In the News

HHVBP Gives Providers More Support with Payers, But May Shrink Business Margins

Home Health Care News | By Andrew Donlan
 
Last Thursday, I moderated three panels at Home Health Care News’ VALUE event, sat in on another three and talked to dozens of attendees, both on the record and off.
 
There were plenty of highlights and insights that came from those conversations.
 
And while everyone seemed to not only have a good time, but also a productive one, my feeling is that the takeaways varied considerably from person to person.
 
Of course, some of that had to do with the diversified groups of providers involved. But mainly, it had to do with the overarching takeaway I had from our event: that most everyone in home-based care has a different definition of value-based care, and most everyone will take a different path to get there.
 
So while a shift toward value may be inevitable, there will be seemingly countless roads that lead there – not just one.
 
In this week’s exclusive, members-only HHCN+ Update, I explore what those different roads and definitions of value-based care may be, and also empty my notebook full of other learnings from the event.

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Older Adults Sacrificing Basic Needs Due to Healthcare Costs

Gallup | By Nicole Willcoxon, PH.D. 

Editor's Note: The research detailed below was conducted in partnership with West Health, a family of nonprofit and nonpartisan organizations focused on lowering healthcare costs for seniors.

WASHINGTON, D.C. -- The health problems Americans start facing when they reach 50 years of age are compounded when the high cost of healthcare prevents them from seeking treatment, taking their prescriptions or leading an otherwise healthy lifestyle. A survey of U.S. adults conducted by West Health and Gallup explored the various ways in which healthcare costs are affecting Americans aged 50 and older today.

The study shows that at least two-thirds of older Americans consider healthcare costs to be at least a minor financial burden. When looking at inability to pay for care, four in 10 report they are concerned; smaller but notable percentages are not seeking treatment, are skipping prescribed medicine or cutting back on basic needs such as food and utilities to pay for healthcare. These problems are generally worse for adults aged 50 to 64, as most do not yet qualify for Medicare, but they also affect those 65 and older.

Older Americans at Risk Due to Cost of Healthcare
More than a third of adults 65 and older (37%) are concerned they will not be able to pay for needed healthcare services in the next year, according to the most recent West Health-Gallup survey. The situation is even worse for older Americans who are not yet eligible for Medicare, with nearly half (45%) of adults aged 50 to 64 reporting the same concern level. This puts nearly 50 million adults aged 50 and older at risk for more severe illness and even death due to the cost of healthcare.

U.S. Department of Health and Human Services data show that out-of-pocket healthcare expenses for adults 65 and older rose 41% from 2009 to 2019; out-of-pocket expenses take up a greater proportion of individuals' expenditures as they age, because of an increase in demand for health services and the reality that Medicare does not cover all health expenses. People 65 and older spend nearly twice as much of their total expenditures on healthcare costs when compared with the general population, even with 94% in this age group being covered by Medicare.

As costs continue to climb over the next decade, the number of Americans 65 and older will also rise, by a rate of about 10,000 people per day, according to the U.S. Census. This rapidly growing group of older Americans -- which those currently 50-64 and aging into Medicare are entering -- is already saying healthcare costs are a financial burden (24% of those 50-64 call it a major burden; 48%, a minor burden). For substantial proportions of older Americans, this burden results in sacrificing basic needs to pay for healthcare -- about one in four adults 65 and older and three in 10 aged 50-64 cut back on food, utilities, clothing or medication due to healthcare costs. This hardship is experienced to a greater degree by older women and Black Americans.

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US Has a "Very Serious" Problem with Covid-19 Vaccine Uptake

CNN | By Ivana Kottasová and Hafsa Khalil 

The United States has a "very serious" problem with Covid-19 vaccination uptake, a top health official has warned.

Vaccines are by far the most powerful tool available against the coronavirus, protecting people from getting seriously ill, being hospitalized, and dying from the virus.

Unlike many less developed countries, the US has enough doses to vaccinate everyone as well as the necessary infrastructure to support the rollout.

The problem: not everyone wants the shot.

"We do have a problem with vaccine uptake that is very serious in the United States and anything we can do to get people more comfortable to be able to accept these potentially life-saving medical products is something that we feel we are compelled to do," said Dr. Peter Marks, director of the Center for Biologics Evaluation and Research.

According to the US Centers for Disease Control and Prevention, 48.7% of people over the age of 12 have been fully vaccinated and received at least one booster dose in the US.

That is a lower rate than in other countries with similar access to vaccines. For example, 69.6% of people over the age of 12 have been boosted in the United Kingdom and 55.5% in Canada. Across the 27 European Union countries, 62.6% of adults have been boosted…

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Citing a Disastrous Pandemic Response, an Expert Panel Will Call for an Overhaul of the U.S. Public Health System

A bipartisan panel of health experts will call on Tuesday for an overhaul of the American public health system that would greatly expand the role of the federal government, giving Washington the authority to set minimum health standards and coordinate a patchwork of nearly 3,000 state, local and tribal agencies.

The recommendations flow from what the panel, the Commonwealth Fund Commission on a National Public Health System, described as the inadequacies and inequities of the United States’ response to the coronavirus pandemic, which has killed more than one million Americans.

Read more @ NY Times

 

100 Million People in America Are Saddled With Health Care Debt

Kaiser Health News | By Noam N. Levey
 
Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated.

Ariane Buck, a young father in Arizona who sells health insurance, couldn’t make an appointment with his doctor for a dangerous intestinal infection because the office said he had outstanding bills.

Allyson Ward and her husband loaded up credit cards, borrowed from relatives, and delayed repaying student loans after the premature birth of their twins left them with $80,000 in debt. Ward, a nurse practitioner, took on extra nursing shifts, working days and nights.

“I wanted to be a mom,” she said. “But we had to have the money.”

The three are among more than 100 million people in America ― including 41% of adults ― beset by a health care system that is systematically pushing patients into debt on a mass scale, an investigation by KHN and NPR shows.

The investigation reveals a problem that, despite new attention from the White House and Congress, is far more pervasive than previously reported. That is because much of the debt that patients accrue is hidden as credit card balances, loans from family, or payment plans to hospitals and other medical providers.

To calculate the true extent and burden of this debt, the KHN-NPR investigation draws on a nationwide poll conducted by KFF for this project. The poll was designed to capture not just bills patients couldn’t afford, but other borrowing used to pay for health care as well.

New analyses of credit bureau, hospital billing, and credit card data by the Urban Institute and other research partners also inform the project. And KHN and NPR reporters conducted hundreds of interviews with patients, physicians, health industry leaders, consumer advocates, and researchers.

The picture is bleak.

In the past five years, more than half of U.S. adults report they’ve gone into debt because of medical or dental bills, the KFF poll found.

A quarter of adults with health care debt owe more than $5,000. And about 1 in 5 with any amount of debt said they don’t expect to ever pay it off.

“Debt is no longer just a bug in our system. It is one of the main products,” said Dr. Rishi Manchanda, who has worked with low-income patients in California for more than a decade and served on the board of the nonprofit RIP Medical Debt. “We have a health care system almost perfectly designed to create debt.”

The burden is forcing families to cut spending on food and other essentials. Millions are being driven from their homes or into bankruptcy, the poll found…

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