage. Those individuals earn between $17,622 and $23,340, and are eligible for significant government subsidies through the federal exchange. Moreover, only 30% who rake in between $23,457 and $29,175 utilized the federal health insurance program.

Now, it is logical that those from the higher income levels do not use the federal exchange, as they can afford their own coverage or are provided some by their employers. And, while the government has done well to advertise their available subsidies and packages to the group right at the poverty line, the fact that only around 40% of those from the next-highest income levels have taken the government up on their financial aid is rather alarming, as they most likely do not have an alternative mode of attaining coverage, and will hence be hit with increasingly stiffer penalties in 2015 and 2016.

So, that begs the question—why is it that those who could benefit from the subsidies simply are not?

Caroline Pearson, senior vice president at Avalere Health, opines that it is because they still do not know about the mandate or the benefits for which they qualify. Her sentiments are felt by many who work in the world of health insurance.

Clearly, the Affordable Care act has done well to insure the poorest sector of the American populous. However, it evidently has room to grow when it comes to assisting those who, while keeping afloat above the federal poverty line, still need significant financial aid in order to practically afford coverage.

Reforms in the Nursing Code of Ethics Aim to Modernize Care

Friday, March 13th, 2015

In January 2015, the American Nurses Association revised their Code of Ethics for the first time since 2001, Nurse.com reports.

The recent revisions are the result of an 18-month process that drew from the insight of some of the United States’ most experienced nurses. The new Code of Ethics touches upon nearly all conceivable aspects of the nursing profession, from providing appropriate end-of-life care to how to handle oneself on social media.

The Code of Ethics has a long history, dating back to 1896, according to Nurse.com. Since then, the Code has evolved into a document of nine provisions and several subsequent interpretive statements that assist nurses in understanding and applying its guidelines. The new revisions process is the first in over 25 years that features revisions in both the nine provisions and the interpretive statements.

The new Code of Ethics touches upon several delicate and difficult issues that nurses face every day on the job. One of the more controversial inclusions in the new Code is a subject that deals with the issue of medically-assisted suicide and euthanasia, a topic that is hotly contested in politics and between ideological groups. Nurse.com reports that the new Code formally prevents any nurse from administering any medicine or treatment that will end the life of a patient, even if that situation comes up in the execution of death-row inmates. The guidelines make it clear that no nurse, anywhere, under any circumstance, should administer a lethal injection.

The American Nursing Association also had to tweak their documents in light of recent technological and social advances, specifically concerning social media. The new mandates that nurses pay extra close attention to not violating patient confidentiality with their personal social media accounts. Nurses who post about the condition of some of their patients on social media sites such as Twitter or Facebook violate the secrecy and privacy of patients, which the new Code of Ethics deems unacceptable.

The Code of Ethics is just one of the reasons why nursing is consistently rated at the top of the list for honest and ethical professions, Nurse.com reports. Surely, the newly revised Code will uphold the industry’s impressive reputation.

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VA Hospitals Face Scrutiny Nationwide

Wednesday, March 11th, 2015

In recent years, VA hospitals have been the subject of a great deal of controversy and scrutiny. In 2014, the Veterans’ Affairs healthcare facilities made headlines because of their inability to provide services for a large number patients, and many had to wait months before they could see doctors in what became known as the “waiting-list scandal.”

In 2015, VA hospitals have done well to cope with the influx of veterans that need appointments with doctors and surgeons. However, reports have shown that the increased quantity of patients seen has caused the average quality of care to decrease.

In a Seattle Times article, Tim Kuncl, former member of the US Coast Guard, shared his misadventures with the Puget Sound VA Health Care System.

Kuncl suffered from a rare pilon fracture in 2011 as he was putting Christmas decorations up on his home in Washington State. Three weeks later, he went to his local VA hospital and received surgery in which doctors inserted several pins, screws, and plates in order to fix his shattered bones. His pain persisted well past his expected recovery time, though, and he ended up having to get two additional surgeries done on the same leg, each one resulting in increased pain and discomfort.

Eventually, Kuncl decided to forego the VA system and get treatment from a private organization, who found that the previous surgeries had irreversibly damaged his leg, and concluded that amputation was the only path left to take. He has since become an advocate for the improvement of the VA healthcare systems.

The unfortunate case of Tim Kuncl is following a trend of increased malpractice. According to the Seattle Times, wrongful-death claims against the VA healthcare systems throughout much of 2014 climbed 43%. The Government Accountability Office has placed Vetrans Health Administration on the “high risk agency” list by virtue of its issues in oversight and training of new employees, according to the Seattle Times. The VA hospitals are treating more patients, but the number of erroneous cases has gone up rather alarmingly.

