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:10/13/2017)... , ... October 13, 2017 , ... Global Healthcare Management’s ... Alexandria Park in Milford, NJ. This free event, sponsored by Global Healthcare Management’s ... The fun run is geared towards children of all ages; it is a ...
(Date:10/13/2017)... , ... October 13, 2017 , ... “America On The ... identity. “America On The Brink” is the creation of published author, William Nowers. ... great-grandchildren. As a WWII veteran, he spent thirty years in the Navy. ...
(Date:10/12/2017)... ... 2017 , ... IsoComforter, Inc. ( https://isocomforter.com ), one of the ... new design of the shoulder pad. The shoulder pad provides optimal support and ... pain while using cold therapy. By utilizing ice and water that is circulated from ...
(Date:10/12/2017)... ... 2017 , ... HMP , a leader in healthcare events and education, today ... Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the Eddie & ... award competition recognizes editorial and design excellence across a range of sectors. This year’s ...
(Date:10/12/2017)... ... October 12, 2017 , ... In the United ... year. In some states—like New York, New Jersey, Massachusetts, Texas, Virginia, Connecticut, and ... havens have extremely low property-tax rates, which contributes to the relatively lower cost ...
Breaking Medicine News(10 mins):
(Date:9/28/2017)... CHICAGO , Sept. 28, 2017 Hill-Rom ... quarter 2017 earnings conference call and webcast on Friday, ... 8:00 a.m. (EDT) and ending at approximately 8:30 a.m. ... to discussing the company,s 2017 financial performance and guidance ... growth opportunities, initiatives to enhance operational performance, and long-range ...
(Date:9/25/2017)... --  Montrium , an industry leader in powerful ... Trial Master Files & Inspection Readiness Conference ( ... Services has selected eTMF Connect to ... a leading European contract research organization (CRO), will ... enable greater collaboration with sponsors, improve compliance and ...
(Date:9/22/2017)... Sept. 22, 2017 AVACEN Medical (AVACEN) announced ... now successfully helping those with the widespread pain associated ... diagnosed Amanda in Essex, England ... my hair, experiencing no sleep at all, tremendous pain, ... I cannot recommend [the AVACEN 100] enough, how this ...
Breaking Medicine Technology: