News Article: Medicare could fail, Leavitt says

Medicare could fail, Leavitt says
By James ThalmanDeseret News
Published: May 29, 2008

The federal government is on the verge of breaking one of its oldest promises to its citizens — health care for the elderly — U.S. Secretary of Health and Human Services Secretary Michael Leavitt told a conference of seniors during a Wednesday visit to Salt Lake.

Shoring up Medicare is the single most important and possibly the ugliest political issue the country will face, but it must face it now, the former Utah governor told the home state crowd gathered at the Little America Hotel for the 21st Annual Utah Conference for Seniors hosted by Sen. Orrin Hatch and his wife, Elaine.

If something isn't done to seriously address how things are today and recognize that the premise of Medicare no longer holds true, the Medicare trust fund could well become insolvent by 2019. Four or five years later, he said, Medicare could come apart from the inertia of economic and demographic forces the plan's designers couldn't have imagined.

It's a combination of things, from the global economy to the mounting obligations to seniors, he said. Generations of younger workers who were counted on to underwrite Medicare are dramatically declining, just as the largest group of Americans in history reach the age when they're likely to use more medical care than they did in the previous 64 years combined.

Another factor is the burgeoning cost of health care, which is estimated by Leavitt's advisers to account for 41 percent of the typical family budget by 2030. In 25 years, the 13 percent of the federal budget now earmarked for health-care services will be more like 23 percent, he said.

"What we see coming is whitewater and treacherous whirlpools," Leavitt said, likening the course of Medicare in the near future to a river with rapids tough enough to challenge the most expert river runners.

He was quick to note the problems can be solved if the various stakeholders — including Congress, the current and next administration, public and private sector employers, and the seniors themselves — get a sense of what's ahead "and get in and start paddling around danger spots."

Leavitt was short on specific measures that could be used to reorient Medicare. The fist step, however, is coming to grips with the fact that the plan will have twice the cost and half the people underwriting, he said.

It will take more positive approaches, similar to the significant cost savings and improved quality achieved through the recently implemented Part D Medicare plan.

"When seniors began to shop, they selected options that created competition and have driven down costs by 40 percent," he said.

Young families struggling to make ends meet today will no doubt argue that the Medicare deal wasn't struck by their generation, he said. Seniors will argue that they paid into the system and expect to have the promise kept.

"I can't stress enough that virtually nothing is how it used to be," Leavitt said, adding that imported goods to the United States will top $2 trillion this year, "a figure inconceivable just 10 years ago."

Like it or not, change is coming.

"We can fight it and fail, we can accept it and survive or we can lead it and prosper," he said.

News Article: Doctors' house calls on the rise. Visits let physicians learn of patients' lives.

Doctors' house calls on the rise
Visits let physicians learn of patients' lives

By CHERIE BLACKP-I REPORTER
John Devine is 82 years old and has no interest in leaving home to socialize with others.

He'll pass on the so-called "senior activities" and get-togethers. He would rather read in the library of his assisted-living facility in Burien.

Wanting to stay home makes doctor visits and routine checkups a bit difficult, though. But Devine, a small, spry man with a Scottish brogue and a mischievous smile, has that taken care of. He has a doctor make a house call to him about once a month for a checkup and to help coordinate any other medical care he needs.

Once considered on the verge of extinction, house calls are making a comeback.

TO VIEW THE REST OF THIS ARTICLE, CLICK HERE:
http://seattlepi.nwsource.com/local/364946_housecalls29.html

Hope everyone had a great Memorial Weekend!

Hope you enjoyed the mild temperatures and had a good holiday!- Steve

News Article: U.S. ads push patients to shop for hospitals

The Bush administration today launches a $1.9 million advertising campaign touting its effort to rate hospitals and urging patients to check a government website before choosing one.
The ad campaign in 58 regional newspapers lists hospitals and their scores on two of more than 30 measures available on the website: the percentage of patients getting antibiotics before surgery to prevent infection and whether patients "always" got help when they asked for it.
The government's campaign promoting the website by the Centers for Medicare & Medicaid Services (CMS) comes amid a flurry of efforts by states and the private sector to rate medical providers. The movement is fueled by demands from employers and consumer groups, including AARP and the Consumers Union, for more information about cost and quality.

To read the rest of this article, click here: http://www.usatoday.com/news/health/2008-05-20-Hospitalads_N.htm

Seeking some amazing Inpatient Case Managers for East Valley!

I am consulting with some East Valley acute facilities that are seeking RN Case Managers with acute care experience (2 years+). These are amazing opportunties with excellent pay/benefits. Please call me for details or if you know someone you can refer, I pay a $1,000 referral bonus/finders fee!

