Showing posts with label medicare improvements. Show all posts
Showing posts with label medicare improvements. Show all posts

Tuesday, November 24, 2015

How Americans are Aging and Changing

The Baby Boomer generation is getting older and lifespans in general are increasing.  As a result  the United States is aging rapidly.  Recently, I attended "The State of Aging in Orange County," a seminar put on by the Office on Aging and other agencies in Orange County, California.  The speakers were outstanding and over the next few weeks this blog will contain posts on some of the information that was covered during the seminar.

In particular, most Baby Boomers will be interested in some of the general facts that were brought up by the speakers.

Redefining What it Means to be Old

Karen Roper, who is Director of OC Community Services and oversees the Office on Aging, the Veterans Service Bureau and several other agencies, said they are working to redefine what it means to be old.  Rather than basing it on someone's age, they want to define it based on a person's functional ability.  After all, she pointed out, some people can be in their 80's or 90's and still be able to live on their own and take care of their shopping, housework, cooking, etc.  On the other hand, a person who is in their 50's or 60's might be suffering from a number of medical conditions, including early onset dementia, which might make it difficult for them function independently at all.  Which person should be considered "old?"

The U.S. Population is Aging Rapidly

Michael Schrader, the Chief Executive Officer of CalOptima, presented fascinating statistics regarding how quickly the American population is aging.  In 2015, there are approximately 40 million people over the age of 65.  Over the next ten years, by 2025, the population of people over the age of 65 will increase by 50% to 60 million.

Social Security and Medicare Will Need to be Reformed

Mr. Schrader revealed that over that same ten year period, Social Security costs are expected to increase by 77% and Medicare costs by 89%.  This is unsustainable without some types of reforms. As was recently mentioned in this blog, one change has already been made in order to save the government money in Social Security expenditures. It was part of the 2015 budget agreement.  The SSA has now eliminated an option couples used to have for maximizing their benefits ... the file and suspend option. 

Among other changes that are being considered are:

* Raise the minimum ages to receive both Social Security and Medicare benefits
* Increase the co-pays and other forms of cost sharing for Medicare beneficiaries
* Change to a need based voucher system for Medicare benefits

New Approaches to Administering Medicare and Medicaid

CalOptima is also experimenting with a new system to make Medicare benefits more efficient, cost effective and easier to use for beneficiaries who qualify for both Medicare and Medicaid (known as Medi-Cal in California).  Many of the people who qualify for both have to deal with four different programs ... Medicare Part A, Medicare part B, Medicare part D, and Medicaid.  Since these people frequently have dementia or other health issues, dealing with all these different  programs is overwhelming.  CalOptima is experimenting with combining all four of those programs into one, adding on dental and vision services, and providing case carriers to assist the recipients.  They believe that reducing the fragmentation will make the program operate more efficiently and less expensively.  In addition, beneficiaries will only have one phone number to call and one person to deal with, which should make things more manageable.

If the CalOptima program works here in Orange County, it will be spread to other parts of the United States.

In the coming weeks, this blog will contain additional information that was provided during the State of Aging seminar ... interspersed with other topics of interest to Baby Boomers.

If you are looking for additional information on retirement planning, coping with health issues, finding good places to retire, changing family relationships or more, use the tabs or pull down menu at the top of this article to find links to hundreds of additional helpful articles on a variety of subjects.

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Wednesday, February 11, 2015

Hopeful News for the Future of Medicare

The November, 2014 "AARP Bulletin" listed some encouraging news for people who are on Medicare or who expect to enroll in Medicare sometime in the future.  Steps are being taken to help Medicare remain solvent somewhat longer than originally expected, even if Congress continues to drag its feet in making funding changes to the program.  Here is a summary of what AARP reported:

Medicare Will Spend Less Than Projected

One of the reasons that the Congressional Budget Office originally predicted that Medicare would run out of money within a decade is because they anticipated that by 2019 Medicare would be spending $14,913 per year for each beneficiary of the program.

However, Medicare costs are not rising as fast as anticipated.  Recently,  the CBO has revised its numbers and now they only expect Medicare to spend $12,478 per year for each beneficiary by 2019.

That is almost $2,500 less per person than they originally projected and is great news for the solvency of the program.

How Medicare is Saving Money

Medicine and medical care has been changing over the past few years.  Hospital stays are getting shorter and, as a result of the Affordable Care Act, there are new incentives for hospitals to take better care of people the first time ... thus reducing the number of re-admissions.

In addition, we Baby Boomers have been taking pretty good care of ourselves.  The influx of younger, healthier Baby Boomers into the program is helping to keep costs down.

More Health Insurers Are Participating in Obamacare

While a few insurers have dropped out of the program, in 2015 they were replaced by 77 new insurers who were offered additional plans in 44 states.  While not all of these insurers will be offering Medicare Advantage or Medicare Supplemental plans, evidence indicates that the more insurers there are in the marketplace, the lower the premiums.  This is good news, both for people on Medicare as well as their younger family members.

More Insurers are Covering End of Life Conversations

The most expensive healthcare often occurs during the last few months of a patient's life.  Often they receive treatments that they do not want, can be painful, and will only minimally extend the length of their life, while decreasing their quality of life.

I saw this personally a few years ago when a 97 year old neighbor was put through open heart surgery.  She never returned home and was in pain during the remaining few months of her life, which she spent in a nursing home.

Now some insurance companies are paying doctors who want to have a conference with their patients about their end-of-life decisions, so that people can decide for themselves what they want to do ... before they are in a crisis situation.  The American Medical Association has also put in a request to Medicare, asking that they also consider paying doctors to discuss these issues with their patients.

There are several benefits to these discussions.  While encouraging end-of-life conferences could save money on unwanted medical treatments, the more important issue is that it will also enable people to have more of a say concerning the treatments they receive during the last few months of their lives ... and whether they want to spend that time at home or in a hospital or skilled nursing facility.

The Government is Cracking Down on Medicare Fraud

Another important issue for the future of Medicare is the effort to reduce Medicare fraud.  It costs the program billions of dollars and seems to be getting worse, rather than better.  In order to keep the program solvent, federal agents and prosecutors are putting more energy into prosecuting these cases.  The Justice Department is using Medicare billing data as one way of tracking cases of fraud.

Retirees who are concerned about keeping Medicare solvent should report any cases of of suspected Medicare fraud in their community.

If we want Medicare to be available as we get older, we all need to report any suspicious charges listed on our bills ... for example, for treatments we did not receive.   Medicare beneficiaries should also file a report any time they hear of someone who is getting kickbacks from doctors for agreeing to get treatments they do not need, or for agreeing to say they received treatments, when they did not.

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