Tag: Kaiser Health News

Death of an Elder Raises Uncomfortable Questions About Adequacy of Care

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2022/12/death-of-an-elder-raises-uncomfortable-questions-about-adequacy-of-care.html

Excerpt:

Yves here. I’ve taken the liberty of changing the title of this Kaiser Health New from A Family Death During the Holidays Prompts Questions and Reflection. The piece pulls its punches, perhaps because the health care journalist author Judith Graham, who regularly writes about aging, is hesitant to come off as an advocate and/or potentially alienate future sources. But you can see she is clearly not happy with the caliber of care her father-in-law received in his final days.

I’ve heard similar stories from readers and I saw it first hand with my mother, who like Graham’s father died at 94. I would be curious if practices are better or worse with the moderately and very old in other countries, particularly in Asia. The two times my mother was hospitalized in her final year, the care was horrid. And it wasn’t as if the staff was overburdened due to Covid. My mother’s aides would call for help, and after >10 minutes of getting no answer, would then go to the nurses’ station to find them doing their nails and watching TV. They also failed to keep her well hydrated and bruised her horribly.

….

But more broadly, an anti-aged attitude was evident. No one seemed willing to work that hard to save an old woman, or even help her have a more dignified death, particularly since she didn’t look that swell. Thanks to Covid, her hair and nails hadn’t been done for over a year and she came to the hospital in flannel pajamas. Notice the photos of the father in law below. Despite the upscale sweater, watch and glass frames, I suspect his very aged skin was held against him.

BTW, according to the Social Security life expectancy table, an average women my mother’s age typically would have lived another 3.8 years. So to hell with the bigots on staff.

And this sorry picture is set to get worse with Covid, with repeat infections reducing health baselines generally and resulting in more demands on doctors, nurses and hospitals that have no ability to increase capacity in less than many years. A sicker population will also produce more prejudice against older patients, even if they are robust and have managed to stay Covid-free.

Author(s): Yves Smith, Judith Graham

Publication Date: 9 December 2022

Publication Site: naked capitalism

2022 Employer Health Benefits Survey

Mary Pat Campbell

Link: https://www.kff.org/health-costs/report/2022-employer-health-benefits-survey/

Graphic:

Excerpt:

This 24th annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. The 2022 survey included 2,188 interviews with non-federal public and private firms.

Annual premiums for employer-sponsored family health coverage reached $22,463 this year, with workers on average paying $6,106 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,763 for single coverage. Workers at smaller firms contribute on average contribute nearly $2,000 more toward the cost of family coverage than workers at smaller firms. They also face general annual deductibles that are $1,000 higher on average. This year’s report also looks at employers’ experiences and views about mental health and substance use services, telemedicine, and wellness programs.

Publication Date: 27 Oct 2022

Publication Site: Kaiser Family Foundation

Drivers in Decline: A Shortage of Volunteers Complicates Access to Care in Rural America

Mary Pat Campbell

Link: https://khn.org/news/article/drivers-in-decline-a-shortage-of-volunteers-complicates-access-to-care-in-rural-america/

Excerpt:

Maybach is unpaid, a volunteer among a cadre organized by Faith in Action in Red Wing, a nonprofit that relies on retirees to ferry residents to essential services.

The riders, mostly seniors, are people who don’t have immediate access to transportation, especially in rural areas where public transit options are either limited or nonexistent.

There are several such programs serving rural counties in Minnesota, but, as with other services across the country, their existence has become precarious because the number of volunteer drivers has steadily declined, according to transportation advocates. Volunteers either get to a point where, because of age, they can no longer drive, or the costs associated with their volunteerism are no longer sustainable. For decades, Congress has refused to increase the rate at which the drivers’ expenses can be reimbursed.

Experts say that with public transit in rural areas already insufficient and the long distances that residents in rural communities must travel to access health care, a decimated volunteer driver network would leave seniors with even fewer transportation options and could interrupt their health management. Already, social service organizations that rely on volunteers have begun to restrict their service options and deny ride requests when drivers aren’t available.

….

