HomeCare Blog for Private Duty

THE ADLWARE FAMILY CARES ABOUT YOU

Starting a home care company can be tough and difficult to wrap your head around all the different aspects of the industry. It is important to either have years of experience in the home care industry or have people to speak with that have knowledge about how the industry works.

Here at ADLware, our employees have had experience in all different aspects of the home care industry, not just in the software side of it. Many of the employees here have moved over to the software side because we see the importance of a great home care software and how it can improve your company and its efficiency. Anytime you call into ADLware we are happy to listen and talk to you about anything to do with home care whether it is software related or not. We care about your company’s success. ADLware has recently started monthly webinars for our start-up clients to receive training on effective ways to run your home care agency. These webinars also give agencies the chance to discuss one with another to brainstorm and share ideas that have helped their individual agencies. Everything ADLware does is to benefit and improve home care agencies across the world. ADLware is not only a leading software but it is employed by people who care about you! Call ADLware today to see a free demo of our software!

HomeCare Blog for Private Duty

APRIL IS PARKINSON’S AWARENESS MONTH III

According to the American Journal of Managed Care, the annual economic impact of Parkinson’s disease in the United States is around $10.8 billion, including both direct medical expenses and indirect costs such as lost income, disability payments and medical costs.

Facts released on the Michael Stern Parkinson’s Research Foundation site reveal the financial burden of Parkinson’s disease on individuals and their families is immense. Drugs commonly used to treat Parkinson’s disease can cost up to $6,000 per year per patient.  Surgical treatments for Parkinson’s disease can cost $25,000 or more. As the disease progresses, institutional care at an assisted-living facility or nursing home may be required and these costs can exceed $100,000, per person annually.

Care providers who are familiar with the symptoms and treatments of Parkinson’s can provide a huge financial relief to families who would rather keep their loved ones at home with private duty care. Take the time to educate your caregivers about this disease, so that you can provide specialty care in your area. Many national foundations such as Michael Sterns’, Michael J. Fox’s, the American Parkinson Disease Association, the National Parkinson’s Foundation, and the Parkinson’s Disease Foundation each work to educate the public about new medications, technologies, research, and forms of relief for those suffering from the disease.

At ADLware, we encourage our partners to stay informed so that together, we can provide the best care.
(Facts courtesy of http://www.parkinsoninfo.org/about-parkinsons-disease/economic-impact/)

HomeCare Blog for Private Duty

MAKING A GOOD DECISION

Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.

At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and house cleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.

As with any important purchase, it is always a good idea to talk with friends, neighbors, and your local area agency on aging to learn more about the home health care agencies in your community. In looking for a home health care agency, the following questions can be used to help guide your search for a home care agency:

  • How long has the agency been serving this community?
  • Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one.
  • Is the agency an approved Medicare provider?
  • Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations?
  • Does the agency have a current license to practice (if required in the state where you live)?
  • Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
  • Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary?
  • How closely do supervisors oversee care to ensure quality?
  • Are agency staff members available around the clock, seven days a week, if necessary?
  • Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
  • How does the agency ensure patient confidentiality?
  • How are agency caregivers hired and trained?
  • What is the procedure for resolving problems when they occur, and who can I call with questions or complaints?
  • Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services?
  • Will the agency provide a list of references for its caregivers?
  • Who does the agency call if the home health care worker cannot come when scheduled?
  • What type of employee screening is done?

For agencies that are looking to be able to answer these questions positively, let ADLware help you. ADLware will put you steps ahead of the competition with all the built in features that our software offers, Make sure that your agency can give good answers to these questions by streamlining your service with ADLwares proven technology.

HomeCare Blog for Private Duty

ANOTHER EXAMPLE OF HOW YOUR COMPANY CAN WORK WITH HOSPITALS TO HELP DISCHARGED CLIENTS

MANATEE -- A new home-health program targeting Manatee and Sarasota residents who have been hospitalized with major health events is aiming to keep those people from going back.

Infinity Homecare, a Lakewood Ranch-based home health care company with locations throughout Florida, also expects to save Medicare dollars as the federal medical insurance program cracks down on hospitals that repeatedly and unnecessarily admit patients suffering the same health condition. It's a new business model for the 700-employee company, but one its clients are embracing.

Bruce Trace, an 88-year-old World War II veteran, is one of 32 clients who have entered Infinity's "patient empowerment program." One night in January, he fell in the kitchen of his Palmetto home after feeling weak for months. Doctors who treated him at Manatee Memorial Hospital discovered that blood clots throughout his body had put him into congestive heart failure.

He was in such bad shape that his doctors told his wife, Dolly, he wouldn't survive the night.

"We thought we were going to lose him," she said.

Trace survived, and then went through rehab at the hospital and in Westminster Towers' Bradenton rehab program. When he got home in February, he was using a walker as he started a doctor-ordered home rehab program with Infinity.

Today, Trace can walk up and down the block without a walker. He carries a cane in his hand that he never uses. Infinity therapists coached him through a rigorous home exercise program to get him to this point.

It's the hardest he's worked in years.

"I was doing what I thought was sufficient," said Trace, formerly a semi-regular bike rider. "But I wasn't."

Responding to Medicare

Much as in Trace's case, Infinity is sending nurses and other health professionals into client homes to teach them how to take care of their own health after major health events such as heart failure, heart attacks and pneumonia. The company developed the program late last year as Medicare started refusing to pay hospitals and doctors when patients were readmitted for the same condition too soon -- in the agency's judgment -- after an initial health event.

Vernon DeSear, a spokesman for Manatee Memorial Hospital in Bradenton, said the Affordable Health Care Act authorizes Medicare to take the hard line on unnecessary readmissions.

