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My, how time flies – the naviHealth Essential Insights blog is celebrating turning four-years-old throughout the month of February! As a thank-you for following along and subscribing to our newsletter over these past four years, we would like to offer you a complimentary ebook “Trials and Triumphs: Finding hope during COVID-19.” Not a subscriber? Click here to receive our weekly newsletter.

Click here to download a free copy of “Trials and Triumphs: Finding hope during COVID-19.”

Title: “Trials and Triumphs: Finding hope during COVID-19”

Summary: As the world steps back, healthcare professionals from around the globe are going above and beyond to serve those in need during this COVID-19 crisis. Dr. Kristofer Smith, naviHealth’s President of Home-Based Medical Care, is one of these dedicated workers, tirelessly answering the call to volunteer for the cause despite not practicing acute care medicine in over a decade. These are his daily stories – uncut and untouched, as told from the front lines.

The post Celebrate NEI turning 4 with the “Trials and Triumphs” ebook appeared first on naviHealth.
Source: Navi

As the novel coronavirus began to spread in March, fear of being hooked to a machine with the end of life looming quickly became a national storyline — particularly for seniors who did not have an end-of-life plan.  As we reflect on National Hospice and Palliative Care month, it is clear just how important it is for seniors and their loved ones to set appropriate care goals before it’s too late.

Reinforce the need for end-of-life planning

When a senior who is living in a long-term care facility is diagnosed with COVID-19, the survival rate is grim. In fact, the toll among long-term care residents makes up 6% of the country’s COVID-19 cases and 39% of deaths, according to the Centers for Disease Control and Prevention (CDC). This has forced end-of-life discussions to happen in a very small window between seniors and family members, or worse, between seniors and emergency department clinicians. Unfortunately, the high volume of COVID-19 patients have made it nearly impossible for these seniors and clinicians to have “adequate time to clarify goals of care.”

Gina BrunoVP, Value-Based CarenaviHealth

“In any sort of emergent situation, it can be very difficult to reflect on goals and wishes and to make sure that our family members are part of decisions and that documents are in place,” said Gina Bruno, vice-president of value-based care at naviHealth. “But this has highlighted the need to have those conversations, have them early, and have them in a time of non-crisis to make sure that seniors have articulated what’s important to them about their ongoing care and any recovery needs they may have.”

The role of palliative care has been severely impacted during the pandemic due to “overburdened health systems, restrictions on face-to-face clinical interactions and sometimes rapid physiologic decline among patients with COVID-19.” However, the gap in care is substantial and is leading to heartbreaking stories of families losing loved ones before any type of care plan can be discussed.

Preparing to have end-of-life planning conversations with your loved ones is crucial, and palliative care workers understand its importance for families. Many providers are beginning to take creative, proactive steps to strengthen the palliative care response to future surges. For example, a hospital in Colorado identified three action pillars in preparation for a second surge:

Improve communication and documentation of patients’ goals of care and preferences for treatment prior to and during a COVID-19 surge.Ensure alternative care processes and spaces for patients receiving comfort-focused care to accommodate expected surge overflow from hospitals, nursing homes and other care facilities.Create a virtual hotline for round-the-clock, specialty-level advice and support to extend palliative care expertise during a surge.

It takes a village – and the village needs to be cared for, too

The epidemic of loneliness is also having a significant impact on the senior population in nursing homes across the country — residents have had limited to no access to family members for more than nine months. Sadly, due to national and local visitor restrictions, many healthcare professionals including hospice workers have found themselves becoming the link between loved ones saying one last virtual goodbye.  

Healthcare professionals have been dealing with the death of their patients at such an alarming rate that experts have warned of the significant mental impact that COVID-19 has and will have on the industry.

“I think what we’ve seen through COVID-19 is the need to support professional caregivers in addition to the family caregivers,” said Bruno.

A study from China of 1,257 healthcare workers attending to COVID-19 patients in 34 hospitals found that 50% showed signs of depression, 45% reported anxiety and 72% had psychological distress. Stress has been an issue for healthcare workers long before the pandemic, with 60% of emergency physicians experiencing burnout in their career, according to the American College of Emergency Physicians.

Healthcare professionals are not only putting their overall health in jeopardy every day they go to work, but their families’ health as well. In fact, it may be their biggest concern throughout the pandemic.

