LGBT seniors marked for removal from survey on elder care services

The US Department of Health and Human Services has proposed the elimination of data collection for LGBT seniors from an annual survey that helps determine how billions of dollars are allocated for vital care services.

The National Survey of Older Americans Act Participants (NSOAAP) collects information about services including senior centers, home-delivered meals and transportation. The proposed 2017 survey is missing a question about the sexuality of respondents, which has been included since 2014.

“It’s a very bad sign because to strip LGBT older adults out of the survey suggests that the federal government believes that the needs of this elder population do not matter,” Michael Adams, chief executive officer of Services and Advocacy for LGBT Elders (Sage), told the Guardian.

Alongside basic demographic data, NSOAAP respondents give information as detailed as how many servings of meat they eat per day and what level of help they need for activities such as walking, dressing and eating.

Such information is used to measure the impact of government-funded services and is included in a report in the annual budget.

Adams said it was important to identify LGBT seniors in the survey because they are underserved.

“It doesn’t matter, frankly, whether LGBT elders are eating chicken or steak or fish in a senior center,” he said, “but what does matter is: are they eating in a senior center at all? Are they receiving care management services? Are they receiving caregiver support?”

Sage and other groups lobbied the Obama administration to include a question about sexuality in the survey. One was introduced in 2014.

The surveys from that year, 2015 and 2016 asked: “Which of the following best represents how you think of yourself: lesbian or gay; straight, that is, not lesbian or gay; bisexual; something else [which respondents were asked to clarify later]; refused; and don’t know [which respondents were also asked to clarify].”

A notice to the Federal Register dated 13 March 2017 said “no changes” had been made to survey. However, in its draft form it does not include the sexuality question.

The health department’s Administration for Community Living (ACL) said on a link to the draft that it “does contain modifications from the currently approved collection”. The agency is accepting comments on the proposal until 12 May.

The health department did not immediately respond to a request for comment. Adams said he would welcome a dialogue with the White House.

“In recent years, we have made significant progress in including LGBT elders in federally supported elder services and we will be watching very closely for any efforts to roll that back,” he said.

The disappearance of the sexuality question comes after moves by the White House to eliminate two federal statistical programs, igniting fears among senior statisticians that data that does not fit with administration policy could cease to be collected.

Last month, the Trump administration rescinded an Obama-era protection that allowed students unfettered access to bathrooms and locker rooms that corresponded with their gender identity.

On Monday, Sage launched a campaign to get LGBT supporters to respond to the call for public comments on the survey draft. As of Monday afternoon, nearly 700 people had sent letters opposing the planned change.

LGBT seniors marked for removal from survey on elder care services

Seniors Flock To Star-Rated Medicare Ideas Below ACA Rollout

An energy under the Cost-effective Care Act to inspire the overall health insurance market to supply larger good quality advantages for seniors is rewarding each elderly Medicare beneficiaries and the bottom lines of well being strategies winning higher government-backed ratings.

A lot more than half of seniors enrolled in so-named Medicare Benefit programs are now enrolled in ideas with ratings of 4 stars or more on a five-star scale, a ranking program developed under the Inexpensive Care Act to guidebook seniors to cost-successful and larger high quality advantages. Programs are rated on this kind of measures like cutting contact waiting instances as effectively as how properly they encourage preventive care such as obtaining standard blood tests for diabetes.

A rating of four is considered above common and a rating of 5 is exceptional and the highest rankings give health ideas a bonus payment and the capacity of the insurers to tout their improvement. There are now 53 % of Medicare Advantage enrollees in plans with 4 or a lot more stars compared to just 24 percent in 2011, according to the Centers for Medicare &amp Medicaid Companies.

Some ideas are carrying out better than other people with Kaiser Permanente among people very best known for its substantial scores and 4 and 5 star ratings. A 5-star rating enables the insurers to industry year-round rather than just during the fall open enrollment period.

But other plans are beginning to tout their four-star or much better ratings to Wall Street, saying it has assisted them enroll more seniors and consider buyers away from rivals.

Consider Aetna Aetna (AET), for illustration, which additional more than 130,000 new members to its Medicare Benefit strategies, executives mentioned for the duration of its very first-quarter earnings call final month. Aetna and its Coventry subsidiary mixed to earn 4 or far more stars for 17 of its Medicare Advantage contracts this 12 months in contrast to twelve contracts in 2013.

