Forget About The Old Methods: New Alzheimer’s Test Poised To Change Industry

March 26, 2014 - Leave a Response

Here is a revolutionary piece of news about Alzheimer’s Disease that you won’t forget anytime soon.

According to a recent article in Forbes Magazine, a team of researchers at Georgetown University have developed a simple blood test which they say can predict, with 90 percent accuracy, whether an individual will develop Alzheimer’s Disease within 2-3 years. 

If larger studies uphold the results, the test could fill a major gap in strategies to combat brain degeneration, which is thought to show symptoms only at a stage when it too late to treat effectively.

Currently, there is no known cure for Alzheimer’s disease. Several promising therapies have been tested in clinical trials over the last few years, but all have failed. However, those trials involved people who had already developed symptoms. Many neuroscientists fear that any benefits of a treatment would be missed in such a study, because it could be impossible to halt the disease once it has manifested in such a severe manner.

The implementation of biomarkers would allow patients to be identified – and recruited into trials – way before their symptoms begin, allowing for a better analysis of potential therapies.

While this is obviously very good news for the over 35 million people worldwide who develop Alzheimer’s disease each year, it may present an unintended consequence: It could destroy private long-term care insurance and any future voluntary government insurance program. A widely available test to predict Alzheimer’s would make any form of voluntary long-term care insurance virtually impossible.

Those scoring positive on the tests will immediate purchase long-term care insurance, eventually overwhelming the system when they become affected. Should insurers get access to the test results, they will either deny coverage or charge significantly higher premiums.

Currently,  more than half of all LTC insurance claims are for cognitive impairment. Surveys show that those who think they are going to contract Alzheimer’s are far more likely to buy than those who don’t.

So the dilemma now deepens.

What happens to those who learn, through this new blood test, they are fated to suffer cognitive impairment with no recognized cure? As a consequence of that knowledge, will they potentially lose access to the only lifeline available to pay for what will prove to be very costly care? What other unseen consequences will arise as a result of this wondrous Alzheimer’s blood test breakthrough?

These are all questions worth asking. Even if we don’t have the answers yet.

A Crazy Tale About Medication Fraud: Teva Pharmaceuticals Forced To Pay Up

March 12, 2014 - Leave a Response

Just how crazy is the following story?

You decide.

According to Crain’s Business Magazine, prominent pharmaceutical manufacturer Teva Pharmaceuticals and a subsidiary have agreed to pay approximately $28 million to the state of Illinois and the United States in a settlement, following claims that Teva paid a Chicago psychiatrist to prescribe an anti-psychotic medication to thousands of nursing home patients insured by the government.

Details released from the office of the U.S. attorney for the Northern District of Illinois alleged that in the aftermath of large payments made by Teva to psychiatrist Dr. Michael Reinstein, the doctor apparently became the largest prescriber of generic clozapine in the country.

“Pharmaceutical companies must not be allowed to improperly influence physicians’ decisions in prescribing medication for their patients,” U.S. Attorney Zachary Fardon said in a written statement. “Instead, those decisions must be made solely on the basis of the patient’s best medical interests.”

It behooves us all to stay within the boundaries of responsibility and not let money be the be-all-and-end-all. As you can see from this story, this pharmaceutical giant thought that playing the system was going to be super profitable.

To put it mildly: They were crazy for thinking that.

The Upcoming White House Agenda: Leaving Us In The Red?

March 5, 2014 - Leave a Response

Time to punch yet another hole in your money belt – things are getting tighter.

The belt buckling and cost-cutting taking place our industry is hitting yet another unprecedented level. According to a recent article in McKnights Magazine, The White House’s proposed 2015 budget includes sharp cuts to skilled nursing facility reimbursements, which has drawn strong criticism from the nation’s largest long-term care provider group.

The American Health Care Association/National Center for Assisted Living – the nation’s largest provider group – slammed the proposed Medicare reductions, noting that the sector has “endured billions in cuts” in recent years.

With the healthcare industry taking so many hits in recent years, one wonders what this new piece of news will do to make things go from bad to worse.

Public response on blogs and social media has varied.

It ranged from anger (“They want to cut nursing home reimbursement even though care is increasingly complex, our aging population is about to explode… and everyone expects us to provide flawless care?!”) to apathy (“There’s no point in fighting with those ruthless politicians, I’m looking for a career change!”) to disbelief (“How do we possibly create the next generation of healthcare leaders when there is nothing positive to promote?”).

Regardless of which category you relate best to, it’s becoming increasingly evident that the old way of doing business is over.

But all hope is not lost.

Yet.

The American Health Care Association/National Center for Assisted Living is supporting proposals that could achieve savings without slashing reimbursements – such as penalizing SNFs that have high hospital readmissions rates.

This tidbit, in particular, caught our eye.