Call me for details, 480.305.6118

Steve

Health Choice Arizona, Inc. Awarded New Contract

FRANKLIN, Tenn.--(BUSINESS WIRE)--IASIS Healthcare® LLC (“IASIS”) announced today that Health Choice Arizona, Inc. (“Health Choice”), IASIS’ prepaid Medicaid and Medicare managed health plan in Phoenix, Arizona, has been awarded a new contract from the Arizona Health Care Cost Containment System (“AHCCCS”), the state agency that administers Arizona’s Medicaid program. Health Choice’s existing contract with AHCCCS expires September 30, 2008. The new contract continues to give Health Choice a state wide presence and provides for a three-year term commencing October 1, 2008, with AHCCCS having the option to renew for two additional one-year periods. The new contract covers Medicaid members in the following Arizona counties: Apache, Coconino, Maricopa, Mohave, Navajo and Pima counties, which are counties covered by Health Choice’s existing contract, as well as Yuma, LaPaz and Santa Cruz counties, which are new counties awarded to Health Choice in the recent bid process.
IASIS, located in Franklin, Tennessee, is a leading owner and operator of medium-sized acute care hospitals in high-growth urban and suburban markets. The Company operates its hospitals with a strong community focus by offering and developing healthcare services targeted to the needs of the markets it serves, promoting strong relationships with physicians and working with local managed care plans. IASIS owns or leases 16 acute care hospital facilities and one behavioral health hospital facility with a total of 2,770 beds in service and has total annual net revenue of approximately $1.9 billion. These hospital facilities are located in six regions: Salt Lake City, Utah; Phoenix, Arizona; Tampa-St. Petersburg, Florida; three cities in Texas, including San Antonio; Las Vegas, Nevada; and West Monroe, Louisiana. IASIS also owns and operates a Medicaid and Medicare managed health plan in Phoenix that serves over 129,000 members.

AHCCCS Contract Awards will bring a host of changes

Reports from various sources are showing significant changes in the acute care contract awards. Most significantly impacted looks like APIPA/United which will loose all but a a few counties and drop around 100,000 lives off the books.

Phoenix Health Plan has picked up six new counties including Pima County. Healthchoice maintains their current counties and may have picked up some additional counties. Mercy Care Plan will fall back to Maricopa, Cochise, Greenlee, and Graham counties.

As a result of the changes, their will assuredly be changes to affect both Case Management and Utilization/Concurrent review nurses and their respective positions within the health plans.

Stay tuned as we track the developments and possible lingering job opportunities that will arrise in the local Medicaid market!

Thanks, Steve

News Article: Chronic ailments have 51% of insured on pills

For the first time, it appears that more than half of all insured Americans are taking prescription medicines regularly for chronic health problems, a study shows.

To view the rest of this article, click here: http://www.freep.com/apps/pbcs.dll/article?AID=/20080514/NEWS07/805140429/1009

Posting Comments

Some have asked how to post comments to more actively participate in this Blog.

At the bottom of each post or news article, there is a section that looks like this:

Posted by Steve Thornley, CSP at 12:54 PM 0 comments - Simply click on the link where it states "0 comments " and it will allow you to post your comment anonymously.

Thanks and let's see some more posts on the blog. We enjoy your comments!

-ST

News Article: Cigna, hospital group agree to deal

Cigna Healthcare of Arizona and Catholic Healthcare West have struck a new 14-month pact that will give Cigna customers access to the health provider's area hospitals and surgical facilities, ending a two-week impasse that disrupted health-care options for many Arizonans.

to see the rest of this article, click here: http://www.azcentral.com/community/mesa/articles/2008/05/10/20080510biz-cigna0510-ON.html

Another great certification! Case Manager touts other certification options!

I recieved an email regarding other certification options for Case Managers. Definitely worth checking out and so I am passing along some good advice.....see below for details. I HAVE ALSO POSTED A LINK ON THE SIDE BAR TO THE American Nurses Credentialing Center. (ANCC)

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I would like you to check out the website for ANCC= American Nurses Credentialing Center which is the credentialing arm of ANA. Although CMSA has long been aligned with the CCM certification, there are other certification options for nurse CM's. I believe CMSA has always "supported" the CCM certification because other professionals such as SW have been an integral part of CMSA. At this point It seems to me the vast majority of CMSA members are nurses, & I'd love to see information regarding the ANCC NCM certification displayed on your site. ANCC certifies nurses in many nursing specialty areas & is indeed the Gold Standard for certification of nursing specialties. This organization offers Magnet certification which is a really big deal for hospitals, & ANCC certification for CM's working in those hospital settings is generally supported as well. So- bottom line- I'd like you to consider placing information re: ANCC certification on your blog in as prominent a format as the CCM info currently posted.

Guess I'm asking for equal time for ANCC NCM certification Steve! Thank you, & again- great job with this new venture!

Approaching another milestone!

We are approaching 500 visitors to the blog! Not bad for being live for just over three weeks. Please keep the blog lively by commenting. If it is easier to email me, I am happy to post your comments and do it annonymously if you prefer.

Thanks! Steve

Is working from home all it's cracked up to be?

As more and more companies move to a work from home program for Case Managers, I seem to have heard mixed results on this type of work situation lately. Sure gas is $3.50 a gallon and traffic is horrible and you can do work in your pj’s…but what about the social interaction that one generally gets from being around co-workers? Is the motivation spurred by teamwork synergy you generally feel working in the office lost as a result of the work from home situation? GIVE ME SOME FEEDBACK! I would love to have some comments on this topic from you all! Please email them or post by hitting on the “Comments” link below this post.