“Our continued momentum speaks to the reputation of the Medicare Advantage plan and the worth we provide relative to conventional charge for support Medicare,” Aetna chief executive officer Mark Bertolini advised Wall Street analysts and investors. “This worth is demonstrated by our STARS functionality where we have a increased percentage of members in 4-STAR or higher strategies than any of our nationwide managed care peers. We carry on to invest in our Medicare Advantage business and task that our STARS performance will enhance in 2015, further improving our worth proposition.”

Practically one particular-third of the nation’s Medicare beneficiaries are enrolled in personal ideas, which are an hard work to move away from the standard fee-for-service plan. Most main carriers this kind of as Humana Humana (HUM), Cigna Cigna (CI), UnitedHealth Group (UNH) and an escalating number of Blue Cross and Blue Shield programs sell Medicare Benefit plans, which also supply further benefits and services to seniors this kind of as disease management, nurse aid hotlines as well as some ideas delivering vision and dental care and wellness packages.

“The Affordable Care Act helps strengthen Medicare Advantage by supplying enhanced benefits and retaining costs lower for Medicare beneficiaries,” the Centers for Medicare and Medicaid Companies said in a statement to Forbes. “We feel that ideas will carry on their robust participation in the Medicare Benefit program in 2015 and beneficiaries will proceed to have a broad array of higher top quality, substantial value, low cost options accessible to them whilst at the same time we are generating specified that plans are delivering value to Medicare and taxpayers.”

Pondering how Obamacare will have an effect on Medicare? The Forbes eBook Inside Obamacare: The Resolve For America’s Ailing Overall health Care Technique answers that query and a lot more. Obtainable now at Amazon and Apple.

Aetna CEO Mark Bertolini says seniors are drawn to the company’s 4-star Medicare Benefit ideas

Seniors Flock To Star-Rated Medicare Ideas Below ACA Rollout

Medicare Seniors Like ObamaCare"s Crew Approach

As the U.S. wellness care method moves away from charge-for-service medication to far more accountable care that utilizes a teamof overall health specialists, seniors covered by Medicare say they are okay with these new designs that consist of nurses, social staff and other allied well being pros in the front lines of their treatment, according to a new analysis.

Increasingly, the Medicare wellness insurance plan for the elderly as part of the Inexpensive Care Act is moving to a program that rewards medical professionals and hospitals for working together to improve care. By contracting with entities known as accountable care organizations and patient-centered health care residences, the suppliers use a staff technique that can involve lower value suppliers and allied overall health pros to give seniors with far more consideration even though at the very same time trying to keep them wholesome and out of more costly care settings.

A new national survey of grownups 65 and older from the John A. Hartford Foundation about “team care and the health-related home” demonstrates 27 % say they like the model and it has enhanced their health. The openness to new models debunks theories by some in wellness care who think patients only want to see a medical doctor for all their well being care needs.

But the bulk of the sample, or 73 % say they want such care and 61 % say they believe it would increase their wellness. The survey, carried out for John A Hartford by PerryUndem Analysis/Communication, polled one,107 adults who have been age 65 or older in late January and early February of this 12 months.

“The weaknesses of care coordination in our present program signify a clear and existing danger to a lot of older sufferers, leading to avoidable harm, errors, issues, overtreatment, and avoidable hospital admissions and readmissions,” said Christopher Langston, system director of the John A. Hartford Basis.

New models of wellness care delivery such as patient-centered medical residences and accountable care organizations emphasize the use of principal care overall health specialists like nurse practitioners and physician assistants and even social employees to far more aggressively guarantee individuals are seeking regular care, taking their medicines and following their diet plans all in the identify of retaining them out of the much more costly care setting like hospitals.

All key insurance carriers like Aetna Aetna (AET), Cigna Cigna (CI), Humana Humana (HUM), UnitedHealth Group UnitedHealth Group (UNH) and Blue Cross and Blue Shield ideas are contracting far more and far more with ACOs and patient centered health-related residences even though moving away from paying providers on a fee for services basis.

Medicare, as well, is moving aggressively toward far more accountable versions with achievement achieving savings.

In the initial year of the Medicare Shared Financial savings Program, practically half of the ACOs that commenced operations in 2012 had reduce medical expenses than projected, exceeding their top quality benchmarks, according to the Centers for Medicare &amp Medicaid Companies. There have been 29 ACOs that generated shared cost savings of a lot more than $ 125 million.

At present, Medicare beneficiaries are assigned an ACO by means of the physician that offers most of their major care providers. As of February 2014, far more than 5.3 million Medicare beneficiaries obtained care by way of an ACO model.