While we cannot always fight the system or change the White House’s agenda, we can put into place procedures that actively work around the labyrinth of complexities being thrown at us each day.

Consider things like customized patient software programs to drastically reduce readmission rates; aggregating your spending data from each supplier and consolidating it into one reporting system for increased financial monitoring; custom sourcing for supplies, equipment and specialty products to help slash costs. These strategic tactics are all tried and true.

So forget about going into the red. Discover smarter solutions – it’s the new black.

Cleaning Up Shop: Why Is The FDA Seeking To Ban Anti-Bacterial Soap Ingredients?

December 16, 2013 - Leave a Response

The US Food and Drug Administration announced a proposed regulation on Monday to ban certain ingredients in anti-bacterial soaps if manufacturers cannot prove that these products are safe to use and more effective than plain soap and water for preventing the spread of infections.

Such a move will likely force makers of personal hygiene products to reformulate all bar soaps, liquid soaps, body washes, and dishwashing liquids labeled as “anti-bacterial” and “antimicrobial” to keep them on store shelves.

According to The Boston Globe, antibacterial soaps made by companies including Dial, Lever, and Dove contain chemicals that have a spotty safety record. “Some data suggest that long-term exposure to certain active ingredients used in antibacterial products — for example, triclosan (liquid soaps) and triclocarban (bar soaps) — could pose health risks, such as bacterial resistance or hormonal effects,” according to a statement released by the FDA.

Almost all soaps labeled “antibacterial” or “antimicrobial” contain at least one of the antibacterial ingredients that the FDA is proposing to ban. Household cleaning products and some toothpastes may also contain them.

Liquid hand sanitizers, such as Purell, and anti-bacterial wipes do not contain the worrisome ingredients. These “leave on” products contain alcohol to kill germs and aren’t affected by the planned regulation, according to the FDA.

“Antibacterial soaps and body washes are used widely and frequently by consumers in everyday home, work, school, and public settings, where the risk of infection is relatively low,” said Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. “Due to consumers’ extensive exposure to the ingredients in antibacterial soaps, we believe there should be a clearly demonstrated benefit from using antibacterial soap to balance any potential risk.”

Manufaturers will have about six months to respond to the planned regulation, which likely won’t be implemented for at least a year. For now, the FDA recommends using plain soap and water to wash hands and to avoid using antibacterial soaps, which will remain on the market for now. If soap and water are not available, an alcohol-based hand sanitizer that contains at least 60 percent alcohol should be used.

What will this potential ban spell for the healthcare industry? Nobody is quite sure yet. But it sure wouldn’t hurt to stock up on those bottles of Purell and boxes of anti-bacterial wipes… just in case.

Modern Medicine Gone Insane: Debate Over Antipsychotic Usage Flaring Up In Massachusetts

November 18, 2013 - Leave a Response

The folks up in Boston are going absolutely crazy – and it’s not because the Red Sox won the World Series.

According to a recent article in the Boston Globe, an ongoing debate over nursing homes’ use of antipsychotics flared during a meeting of the Joint Committee on Elder Affairs.

Three separate bills under consideration would require written consent from nursing home residents or their legal representatives prior to administration of antipsychotic drugs. Two of the consent bills are in the Senate and one is being considered by the House.

Representatives of the Massachusetts Psychiatric Society said the requirements would hamstring caregivers, to the detriment of residents who genuinely need antipsychotics.

Supporters believe unnecessary antipsychotic prescribing is harming residents.

The Bay State has one of the highest antipsychotic prescribing rates in the country, according to a 2010 Globe analysis. This analysis spurred the Massachusetts Senior Care Foundation to launch an antipsychotic reduction campaign.

Of course, it’s also possible that the insanely high price tags of name-brand medications may have caused some people in New England to simply go crazy.

Maybe they should start considering generics. 

Bringing The Point Home: Why Does The Government Want To Keep LTC Patients Housed Up?

November 14, 2013 - Leave a Response

Just when you thought our political leaders couldn’t possibly shake up the healthcare industry any more than they already have, politicians in the State of New York figured out how to do just that.

An October report released by officials outlines a plan to keep more LTC patients in the community and out of nursing or adult homes. The plan sets a goal of a 10 percent reduction in the number of long-stay nursing home residents over the next five years and a corresponding increase in the availability of housing and services in the community.

This may come as unwelcome news to an industry that relies on keeping the bed count full to ensure profitability.

Long-term-care patients who need help walking or are wheelchair-bound used to have to move into a nursing home. That changed last month when Governor Andrew Cuomo signed a law allowing state-designated assisted living programs to care for people needing an extra level of mobility support.

These are people who need functional assistance, but not necessarily around-the-clock nursing care. The State of New York is of the opinion that letting people stay where they are is better for the residents.

Although this point remains debatable – particularly in light of the fact that these elderly patients may have no family or friends to keep a watchful eye out on them – the fact that New York would ordinarily be footing the bill for patients residing in LTC facilities may have played a greater role in this decision.