For direct care workers such as nursing assistants, personal care aides and home health aides who work in residential care settings and private homes, many are forced to decide between the health of their family and their financial well-being.

LeadingAge recently released a study on the impact that increasing wages for direct care workers can have on the level of quality care, overall costs and staffing shortages. Raising pay to what MIT has identified as a “living wage” would reduce labor shortages by 330,000 full-time employees by 2022 and reduce the use of public programs by 16.8%, or $1.6 billion. According to the research, these increases would allow care recipients to experience better quality care, payors will see reduced costs for avoidable adverse events and employers will experience fewer vacancies and a lower turnover rate.

But above all else, the study shows that the pay increase will allow one in eight direct care workers to no longer live in poverty.

“Above all, COVID-19 has exposed just how interconnected we all are— patient, provider, caregiver— and the need to make sure that everyone in that village is healthy,” said Bruno.
The post Setting appropriate care goals and taking care of ‘the village’ appeared first on naviHealth.
Source: Navi

Boasting a higher quality of care at lower consumer costs, Medicare Advantage plans are quickly edging out traditional fee-for-service Medicare, says the Better Medicare Alliance (BMA) State of Medicare Advantage report.

The Medicare open enrollment period ends December 7.

In fact, Congresswoman Allyson W. Schwartz, President and CEO of BMA, reports a “record-setting 99% satisfaction rate” for Medicare Advantage. The cost savings are impressive too: Medicare Advantage plans provide an average $1,598 in cost savings when compared to its traditional counterpart.

October 17 marks the beginning of open enrollment for Medicare until December 7, 2020. Here are some key trends and updates to know.

Medicare Advantage participation continues to increase

Released this July, the report states more than one in three Medicare beneficiaries are currently enrolled in Medicare Advantage.

This high rate of participation correlates with a 49% jump in the number of plans available since 2017, according to Health Payer Intelligence. Also, nearly all Medicare beneficiaries—99%—now have access to at least one Medicare Advantage plan.

With so much positive data around health care quality and savings—and such a tremendous uptick in enrollment—it’s no surprise many experts believe Medicare Advantage plans are the future of Medicare. Since 2017, Medicare Advantage has grown by more than 30%, and by 2030, Medicare Advantage is projected to increase to nearly 51% of total Medicare enrollment.

CMS announces lower premium costs expected for 2021 Medicare Advantage plans

With open enrollment currently underway through December 7, the Centers for Medicare & Medicaid Services (CMS) and White House leadership announced that the average 2021 premiums for Medicare Advantage plans are “expected to decline 34.2% from 2017.”

CMS said that the average monthly premium will be the lowest it’s been since 2007. Also, seniors who use insulin will “have over 1,600 Medicare Advantage and Part D prescription drug plans to choose from that will offer insulin at no more than a $35 monthly copay beginning in January.”

The role Medicare Advantage plays during COVID-19

The coverage of supplemental benefits like vision or hearing have become increasingly important during this time of COVID-19. Going forward in our new normal of continued protective measures and health precautions, seniors should leverage the opportunity to choose a Medicare Advantage plan that offers these additional benefits.

Lower costs may grab the headlines, but what everyone wants—patients, providers and plan administrators alike—is better health overall. Without a corresponding improvement in outcomes, the decreasing costs only have value in terms of dollars saved. But the value of lives improved through better health? That kind of win is invaluable. Here are a few stats of significance around improved health outcomes from the report:

Medicare Advantage beneficiaries had lower rates of potentially avoidable hospitalizations than traditional Medicare beneficiaries.A large-scale report that examined care for individuals with multiple chronic conditions found that Medicare Advantage beneficiaries experienced 23% fewer inpatient hospital stays and 33% fewer emergency room visits than in traditional Medicare.

Another impact that COVID-19 will have for Medicare will be during the current open enrollment, which starts today and ends on December 7. Medicare currently covers the costs associated with COVID-19 lab testing, antibody testing, medically necessary hospitalizations and hospital quarantines, as well as a potential vaccine. According to Healthpayer Intelligence, COVID-19 treatment potentially costing between $9,000 to more than $20,000. However, an August brief from the Peterson-Kaiser Family Foundation states that coronavirus waivers for a little over 31% of payers on the individual and fully-insured markets will end in December 2020.