But accountable designs like healthcare houses aren’t really prepared for prime time, citing scientific studies that have questioned their results.

“Team care is even now a function in progress,” Langston stated.

Even now, the help of seniors to a staff strategy signifies health care residences and other accountable care designs have a promising potential, the survey indicates.

“The reality that older grownups say that group care enhanced their overall health is very significant,” Langston said. “We should build on this finding, increase the model, and make crew care obtainable to more sufferers who can advantage from it.”

Medicare Seniors Like ObamaCare"s Crew Approach

Obamacare: Clarifying How Seniors Die (Satire)

President Obama gave a nationally televised handle back in 2009 to “clarify any misunderstandings” about his wellness care proposal assuring Americans that under the new bill senior citizens, and not the federal government, will have the appropriate to decide on how they are executed.

“Let me dispel these ridiculous rumors once and for all and set the record straight. Underneath my prepare, seniors are going to be killed the way they want to be killed, finish of story”, mentioned the president, who acknowledged that “wiping out” the nation’s elderly population has always been his No. one priority.

“If your grandmother would rather be euthanized in the privacy of her very own property than be gutted and hanged on a high school soccer field, she is entitled to that correct.”

“Once again, let me be flawlessly clear,” Obama continued. “Seniors, rest straightforward knowing that I will by no means, under any circumstance, sign a bill that does not give you the choice of currently being murdered by my administration in a manner of your picking. I guarantee you that.”

In the course of his 45-minute tackle, the president repeatedly stressed his deep and abiding respect for the nation’s 65-and-in excess of citizens, saying that murdering them in approaches they wouldn’t want to be murdered would be both un-American and “flat-out wrong.”
Obama also accused his opponents of employing scare tactics to score political factors, manipulating seniors’ fears with misinformation about their upcoming state-mandated deaths.

The president stated he sympathized with and related to the fears of older Americans, incorporating that if a politician told him he could only be killed by currently being forcibly eliminated from his property and shot in the street like a puppy, but left out the fact that he could also be put down by painless lethal injection, he would be scared also.

“Folks’ concerns more than my strategy are all based on bogus claims that we intend to set up death panels to kill off senior citizens,” Obama said. “Well, that is preposterous. A death panel is only one particular of many methods we can exterminate the elderly. Beneath my strategy, they can be beaten or poisoned to death. They can be murdered by the Marines or the Air National Guard. They can die quick or they can die slow. They can even be drowned in their own bathtubs.”

“The stage is”, Obama continued, “there is a way to die in this strategy for absolutely everyone.”
According to the 970-page bill, seniors would have accessibility to far more than 600 methods of execution, all of which would be covered by Medicare. The legislation would also permit aging Americans to keep their personal main care doctors if they desire to be euthanized by their family doctor.

The bill also get in touch with for the creation of government-run carbon monoxide poisoning clinics, termination chambers in all YMCA basements, and a new giant pit in the Nevada desert in which seniors can be dumped and buried en masse.

“Let the record present, I am opposed to the government getting more concerned in people’s lives,” Obama explained. “But in occasions of fantastic change government has usually stepped in to lend a helping hand. That is why cost-free shuttle buses to college gymnasiums pumped complete of sarin gas will be supplied for all our seniors.”

Following the speech, White Home sources mentioned they expected total party help for the proposal. Even so, some far-left leaning Democrats have openly criticized the president for backing down from his preliminary policy of death panels, arguing that a system offering several execution options entirely undermines their best of a single universal senior-killing policy.

“The president has watered down a flawlessly sensible plan in hopes of placating the opposition.” Senator Jar Rockefeller (D-WV) said, “Look, we started this health care crusade because we think that death panels are the extremely best way to eradicate the senior population, and I, for a single, stand company in that belief.”
The Republican response was even more sternly worded.

“Seniors!” Property minority leader John Boehner (R-OH) mentioned, “Run for your lives! Obama is coming to destroy you! He will destroy all of you!”

Even so, many older Americans lauded the president for last but not least speaking to them like adults on the matter, and explained that for the 1st time in months they felt they weren’t becoming taken benefit of.

“It was refreshing to come to feel like I wasn’t getting utilised as a pawn to settle 1 political party’s score towards another.” 74-12 months outdated Florida resident Rose Benzio advised reporters. “I did not agree with everything President Obama had to say, but I feel there is almost certainly an choice in his plan that will suit me. Decapitation sounds exciting.”

Reprinted with permission by The Onion.
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Obamacare: Clarifying How Seniors Die (Satire)