Click the link below for more information about this story:

http://www.uticaod.com/news/x1783716085/State-plan-aims-to-keep-more-seniors-out-of-nursing-homes

Ultimately, the ones left holding the proverbial bag here are the LTC facilities themselves.

Which leads us to procurement solutions. GPO services. Utilization management.

These things will become the universal standard; the need to drastically reduce expenditures will now be kicking into overdrive. And it took a questionable government initiative aimed at keeping the elderly and infirm in their houses to bring that point home.

Deathly Serious: Venezuela’s Health System Collapsing As Hospitals Run Short On Medical Supplies

November 6, 2013 - Leave a Response

Will Venezuela prove to be the newest battleground for GPOs in the medical supply industry looking to expand market share across the globe?

Only time will tell.

As Venezuela reels in political and economic crisis, hospitals continue to send sick patients home from a medical system on the brink of collapse.

At Central Hospital in Maracay, doctors last month discharged some 300 cancer patients when medical supply shortages forced triage, leaving most non-emergency patients — the long-term sick — without any treatment. 

Doctors in Venezuela say no government healthcare statistics have been collected since 2010, although they know for sure they’re lacking medical supplies across the gamut: needles, syringes, paraffin used in biopsies for cancer diagnostics, X-ray film, imaging paper, and so forth.

To further complicate this appalling situation, Venezuela suspended organ donations and transplants, as 70 percent of the country’s radiotherapy machines clunked out of repair.

In a country of nearly 30 million people, the medical shortages continue to harm many cancer patients. In an estimate from Douglas Natera, president of the Venezuelan Medical Federation, radiotherapy machine shortages may cut cancer treatment for 5,000 of the current 19,000 cancer patients requiring care.

For additional details about this ongoing story, please click the following link:

 http://www.medicaldaily.com/venezuelas-health-system-verges-collapse-hospitals-run-short-supplies-262145

Ironically, the collapse of Venezuela’s medical system follows the death from cancer of the late authoritarian leader Hugo Chavez, a “socialist hero” to many in Latin America. It would be truly fascinating to see the sickly health system of Venezuela healed by “capitalist companies” hailing from the United States of America.

But frankly, what other realistic options are there?

Apparently, dependable medical supply companies in that pitiful region are – no pun intended here – in rather short supply.

Say Cheese: It’s Nothing To Smile About

October 31, 2013 - Leave a Response

The politicians in Washington are keeping the LTC industry on its toes with the new Affordable Healthcare Act and it’s complete revamping of the marketplace.

But that’s not the only thing we should be looking at uneasily.

An unrelated fight over renewing the nation’s farm bill has centered on cuts to the $80 billion-a-year food stamp program. But there could be unintended consequences if no agreement is reached: higher milk prices.

Should LTC operators be nervous or is this just politics as usual? If milk prices do indeed soar higher, it remains to be seen how badly it’ll hit our industry. Will this affect all dairy products such as cheese and dairy-based sauces? In the dietary arena, these items can make up for approximately 25% of your total food expenditures.

Check out the full story with this link:

http://www.foxnews.com/politics/2013/10/28/farm-bill-stalemate-could-send-milk-prices-skyward/

The bottom line? While our industry had a similar scare like this a while back, it remains doubtful that an upcoming spike in dairy products is happening anytime soon. But it’s worth keeping an eye out on these interesting developments.

Stay tuned.

Double Trouble or Double Profits?

October 16, 2013 - Leave a Response

Two Industry Leaders Join Forces To Help SNF Industry Ahead Of Anticipated Medicare and Medicaid Cuts

 

With the looming potential of huge Medicare cuts on the congressional budgetary table, the SNF industry has what to be worried about.

According to a recent article in McKight’s magazine, the American Health Care Association has warned that if the congressional budget deficit committee fails to find other ways to save $1.5 trillion over 10 years, there will be automatic across-the-board cuts.

This would mean a 2% reduction in Medicare reimbursement starting in 2013, which the association said would slam struggling skilled nursing facilities. Combined with the 11.1% Medicare rate cut scheduled to hit in October, AHCA estimates that a typical 100-bed SNF could stand to lose up to $50,000, or the equivalent of two direct-care workers.

“These cuts don’t occur in a vacuum,” said AHCA President and CEO Mark Parkinson. “We hope Congress and the administration understand this latest proposal comes on the heels of several other deep reductions in provider funding – cuts that have taken their toll on our sector.”

In the wake of these significant developments, two industry powerhouses – Prime Source GPO and Caretech Group – have recently announced the formation of a strategic alliance to provide the SNF community with provide broader savings opportunities.

Prime Source is a rapidly expanding GPO servicing SNF and LTC facilities throughout the United States.  The company offers cost reduction services, access to an exclusive network of vendors, informational tools and customized solutions to help clientele lower costs and increase profitability.

