The American Geriatrics Society Focuses on the Future of Elder Care

With an estimated 20 percent of the United States population accounting for those 65 and older by 2030, the American Geriatrics Society (AGS) is focusing on how to improve medical care in the geriatric community. One concern is the low number of doctors specializing in geriatric care. U.S. News and World Report-Health estimates that approximately 17,000 geriatricians are necessary to care for the growing elderly population, but that there is currently only about 7,500 or more certified in America.

One goal of AGC is to find additional funding to support medical students studying to be a geriatrician. One of the reasons why many graduating medical students choose other medical specialties is that private insurance has higher payouts. When it comes to Medicare and Medicaid, the reimbursement rates are lower. With high debt upon graduation, going into geriatrics may not be an option for new doctors. With more educational funding, the number of doctors entering the geriatric field is apt to increase.

Additionally, there is a focus on other skilled professional fields which care for the elderly. This includes occupational therapists, physical therapists, nurses, social workers, and home health care aids. Often these health care providers must work together to support an elderly individual who suffers from multiple chronic issues. With the elderly, often a more holistic approach is better because much of the medical care will focus on daily functionality, such as getting dressed and eating.

Understanding the options for an elderly loved one can be challenging. Applying for Medicaid and making sure necessary needs are covered can be a complex process. P&P Medicaid provides Medicaid application services. The company also provides a full range of geriatric care management services to help individuals and their families make decisions about and supervise their long-term care needs.  Please contact P&P Medicaid Consulting, Inc. at (516) 541-4770 for more information.

Is the Affordable Care Act the New Medicaid/Medicare?

Wilbur J. Cohen, U.S. Secretary of Health, Education and Welfare under President Lyndon B. Johnson, created the United States Medicare and Medicaid programs in the 1960s.  Inspired by the success New Deal at the end of the Great Depression, Cohen aimed to provide “relief, recovery and reform” to older and low-income Americans who could not afford coverage in the competitive commercial market.

It’s hard to believe President Johnson could have imagined such success for the Medicare and Medicaid programs when he signed them into law in July 1965. At that time, his main objective was simply to provide “the miracle of healing to the old and to the poor.”

While Medicaid is a federally funded program, it is controlled by local governments in each state and county. If one is eligible, based on age and disability, several applications and an evaluation of a person’s income and resource restrictions must be coordinated to determine to what degree Medicaid will to help pay for all medical expenses. Medicare offers many similar services as Medicaid, but it is available only to people over age 65, or younger if they are found to be certified disabled, who have worked and paid into the U.S. Social Security system.

Today, at the 50 year anniversary of the two programs, the nation still relies on that legislation. In fact, the Obama administration continues to make improvements to both platforms, in addition to using them as a basis for the Affordable Care Act, referred to by many as “Obamacare.” Like Medicare and Medicaid, the Affordable Care Act offers a combination of federal and private healthcare coverage. Unlike its predecessors, the program is open to all Americans, rather than just the elderly or those with limited incomes.

First enacted in March 2010, Obamacare’s original provisions led many insurers to forecast a decline in enrollment due to an increase in out-of-pocket expenses. Under pressure from the Obama administration’s Affordable Care Act, however, Congress reduced payments to Medicare Advantage. The legislation stated that beginning in 2014, Medicare Advantage plans could not spend more than 15 percent of Medicare payment on administrative or insurance costs. This could result in a reduction of individual member plan cost by up to $1,000 without reduction of benefits. Since this legislation was passed, member enrollment unexpectedly increased from 11 million in 2010 to 16.6 million in 2015.

Today, under Obamacare, more than half of the states’ governments have expanded Medicaid eligibility. Overall health insurance enrollment has soared thanks to government subsidies to private insurers who are now providing and coordinating almost 80 percent of new beneficiaries. Additionally, over 30 percent of the 55 million Medicare beneficiaries and more than half the 66 million Medicaid beneficiaries are now in privatized health care plans. White House officials are hopeful that Obama’s healthcare program will one day garner the standing and popularity of Medicare and Medicaid.