Volunteers, like Maybach, are eligible for a reimbursement of 14 cents per mile, which generally doesn’t come close to covering the cost of gas and wear and tear on a vehicle. And while the Internal Revenue Service increased the business rate from 58.5 cents per mile to 62.5 cents per mile in June, it did not raise the charitable rate because it is under Congress’ purview and must be set by statute. The charitable rate was last changed in 1997.

Author(s): Christina Saint Louis

Publication Date: 24 Oct 2022

Publication Site: Kaiser Health News

Say What? Hearing Aids Available Over-the-Counter for as Low as $199, and Without a Prescription

Mary Pat Campbell

Link: https://khn.org/news/article/hearing-aids-over-the-counter-without-prescription/

Excerpt:

Starting Monday, consumers will be able to buy hearing aids directly off store shelves and at dramatically lower prices as a 2017 federal law finally takes effect.

Where for decades it cost thousands of dollars to get a device that could be purchased only with a prescription from an audiologist or other hearing professional, now a new category of over-the-counter aids are selling for hundreds of dollars. Walmart says it will sell a hearing aid for as little as $199.

The over-the-counter aids are intended for adults with mild to moderate hearing loss — a market of tens of millions of people, many of whom have until now avoided getting help because devices were so expensive.

Author(s): Phil Galewitz

Publication Date: 17 Oct 2022

Publication Site: Kaiser Health News

Death Is Anything but a Dying Business as Private Equity Cashes In

Mary Pat Campbell

Link: https://khn.org/news/article/funeral-homes-private-equity-death-care/

Excerpt:

Private equity firms are investing in health care from cradle to grave, and in that latter category quite literally. A small but growing percentage of the funeral home industry — and the broader death care market — is being gobbled up by private equity-backed firms attracted by high profit margins, predictable income, and the eventual deaths of tens of millions of baby boomers.

The funeral home industry is in many ways a prime target for private equity, which looks for markets that are highly fragmented and could benefit from consolidation. By cobbling together chains of funeral homes, these firms can leverage economies of scale in purchasing, improve marketing strategies, and share administrative functions.

According to industry officials, about 19,000 funeral homes make up the $23 billion industry in the U.S., at least 80% of which remain privately owned and operated — mostly mom and pop businesses, with a few regional chains thrown in. The remaining 20%, or about 3,800 homes, are owned by funeral home chains, and private equity-backed firms own about 1,000 of those.

….

Robertson said the funeral home industry is different from other sectors that private equity firms might consider investing in, describing it as a calling comparable to working in hospice care. Foundation Partners is fortunate their backers understand the service part of the industry, as well as the financials, he said. “Private equity firms aren’t necessarily known for having deep compassion for people. They’re more known for their financial returns,” he said. “To get both is really important.”

Foundation Partners owns Tulip Cremation, an online service that allows people to order a cremation with just a few clicks — and without having to set foot in a funeral home. Tulip currently operates in nine states where Foundation Partners has funeral homes. The company expects the service to eventually operate nationally.

Author(s): Markian Hawryluk

Publication Date: 22 Sept 2022

Publication Site: Kaiser Health News

Embedded Bias: How Medical Records Sow Discrimination

Mary Pat Campbell

Link: https://khn.org/news/article/electronic-medical-records-doctor-bias-open-notes-treatment-discrimination/

Excerpt:

Narrow or prejudiced thinking is simple to write down and easy to copy and paste over and over. Descriptions such as “difficult” and “disruptive” can become hard to escape. Once so labeled, patients can experience “downstream effects,” said Dr. Hardeep Singh, an expert in misdiagnosis who works at the Michael E. DeBakey Veterans Affairs Medical Center in Houston. He estimates misdiagnosis affects 12 million patients a year.

Conveying bias can be as simple as a pair of quotation marks. One team of researchers found that Black patients, in particular, were quoted in their records more frequently than other patients when physicians were characterizing their symptoms or health issues. The quotation mark patterns detected by researchers could be a sign of disrespect, used to communicate irony or sarcasm to future clinical readers. Among the types of phrases the researchers spotlighted were colloquial language or statements made in Black or ethnic slang.

“Black patients may be subject to systematic bias in physicians’ perceptions of their credibility,” the authors of the paper wrote.