In other news, the VA healthcare system in Tomah, Wisconsin has become the subject of investigation as whistleblowers revealed that facilities have been overprescribing narcotic drugs, the StarTribune reports. In response, the VA has implemented new computer software that helps to monitor the allocation of prescription medicines. The program is called the “opioid therapy risk report,” and currently over 2,000 VA doctors nationwide now have access to the software.

With luck, the complaints against the VA healthcare systems that are piling up will reduce very soon, as the government has decided to increase its funding. The Puget Sound VA’s budget is $7.4 million larger in 2015 than it was in 2014, and will be $14.9 million larger in 2016, the Seattle Times reports. The additional funding should result in faster treatment and higher quality of care for our nation’s veterans.

Medicare Payment Overhaul is in the Works

Friday, February 6th, 2015

The Obama Administration recently announced a rapid reconstruction of the American Medicare system by the year 2018. The president intends to change the way that the enormous Medicare program makes payments to hospitals and physicians, shifting away from a “fee-for-service” system, which simply encourages to see a large volume of patients rather than deliver each one the best possible care.

According to the LA Times, Medicare will start making 30% of its direct payments to hospitals and doctors through alternative payment models. These models offer a rewards system to doctors and hospitals that provide care to patients under budget while simultaneously delivering excellent care to the patients. The overall goal of this transition is to transform the American healthcare system into a quality-based institution. The LA Times also reports that such a change to the Medicare system is paramount, as finding an efficient way to pay for healthcare will become more and more important as the baby boomer generation starts to retire.

In 2014, only 20% of Medicare spending (about $72 billion, according to Kaiser Health News) was done through alternative payment models. The shift to 30% will raise the total sum to about $113 billion. On January 26th, U.S. Secretary of Health and Human Services Sylvia M. Burwell wrote an article in the New England Journal of Medicine in which she announced that by 2018, she hopes to have 50% of all Medicare payments done through alternative payment models.

The ramifications of this plan are already being felt throughout the private sector of the healthcare industry, as commercial insurers and prominent employers have begun to invest in new payment models, the LA Times reports.

Most influential figures in the healthcare world have heralded this as a progressive and necessary step. Ensuring that the Medicare system spends its money wisely is remarkably important, as this year it is estimated that the program will spend over $600 billion to insure nearly 50 million different disabled and retired Americans. Kaiser Health News reports that with these aforementioned changes implemented, 90% of all Medicare spending will be linked to quality of care in some regard.

What’s Ahead for Home Healthcare Staffing?

Monday, August 25th, 2014

What’s ahead for the home healthcare employment?

Plenty!

The home healthcare industry remains one of the fastest-growing in the United States, with no signs of slowing down. The US Department of labor estimates the profession will grow by almost 50% by 2022, which is close to five times faster than the average for all occupations.

Most home care positions require little training and often don’t mandate a high-school diploma, which can be an attractive option for those looking to break into the healthcare field without the time and cost of college. Home healthcare has its rewards, but there are also lots of cons. Low wages (median yearly wage is about $20,000), physically demanding environments, lack of full-time hours and no health benefits plague workers and lead to an extremely high turnover rate. A recent article in the Wall Street Journal notes that home healthcare turnover averages around 50% each year.

The primary contributor to industry turnover is pay. Demand for home healthcare staffing is strong… and getting stronger. To keep up with the pace, the homecare industry needs to make itself more appealing – starting with better pay and job stability.

Starting on January 1, 2015, the U.S. Department of Labor will require all direct care workers employed by staffing agencies and home care agencies to be covered by minimum wage and overtime protections. This sounds like a solid plan on the surface; however, this could backfire and actually cause home health workers to lose money. Caregivers often work lots of overtime to boost their paychecks, but the new law may cause homecare agencies to enact shorter shifts and cut back on overtime hours due to higher costs.

Even with minimum wage protections in place, the home health industry may still struggle with significant turnover while trying to appease increasing demand. Improved training opportunities may be another solution to reducing the turnover. If agencies provide non-medical caregivers with opportunities for additional training, employees may be motivated to use their home health experience as a stepping-stone to a more specialized career in the healthcare industry.

One thing is certain – the home health boom is coming. If better pay isn’t in your agency’s budget, now is the time to develop new and innovative ways to attract and retain the top caregivers.

Working capital to meet rising home healthcare staffing demands

Accounts receivable factoring for home healthcare is quick funding solution that helps home care agencies cover payroll on-time, every-time. Rather than worry about delayed payments from slow-paying customers, Medicare, Medicaid or HMO’s, factoring home care receivables can get you the funding you need to manage your growing business.

Which State is the Best for Nurses?