Thanks, Steve

Article: For many, nursing is a mid-career choice.

By Taryn Plumb, Boston Globe Correspondent May 4, 2008

We've all heard the old nursery rhyme about the butcher, the baker, and the candlestick maker.

Well, before becoming a nurse, Melissa Mattola-Kiatos was a third of the way through that lineup - as well as a few others.

In addition to her post as a junior butcher at Elm Street Market in her hometown of Everett, she once supervised a four-star restaurant at Faneuil Hall; performed hand rubs as a salesgirl at Donna Karan; and managed mutual funds for two investment companies.

Finally, four years ago, the Saugus 33-year-old decided to give nursing a go.

"I'm hoping this career sticks," she quipped as she sat in a narrow break room lined with lockers and stacked with medical textbooks at Melrose-Wakefield Hospital, where she has worked for two years.

But really, she said, "To date, becoming a nurse is the best decision I ever made."

She will celebrate that pride - alongside millions of colorful scrub-wearing comrades across the country - during National Nurses Week, May 6 through 12.

Mattola-Kiatos - a self-described overachiever who graduated from the Lawrence Memorial/Regis College Collaborative Associate of Science in Nursing Program and plans to pursue an advanced degree in nursing - is never short on praise for her job. "It's so personally rewarding," she said.

"I chose to do this. It wasn't something I fell into out of high school."

And she's hardly alone in her mid-career choice.

According to a 2002 survey by the Massachusetts Colleagues in Caring Collaborative, the mean age of graduating nursing students was 31.6.

David Schildmeier, spokesman for the Massachusetts Nurses Association, noted a few reasons for that trend: job security, better pay, and career satisfaction. "Many people come to nursing because they see meaning," he said.

That has been the case for Mattola-Kiatos. She said she gets the feeling at the end of every day that she's accomplished something. And despite the widely held belief that nurses do all the grunt work - emptying bed pans and changing bandages - she said there's a great deal of variety in her job.

For starters, she deals with a broad spectrum of patients, from those requiring hip or knee surgery to others who have pneumonia or appendicitis. "It's always something different," said Mattola-Kiatos, who often shows off pictures of her 85-pound Labrador, Wrigley, and is an avid Red Sox fan who wears her BoSox scrubs whenever knuckleballer Tim Wakefield pitches.
The challenge is in assessing the patient's needs, she said, from elders facing fears of dying to young moms fretting about day care.

"You spend time with patients and do everything in your power to meet their medical needs, but also their emotional needs," she said.

Generally, she works with four to five patients a day on Melrose-Wakefield's Med 4, a U-shaped complex with orange doors that smells of antiseptic, and the constant, soft beeping of various machines blending into the background. On a recent sun-soaked afternoon, she performed her rounds while mentoring new grads. Dressed in pink and green scrubs, a stethoscope slung around her neck, she mixed a batch of medicine at a counter, then entered a shaded room.

"Hi, my friend," she said with a smile to Albert D'Arco of Everett, an 80-year-old hunched on the bed in a hospital gown, his wrists wrapped in green, orange, and white hospital bands.

Calling him "Mr. D'Arco," Mattola-Kiatos inserted an IV into his right arm, pressed a button on a machine that beeped to life, and keyed in a series of numbers. "Are you 20?" she asked playfully before leaving the room. He laughed as he lay back in the bed, "Multiply that by 4."

Afterward, his son, Manny D'Arco of Winchester, described Mattola-Kiatos as "very professional, but very caring, too - which is lacking in a lot of healthcare professionals these days." He shrugged. "I feel better when she's up here."

Miguel Rivera, director of Med 4, agreed that Mattola-Kiatos has a certain way with patients. She's an "above and beyond type of employee," he said. She's "charismatic, with personality."

Yet Mattola-Kiatos will tell you that it's the patients who "stick in my head." With some, "I could tell you what room they stayed in, their full name, everything about them."

Still, she described the frustrations of the job, as well. For instance, there are always puzzles in diagnosing patients' injuries and sicknesses, she said. And, not surprisingly, the hardest days on the floor are when people die. She remembers the first time that happened. Although she didn't know the patient and had never seen him before, she "just started to cry."

On the other hand, day-to-day business brings regular rewards - the patients with stomach pains who come in hunched over and leave with smiles and hugs, for instance; or others who require hip replacements and go home with the ability to walk (or even dance) again.
In those cases, she said, "I did my job."

News Article: Walmart Widens Drug Discount Program

To see this article, click this link: http://online.wsj.com/article/SB121002048022568563.html?mod=dist_smartbrief

Poll Results.....

POLL OF THE WEEK: How do you rate your employers own health insurance benefits?

Wow, out of 18 people that responded- 50% said the health insurance they are offered by their employers was poor/below average!- I guess we have a long way to go with the insurance aspect of what employers offer for benefits.

Interesting!

Thanks, ST