Navigation Links
The Affordable Care Act could have negative consequences for elderly recipients
Date:6/22/2012

WASHINGTON Three provisions of the Affordable Care Act (ACA) intended to enhance care transitions and prevent avoidable outcomes for the Medicare population are found to have inadequately addressed the needs of older, vulnerable recipients of long-term services and supports, according to George Washington University School of Nursing Assistant Research Professor Ellen Kurtzman, MPH, RN, FAAN.

Ms. Kurtzman was one of six authors of the paper examining the consequences of select ACA provisions on this subgroup of frail older adults. In the paper "Unintended Consequences Of Steps To Cut Readmissions And Reform Payment May Threaten Care Of Vulnerable Older Adults" published first online in the medical journal, "Health Affairs," three provisions were reviewed: the Hospital Readmissions Reduction Program, the National Pilot Program on Payment Bundling and the Community-Based Care Transitions Program.

The research found that these provisions inadequately address the unique needs of elderly Americans receiving long-term services and supports, and in some instances, produce unintended consequences that contribute to avoidable poor outcomes.

  • Hospital Readmission Reduction Program. This program financially penalizes hospitals with excessive Medicare 30-day rehospitalization rates for three target conditions and should lead to improvements in care that will benefit all inpatients including the subgroup studied. However, in order to reduce frail older adults' risk of rehospitalization, attention will need to be paid to the alignment and coordination between providers of acute care and long-term services and supports. Furthermore, older adults receiving long-term services and supports are frequently rehospitalized for conditions that are not being targeted by this policy. Therefore, more immediate improvements in care are likely to be realized for this vulnerable population if penalties targeted alternative diagnoses and accounted for coexisting conditions.
  • National Pilot Program on Payment Bundling. Bundled paymentsa set dollar amount paid to a hospital system for an episode of careare designed to motivate providers to deliver care in the lowest-cost setting and to maximize operating margins while avoiding expensive post-acute stays and preventable rehospitalizations. However, under the pilot program, long-term services and support, which are chronic in nature and do not lend themselves to this payment model, are excluded as part of the "bundle." The authors point out that while the pilot should increase coordination within the bundle, there are no incentives to coordinate care before or beyond the bundle. Additionally, the fixed-fee structure of the payment model creates legitimate concerns about withholding services to realize savings.
  • Community-Based Care Transitions Program. To date, 30 sites have been selected to participate in this program, which links community-based organizations with one or more hospitals with high readmission rates to provide transitional care services. However, the authors point out that under this program, hospitals serve as the "hubs" of care and frail older adults who are not hospitalized or who live outside the geographic regions served by these organizations may have limited access to needed transitional care services.

"While the Affordable Care Act makes significant investments in improving care transitions and reducing fragmentation, there are significant gaps for a vulnerable subgroup of older adults receiving long term services and supports," said Ms. Kurtzman. "To address potential gaps and emerging risks, we recommend policy makers carefully monitor the law's implementation, advance payment policies that integrate care more fully and support providers in delivery system changes. Without anticipating unintended consequences and retooling the payment and delivery systems, reform could fall short of its transformative promise."


'/>"/>
Contact: Latarsha Gatlin
lgatlin@gwu.edu
202-994-5631
George Washington University
Source:Eurekalert

Related medicine news :

1. Blood test for pregnant women could predict risk of having dangerously small babies
2. Could Sunlight Lower Your Odds for Pancreatic Cancer?
3. Could Psoriasis Increase Odds for Type 2 Diabetes?
4. Cheaper drug could lead to serious eye issues
5. Control gene for conveyor belt cells could help improve oral vaccines, treat intestinal disease
6. Mouse Study Suggests Certain Fats Could Trigger Crohns, Colitis
7. Noisy Wards Could Threaten Hospital Patients Health
8. 2-1-1 could be effective tool in fighting cancer disparities
9. Could Bloodletting Ease Heart Risks for the Obese?
10. Diabetes drug could be a promising therapy for traumatic brain injury
11. Super-sensitive tests could detect diseases earlier
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/7/2016)... (Dec. 3, 2016) , ... (PRWEB) December 07, ... ... only patient advocacy nonprofit for individuals impacted by cerebral cavernous angiomas, was awarded ... New Mexico with a patient engagement program. New Mexico has more people with ...
(Date:12/7/2016)... ... December 07, 2016 , ... Dr. ... at the International Probiotic Association’s Washington DC workshop on November 2nd. The conference ... in dialog regarding probiotic dietary supplement regulations. , Dr. Leyer spoke about ...
(Date:12/7/2016)... ... December 07, 2016 , ... "Hacking into my medical record wouldn’t be ... 'a genius.'" Thus begins "Margaret in Berlin," Book Twelve in the Margaret of ... Books, Inc. These novels narrate the lives of a poor teenager and her ...
(Date:12/6/2016)... , ... December 06, 2016 , ... ... agreed to collaborate in developing a vaccine against the Middle East Respiratory Syndrome ... can be available in South Korea for emergency deployment in the event of ...
(Date:12/6/2016)... ... December 06, 2016 , ... Individuals who seek to reduce ... drinking more water or limiting their exposure to the sun, according to a November ... group Beverly Hills Physicians (BHP) notes that, while preventive measures to help keep ourselves ...
Breaking Medicine News(10 mins):
(Date:12/6/2016)... DIEGO , Dec. 6, 2016  Arcturus ... RNA medicines company, announced today that it entered ... develop RNA-based therapeutics for the treatment of NASH ... wholly-owned therapeutic delivery platform LUNAR™ and UNA Oligomer ... "Given Takeda,s long-standing commitment to and expertise ...
(Date:12/6/2016)... OCEAN VIEW, Delaware , December 6, 2016 ... 2024; as per a new research report by Global Market Insights, Inc. ... ... GMI logo ... Increasing global population, growing women employment rates and rising consumer ...
(Date:12/5/2016)... 5, 2016  Balloon catheter is an innovative medical ... into the femoral artery in the leg or sometimes ... constricted blood vessels. These products are generally used to ... deposition of lipid substances in the blood vessel. In ... projected to expand at a CAGR of 3.8% during ...
Breaking Medicine Technology: