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Commentary: A message from Medicare

Marilyn Tavenner

Marilyn Tavenner

This past Wednesday, more than 1.3 million Georgians began the Open Enrollment period for Medicare.

It’s a time for seniors and people with disabilities to look through their choices for the government program’s coverage.

In a new GHN Commentary, the administrator of the Centers for Medicare & Medicaid Services urges Medicare beneficiaries to take their time in assessing the plans’ costs and benefits.

“This year, people with Medicare who choose to enroll in a Medicare health or prescription drug plan will have access to more high-rated, four- and five-star plans than ever before,’’ writes Marilyn Tavenner.

Here’s a link to Tavenner’s Commentary.

Georgia Health News welcomes Commentary submissions. If you would like to propose a Commentary piece for Georgia Health News, please email Andy Miller, editor of GHN, at amiller@georgiahealthnews.com

Use of antipsychotic drugs cut in nursing homes

Georgia has reduced its use of antipsychotic medications on nursing home residents by 26 percent, one of the largest drops in the nation.

smslogoThe decrease, occurring from the end of 2011 to the end of 2013, was powered in part by a pilot program targeting the Georgia nursing homes that had the highest use of antipsychotics.

Nationally, the prevalence of these drugs in long-stay nursing home patients dropped by 15 percent over that period, federal officials announced last week.

The federal Centers for Medicare and Medicaid Services has pushed for a decrease in the use of antipsychotics in managing dementia patients in nursing homes. full story

Another important change in state benefit plan

Blue Cross and Blue Shield of Georgia is dropping its Medicare Advantage plan for next year for retirees in the State Health Benefit Plan.

That means UnitedHealthcare will be the sole provider of the Advantage plans for 2015. (Blue Cross is the sole provider for 2014.)

The Georgia Department of Community Health is informing retiree health plan members about the Blue Cross move through email and letter this month, letting them know that the decision won’t affect the coverage in effect for the current year.

SHBP_CoverImage

Medicare Advantage is a health plan offered by a private company that contracts with the federally administered Medicare program to provide benefits. The majority of the 54 million people on Medicare are in the traditional Medicare program, with about 30 percent enrolled in an Advantage plan, according to the Kaiser Family Foundation.

More than 102,000 people are in Medicare Advantage plans under Georgia’s State Health Benefit Plan, according to Community Health, which runs the health plan.

Blue Cross said Monday that its decision to discontinue its Advantage plan was made jointly with the SHBP.

Still, in a comparison of next year’s rates, Blue Cross had premiums that were much higher than United’s. full story

Freestanding ERs target suburbs, rural panel told

Freestanding emergency departments have been proposed in Georgia as a potential solution for struggling rural hospitals, or newly closed ones, that want to remain operational in downsized form to help patients in need.

Healthcare CostBut the trend toward such standalone emergency rooms nationally is totally different from that picture, members of the Georgia Rural Hospital Stabilization Committee were told Monday.

Freestanding EDs are actually proliferating in suburban areas, targeting high-income patients who have private insurance, said Charles Horne of accounting firm Draffin & Tucker. The prevailing emphasis is on patient convenience, not need, he told committee members at a meeting in Cordele.

Earlier this year, Gov. Nathan Deal backed a change in state licensing rules that would permit a stand-alone emergency department and some other services in rural areas that have a financially ailing – or closed – hospital.

But so far, no organization has applied to create such a facility in the state.

Meanwhile, four rural hospitals have closed in the past two years in Georgia, and others are having severe financial problems. full story

Experts on a roll … to help rural doctors

“Meaningful use.”

It’s another confounding term in the often opaque lexicon of health care. But it represents a concept that is important for health care providers’ bottom lines.

The basic idea is that Medicare and Medicaid will pay incentives for hospitals and doctors to demonstrate “meaningful use” of electronic health records (EHRs) to improve patient care.

And to help rural doctors get up to speed with education and technical assistance on meaningful use, a two-day bus tour swept through central and eastern Georgia last week.

Technical assistance is given at Taylor Regional Medical Center.

Technical assistance is given at Taylor Regional Medical Center.

Experts on board the bus came from GA-HITEC at Morehouse School of Medicine in Atlanta; the state Department of Community Health; HP Medicaid; the Georgia Health Information Network; the Medical Association of Georgia; and HomeTown Health. They visited Thomaston, Hawkinsville, Eastman, Fitzgerald, Baxley, Springfield and Swainsboro to provide hands-on help to physicians and others.

“There have not been many resources out in rural areas,’’ Kathy Whitmire of HomeTown Health, an organization of rural hospitals in the state, told GHN. She said the experts consulted with physician practices representing more than 120 eligible doctors, physician assistants and nurse practitioners. full story

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