Caretech Group, founded in 1994, is a procurement services group that has garnered recognition as a pioneer in long-term care, providing innovative supply chain solutions and data-driven analytical software tools to facilities. The company specializes in combining traditional purchasing services with hi-tech business intelligence to improve the overall financial health and operational performance of facilities, empowering administrators to make smarter decisions and effectively manage cash flow.

“Prime Source’s exclusive vendor contracts and consolidated buying power are a perfect complement to our extensive procurement experience and advanced technology solutions,” says Paul Hellman, Founder and CEO of Caretech Group.  “This alliance will offer significant advantages to customers across the country, which will directly translate into bigger savings for their facilities.” 

Michael Greenfield of Prime Source agrees with those sentiments and optimistically points out why this situation may actually be a benefit for many.

“In these turbulent times, every SNF out there has got to start being more aggressive about cutting costs,” he notes.

“The inevitable Medicare cuts will force them to make do with less funding. We are here to help our industry weather the upcoming fiscal storm by discovering new ways to continuously slash costs – and allow these facilities to come out stronger and more profitable as a result.”

                                                                     

 

 

 

Surviving the Triple “Whammy”

December 30, 2012 - Leave a Response

              Long term budget problems at the national and state levels are creating a state of dread for nursing home providers.  The Fiscal Cliff is looming and there are potential cuts to Medicare regardless of whether Washington avoids the Cliff.  The NY State Budget Crisis Task Force released a report on December 17, with a somber evaluation of the state’s finances.  It particular it highlighted the unsustainable Medicaid budget.  Finally, there is the fast approaching outsourcing of nursing home reimbursement by the State to Medicaid Managed Long Term Care plans.  These three currents are converging and will have a significant impact on an already battered industry.  The question is how to survive this triple “whammy.”

                Regardless of Fiscal Cliff negotiations, nursing homes will face significant reductions in Federal funds for both Medicare and Medicaid.  MedPAC calls for a four percent (4%) reduction in Medicare rates for nursing homes.  The National Association of State Budget Officers and The National Governors Association issued a joint report that reviewed the reduction in the Federal contribution to Medicaid.  States will either cut Medicaid or raise taxes.  Lastly, the Federal Government is looking to cap the Provider Assessment (Tax) process, used by states to optimize the Federal share of Medicaid.  These potential hits will be intensified by the realities of long term budget problems in NY.

                The State Budget Crisis Task Force, chaired by Richard Ravitch and Paul Volker reported that the NYS budget is unsustainable since expenditures are growing faster than revenues.  Medicaid is a significant problem; its budget is larger than the combined budgets of Florida, Pennsylvania and Texas.  The report recognizes that the cap enacted in the first year of the Governor’s tenure has reduced the annual increase in Medicaid spending. I It is not certain that it will reduce this budget item.  Under these circumstances, it is likely that the reduction to Medicaid reimbursement to nursing homes will be embraced by Managed Long Term Care plans.

                NYS has removed itself from the reimbursement “hot potato,” assigning this responsibility to Managed Care plans.  Cost will be an absolute priority for the plans; Plans will reduce reimbursement to nursing homes to absorb cuts from the State.  Plans we be driven to maximize their profits.  There are currently thirty-six (36) plans, twenty-six (26) in the NY metropolitan area, and many more in the queue waiting for approval to operate.  It is likely that many of these plans exist so that their owners can sell them to larger other Plans after they demonstrate significant profits.  There will ultimately be fewer plans once consolidation takes place.  The impact of this will place extreme pressure on nursing homes to reduce their costs.

                This quick description of the triple “whammy” is not an exaggeration of the potential forces that will require nursing homes to examine how they do business.  Nursing homes must find ways to become more efficient and effective.  Quality is still in the equation, even if it is limited for the data presented on Nursing Home Compare (since more and more consumers are using this site in their selection process).  Self-examination is hard, painful and perhaps too time consuming in this volatile environment; nursing homes don’t have to do this alone.  With Caretech as a strategic partner, a nursing home can find significant savings necessary to survive the pain coming from this “whammy.”

                Caretech offers many approaches to reduce expenses: 

  • Better pricing on supplies
  • Product substitutions that provide the same quality at a lower price
  • Utilization management
  • Outsourcing the purchasing and accounts payable function
  • Pharmacy benefit management (assuring the Part D and managed care plan appropriately pay the pharmacy instead of shifting it to the nursing home)
  • Lean thinking.

                The impact or all or some of these interventions can be significant and ongoing.  In a time when nursing homes may struggle to survive these forces, a strategic partner can help an organization survive and perhaps even thrive.  Make Caretech your strategic partner.

 

               On behalf of Caretech, wishing you a happy, healthy and successful 2013!

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