That’s just one study in an incoming tide focused on the variations in the language that clinicians use to describe patients of different races and genders. In many ways, the research is just catching up to what patients and doctors knew already, that discrimination can be conveyed and furthered by partial accounts.

Author(s): Darius Tahir

Publication Date: 26 Sept 2022

Publication Site: Kaiser Health News

Montana Health Officials Aim to Boost Oversight of Nonprofit Hospitals’ Giving

Mary Pat Campbell

Link: https://khn.org/news/article/montana-health-oversight-nonprofit-hospitals-giving-charity/

Excerpt:

Montana health officials are proposing to oversee and set standards for the charitable contributions that nonprofit hospitals make in their communities each year to justify their access to millions of dollars in tax exemptions.

The proposal is part of a package of legislation that the state Department of Public Health and Human Services will ask lawmakers to approve when they convene in January. It comes two years after a state audit called on the department to play more of a watchdog role and nine months after a KHN investigation found some of Montana’s wealthiest hospitals lag behind state and national averages in community giving.

….

The IRS requires nonprofit hospitals to tally what they spend to “promote health” to benefit “the community as a whole.” How hospitals count such contributions to justify their tax exemptions is opaque and varies widely. National researchers who study community benefits have called for tightening standards for what counts toward the requirement.

Author(s): Katheryn Houghton

Publication Date: 28 Sept 2022

Publication Site: Kaiser Health News

Rapper Fat Joe Says No One Is Making Sure Hospitals Post Their Prices

Mary Pat Campbell

Link: https://khn.org/news/article/rapper-fat-joe-hospitals-price-transparency-fact-check/

Excerpt:

Rapper Fat Joe takes on hospital industry executives in an advertisement, contending that many hospitals are disobeying a law that requires them to publicly post the prices they charge cash-paying patients and insurance companies for every service they offer.

The ad, paid for by a group called Power to the Patients, states, correctly, that hospitals must list their negotiated prices and asserts that the rule helps patients by making it harder for them to be overcharged. The ad also blames politicians and regulators because the price information is still not necessarily available.

…..

Hospitals have dragged their feet, and compliance is spotty. Studies have found that many hospitals have posted at least some data but that large shares of the facilities have failed to post everything required.

….

In early June, CMS issued penalty fines of about $1.1 million against two Georgia hospitals — Northside Hospital Atlanta and Northside Hospital Cherokee — that are owned by the same company. Those were the first fines issued under the new rules.

As of late July, the agency had sent 368 warning notices to hospitals and issued 188 corrective action plan requests to hospitals that had previously received warning notices but had not yet corrected deficiencies, according to a statement from Dr. Meena Seshamani, deputy administrator and director of the Center for Medicare.

Author(s): Julie Appleby

Publication Date: 10 Aug 2022

Publication Site: Kaiser Health News

Despite a First-Ever ‘Right-to-Repair’ Law, There’s No Easy Fix for Wheelchair Users

Mary Pat Campbell

Link: https://khn.org/news/article/power-wheelchair-users-right-to-repair-law-no-easy-fix/

Excerpt:

The multibillion-dollar power-wheelchair market is dominated by two national suppliers, Numotion and National Seating and Mobility. Both are owned by private equity firms that seek to increase profits and cut spending. One way they do that is by limiting what they spend on technicians and repairs, which, when combined with insurance and regulatory obstacles, frustrates wheelchair users seeking timely fixes.

The $70 billion durable medical equipment market has been an attractive target for private equity investment because of the aging U.S. population, the increasing prevalence of chronic conditions, and a growing preference for older adults to be treated at home, according to the investment banking firm Provident Healthcare Partners. Medicare’s use of competitive bidding favors large companies that can achieve economies of scale in manufacturing and administrative costs, often at the price of quality and customer service.

Regulations set by Medicare and adopted by most Medicaid and commercial health plans have led to lower-quality products, no coverage for preventive maintenance, and enough red tape to bring wheelchairs to a halt.