Monday, June 23rd, 2014

That the nursing industry is changing is indisputable. Social and economic pressures are transforming the industry and will have a continuing impact on new nurses looking to establish themselves in the industry. Where are the nursing jobs? What state offers the best standard of living for its nurses?

WalletHub released a recent analysis of the industry nationwide (including the District of Columbia) with a breakdown of the best – and worst – states for nurses along a variety of criteria. Depending on your area of focus and your career goals, below you will find out which states to pursue…and which to avoid.

Jobs

Nursing is an overall high-demand field, particularly given the impact of the Affordable Care Act on the insured population. However, some states have more openings than others and provide a more ideal destination for the newly minted nurse in search of a job.

Most job openings: District of Columbia

Least job openings: Alabama

Most healthcare facilities per capita: Oregon

Least healthcare facilities per capita: Delaware

Salary

Even the most rewarding position should come with a salary that covers the cost of living and, hopefully, allows an experienced nurse to invest in the future. What kind of price tag comes on your dream job? Find out where you’re likely to get it, and where you may need to pass. (Salary rankings are adjusted for cost of living.)

Highest annual salaries: Texas

Lowest annual salaries: Hawaii

Demographics

A nurse’s dream job location also depends on his or her specialty. Many specialties – including pediatrics, labor & delivery, and elderly care – are concentrated in a single age group, and choosing a location with low numbers of patients in that demographic means finding the right job will prove difficult. WalletHub projected the concentration of patients over 65 in each state by 2030.

Highest percentage of population over 65: Florida

Lowest percentage of population over 65: Utah

This is just a sample of the data and perspectives available in WalletHub’s survey. For more information, visit their site.

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ACA: Race to Enrollment Deadline is Frustrating but Successful

Wednesday, April 2nd, 2014

By now, Monday’s deadline to enroll in a valid health insurance plan is old news – as is the eleventh-hour rule change allowing consumers to apply for short-term extensions as long as they have attempted to enroll before March 31.

Many more consumers will fall into that latter category thanks to a last-minute race by thousands to meet the enrollment deadline, a process highlighted by more difficulty accessing state and federal marketplace Web sites.

The online marketplaces went through intermittent overload periods until mid-afternoon on March 31. Consumers at home and enrollment counselors processing in-person applications were shut out of the Web site for long periods, likely due to a software glitch discovered during an overnight maintenance session. Enrollment counselors could do little more than create an account for each consumer so they would be eligible for the enrollment extension.

State-run exchanges faced similar difficulties, as well as similar influxes of consumers looking to beat the deadline. At all levels, consumers that have accessed the marketplace but have not successfully enrolled in a healthcare plan will have a blanket extension until mid-April to complete their enrollment without paying the tax penalty.

Despite the minor Web site setbacks and the decision of many Americans to not enroll in marketplace health plans at all, figures released April 1 indicate that completed enrollments exceeded the Congressional Budget Office’s projected target of seven million to the tune of at least 100,000 additional enrollments. That number does not include Medicaid enrollments in states with expanded eligibility, nor does it include consumers who began the enrollment process but did not yet complete it.

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Dropping Spouses from Healthcare May Increase Employer Costs

Monday, January 27th, 2014

The Employee Benefit Research Institute published a study in this month’s issue of their Notes that suggests that the employer trend of excluding spouses from health care coverage may cost them more in the long run.

As many as 15 percent of employers nationwide have already eliminated spousal coverage in cases where the previously-covered spouse has access to health care through his or her own employer. NPR reports that a continuing trend of such cuts may offset any short-term savings as their own employees lose spousal coverage picked up by other companies.

A simple example: Company A and Company B both offer spousal health care coverage. Company A currently covers Employee A and Spouse A, who works for Company B. Company B covers Employee B and Spouse B, who works for Company A. If both companies eliminate spousal coverage, Spouse A and Spouse B will return to their own company’s health care plan, which means that at the very least the companies have not saved any money.

Further, if the companies have traditionally subsidized a lower amount for spouses then each will face higher health care costs by covering two of their own employees.

Situation: Each Company Covers Spouses (cost to company)

Company A

Company B

Employee A: $5,000/year

Employee B: $5,000/year

Spouse A: $3,500/year

Spouse B: $3,500/year

Situation: Neither Company Covers Spouses (cost to company)

Company A

Company B

Employee A: $5,000/year

Employee B: $5,000/year

Spouse B: $5,000/year

Spouse A: $5,000/year

*The figures above are purely hypothetical and are only meant for illustrative purposes.

According to a weekend report in Forbes, meanwhile, more full-time employees are enrolling in employer-provided health care to take advantage of better coverage at lower costs than the plans provided on the health care exchanges. These new enrollees may also contribute to rising employer costs, even without an influx of employees who have lost coverage under their spouses’ plans.

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