With more plan choices, lower premiums and increased access to additional benefits, the expansion of Medicare Advantage is welcome news in uncertain times. As the country moves towards an historic election in the midst of a global pandemic, the strength of Medicare Advantage in meeting the needs of today’s older Americans is reassuring. Its continued growth bodes well for tomorrow’s seniors.
The post What’s new with Medicare Advantage – and what you need to know during open enrollment appeared first on naviHealth.
Source: Navi

October is Health Literacy Month, a time to draw awareness to the need for health literacy as well as how we can improve it. Approximately 80 million adults in the United States are estimated to have a lower health literacy; however, the senior population tends to be impacted at a significantly higher rate. But what causes such an alarming statistic?

According to the Health Resources and Services Administration, health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions.” There are many health disparities that attribute to lower health literacy including language barriers, financial issues and cultural boundaries.

While studies have found that the research on the relationship between health literacy and disparities is still mixed and fairly limited, health disparities and health literacy typically come across similar barriers. A 2015 study on the “Relationship between Health Literacy and Health Disparities” showed that people who likely “fall victim to social disparities, which in turn lead to worse health outcomes, are also more likely to have lower levels of health literacy.”

There has been a lot of discussion about healthcare equity and equality, specifically during COVID-19. There is an important distinction between the two. For example, healthcare equality refers to giving everyone the same treatment while equity refers to a more tailored approach aimed at providing individualized solutions. Adjacent to this conversation lies health literacy – seniors not only need equal access to healthcare resources, but they need individualized solutions that include ways to overcome social, economic and educational barriers.

How the healthcare system can provide opportunities to increase health literacy

Rima E. Rudd, ScDHarvard T.H. Chan School of Public Health

With the senior population projected to make up about 20% of the population by 2030, and only 3% of seniors are proficient in health literacy, a lot needs to be done to improve the current situation. The National Assessment of Adult Literacy (NAAL) also indicates that 71% of adults older than age 60 had difficulty in using print materials, 80% had difficulty using documents such as forms or charts and 68% had difficulty with interpreting numbers and doing calculations.

To increase health literacy, Rima E. Rudd, ScD, a lecturer on health literacy at the Harvard T.H. Chan School of Public Health said the following must be done:

Enhance literacy and communication skills of people and professionals.Improve health texts.Make it easier to take action or complete tasks.Eliminate barriers to health care and services.Change the atmosphere of health-related sites and systems.

“The healthcare system in the U.S. compared to the healthcare systems in most other industrialized nations has not been designed well for post-hospital care,” Rudd said. “Achieving equity is an important goal but to do so means tackling systemic issues. For example, we need to change the notion that care and responsibility ends at the outside steps of an institution. Follow-up care and services are as important as inside care. Otherwise, as we well know, returns are to be expected.”

Could a successful discharge plan be the key?

Dr. Jane JihCo-Director, Multiethnic Health Equity Research CenterUniversity of California, San Francisco

Discharging from a hospital setting to a post-acute care provider, or to the patient’s home, can be a vulnerable time for older adults and their caregivers and family members, explained Dr. Jane Jih, an assistant professor and co-director of the Multiethnic Health Equity Research Center at the University of California, San Francisco.

Communication barriers between the patient and/or their caregiver or family members and the clinical team could affect health outcomes after discharge and result in rehospitalization, Jih added.

“This is even more pronounced for older adult patients who do not speak English well or are from minority groups as the healthcare system in the U.S. by and large is designed for a health literate, English-speaking population,” Jih said. Identifying these types of disparities with the patient prior to discharge would promote health equity, according to Jih.

Medical professionals and health systems have a responsibility when it comes to a senior’s access to care and health after a hospital stay, Rudd said. Rudd believes the most important thing a health system can provide is a clear discharge plan for the patient and their caregivers and to continue providing opportunities for open lines of communication between the providers and the patient. Additionally, anyone discharged from a hospital will be well served by social services that are designed to fill the gaps in needed resources.

While we may not be able to solve healthcare literacy, equity or equality with the flip of a switch, there is one action that can be taken that healthcare systems can do for each of their patients — that action is communication. Healthcare systems can provide more than an open line of communication throughout the discharge process by taking the extra step and assuring that their patients not only understand how to take care of themselves but to provide access to the care that the patient needs.
The post Opening doors and improving the health literacy rate of seniors appeared first on naviHealth.
Source: Navi