Power wheelchair users have long been fighting for the right to repair their wheelchairs themselves or through independent repair shops. Medicare and most insurance companies will replace complex wheelchairs only every five years. The wheelchair suppliers that have contracts with public and private health insurance plans restrict access to parts, tools, and service manuals. They usually keep a limited inventory of parts on hand and wait until health plans approve repair claims before ordering parts.

Some chairs require a software passcode or a physical key for any repairs. Wheelchair users who make fixes themselves may void their warranty or lose out on insurance payments for repairs.

Author(s): Markian Hawryluk

Publication Date: 2 June 2022

Publication Site: Kaiser Health News

Pandemic-fueled shortages of home health aides strand patients without care

Mary Pat Campbell

Link:https://www.cnn.com/2022/02/03/health/home-health-care-aide-shortage-khn-partner-wellness/index.html

Excerpt:

Frail older adults are finding it harder than ever to get paid help amid acute staff shortages at home health agencies.

Several trends are fueling the shortages: Hospitals and other employers are hiring away home health workers with better pay and benefits. Many aides have fallen ill or been exposed to Covid-19 during the recent surge of omicron cases and must quarantine for a time. And staffers are burned out after working during the pandemic in difficult, anxiety-provoking circumstances.

The implications for older adults are dire. Some seniors who are ready for discharge are waiting in hospitals or rehabilitation centers for several days before home care services can be arranged. Some are returning home with less help than would be optimal. Some are experiencing cutbacks in services. And some simply can’t find care.

Author(s):Judith Graham, Kaiser Health News

Publication Date: 3 Feb 2022

Publication Site: CNN

In one of the country’s most vaccinated places, masks were still key to slowing Covid-19

Mary Pat Campbell

Link:https://www.cnn.com/2021/10/01/health/covid-vaccine-colorado-tourist-town/

Excerpt:

San Juan County, Colorado, can boast that 99.9% of its eligible population has received at least one dose of covid-19 vaccine, putting it in the top 10 counties in the nation, according to data from the Centers for Disease Control and Prevention.

If vaccines were the singular armor against covid’s spread, then on paper, San Juan County, with its 730 or so residents on file, would be one of the most bulletproof places in the nation.

Yet the past few months have shown the complexity of this phase of the pandemic. Even in an extremely vaccinated place, the shots alone aren’t enough because geographic boundaries are porous, vaccine effectiveness may be waning over time and the delta variant is highly contagious. Infectious-disease experts say masks are still necessary to control the spread of the virus.

Author(s): Rae Ellen Bichell, KHN

Publication Date: 1 Oct 2021

Publication Site: CNN

Black and Hispanic Americans Suffer Most in Biggest US Decline in Life Expectancy Since WWII

Mary Pat Campbell
Black and Hispanic Americans Suffer Most in Biggest US Decline in Life Expectancy Since WWII

Excerpt:

Indeed, new research published Wednesday in the BMJ shows just how wide that gap has grown. Life expectancy across the country plummeted by nearly two years from 2018 to 2020, the largest decline since 1943, when American troops were dying in World War II, according to the study. But while white Americans lost 1.36 years, Black Americans lost 3.25 years and Hispanic Americans lost 3.88 years. Given that life expectancy typically varies only by a month or two from year to year, losses of this magnitude are “pretty catastrophic,” said Dr. Steven Woolf, a professor at Virginia Commonwealth University and lead author of the study.

Over the two years included in the study, the average loss of life expectancy in the U.S. was nearly nine times greater than the average in 16 other developed nations, whose residents can now expect to live 4.7 years longer than Americans. Compared with their peers in other countries, Americans died not only in greater numbers but at younger ages during this period.

The U.S. mortality rate spiked by nearly 23% in 2020, when there were roughly 522,000 more deaths than normally would be expected. Not all of these deaths were directly attributable to covid-19. Fatal heart attacks and strokes both increased in 2020, at least partly fueled by delayed treatment or lack of access to medical care, Woolf said. More than 40% of Americans put off treatment during the early months of the pandemic, when hospitals were stretched thin and going into a medical facility seemed risky. Without prompt medical attention, heart attacks can cause congestive heart failure; delaying treatment of strokes raises the risk of long-term disability.

Author(s): Liz Szabo

Publication Date: 24 June 2021

Publication Site: Kaiser Health News