Infinity's program taps into a good line of business as hospitals like Manatee Memorial try to avoid those readmissions. It also gets Infinity ahead of the curve in how it provides rehabilitation services. Shannon Abbott, Infinity's vice president of clinical strategies, said the patient empowerment program is based on outcomes, meaning Infinity helps patients meet health and mobility goals, and to stay out of the hospital.

The company is currently paid to work with patients on 60-day cycles, but Abbott sees that changing in the near future. As Medicare looks to cut its payouts, she said the agency will likely base future payments on whether and how many outcome goals Infinity helps its patients achieve.

Abbott said cases like Trace's are the ideal result. Her company designed the patient empowerment program late last year in response to Medicare's unnecessary readmission policy. The company is emphasizing several diseases this year to raise awareness, including congestive heart failure, chronic obstructive pulmonary disease and diabetes.

A typical result for patients like Trace would have been one or more emergency trips back to the hospital in the months following rehab, Abbott said. Those trips would have occurred after a patient failed to keep up with medications, weight goals, exercise, or to properly monitor disease symptoms.

Older rehab models relied on a telemonitor system, under which patients were taught to use a computer system to monitor blood pressure, weight and other vitals. That information was used by Infinity to guide rehab. But when the rented system left a patient's home at the end of rehab, no one - including the patient - continued to monitor these factors along any sort of structure.

"All you really did was make a patient dependent on a piece of machinery," Abbott said.

Patients Get New Tools

The new program teaches patients to use what they have at home to monitor their health. For example, a patient might learn to use a blood pressure cuff and a scale, then to track those results.

During his home rehab, Trace has tracked his exercise, weight, diet, medication and other vital statistics in a 44-page journal Infinity provides its clients. It's something he will continue to do after rehab.

Central to the program is goal setting. Abbott said clients are asked to set a goal for their recovery, whether it be walking to the mailbox or getting on a plane to visit relatives. Trace's goal is to get back behind the wheel of his car. He hasn't yet, but he said he will be driving again soon.

Abbott said Infinity expects the program to be used with a large number of its clients. For example, of the 15,000 clients Infinity saw in 2013, 568 had congestive heart failure as a primary or secondary diagnosis.

Dr. Tom Wilkinson, an internal medicine specialist who works between his own practice and Blake and Manatee Memorial hospitals, said Infinity's program is a refocus of what health professionals have learned about acute conditions recovery over the past few decades.

"They do so much better at home," he said. "They're happier, they live longer."

Wilkinson said Infinity's treatment method will likely lead to fewer readmissions, which is good for the patient. Home care, he said, is almost always the preferred treatment for patients recovering from an acute health condition. It's also a money saver.

"It makes more sense to provide care in the home for dollars a day, versus thousands a day in the hospital," Wilkinson said.

With ADLware's ability to track hospitalization of your clients your company can do the same as MANATEE. You can ensure the well being of your clients and work with hospitals, giving you the opportunity to find new clients who may need your help after being discharged.

Read more here: http://www.bradenton.com/2014/04/07/5089190/home-care-program-aimed-at-patient.html#storylink=cpy

HomeCare Blog for Private Duty

WHAT IT MEANS TO BE A PART OF ADLWARE

When people begin investigating our product and services at ADLware, I am often asked for referrals that they can contact to get a third-party’s opinion.  We love getting our customers in contact with anyone who wants to learn more, because our customers truly know what it means to be a part of the ADLware family: good people and solid relationships.

We recognize that this unique industry of home care services requires many intangibles that aren’t necessarily found at your local educational programs.  The ability that good people have in forming a special bond with the the client is something that’s difficult to teach, and is an inherent quality that is a pre-requisite to success in home care.  That’s because solid relationships are the fruits of good people’s efforts.  These defining characteristics are principles upon which we at ADLware are built as well.  We don’t directly work with clients or caregivers, but we wanted to adopt the same ideology of the agency’s we support to ensure that we would work together seamlessly, just like our product does with your business needs. 

ADLware is a comprehensive home care software product that allows you to schedule, bill, process payroll, build custom reports and communicate efficiently with all you do business with.  To learn more about exactly how our good people and solid relationships work for your business benefit, contact us today to view a free demo of our software - you won’t regret it!

HomeCare Blog for Private Duty

ADLWARE SUPPORT

A home care agency has a lot of pressure on their hands when caring for senior citizens. Many times the lives of seniors rest on their shoulders and it is important to give them reliable care. Since managing this care is so important, agencies will turn to software to help them become more effective. A home care software should be reliable and when something does come up, the agency can depend on the software’s support team to help out. Home care software can be confusing and robust so the help of a great support team is very important. At ADLware we provide the best support in the industry.

ADLware has a dedicated support team that will treat your company as if the life of your agency rests on their shoulders. They care about your success, so they are easy and pleasant to work with. After signing up with ADLware, they will do unlimited training to get you familiar with the system and then unlimited tech support after that. They also offer an online site that has training videos and training material for you to look at whenever is convenient for you. Whenever you have a question on how to do something in the system or if you ever have a problem, give ADLware a call and all your questions will be resolved with a loving member of the ADLware support team.

Contact ADLware today to see a demo of the software and how it can best benefit you!

HomeCare Blog for Private Duty

APRIL IS PARKINSON’S AWARENESS MONTH II

In honor of Parkinson’s Awareness month, we at ALDware wanted to feature a special story about those living with this disease, courtesy of our friends at the American Parkinson Disease Association, a grassroots organization that seeks to help ease the burden and find the cure:

http://www.apdaparkinson.org/a-true-love-story-helps-to-ease-the-burden-find-the-cure-for-parkinsons-disease/
 
New York, New York – Francine Justa was one of the most respected and charismatic leaders of New York City's affordable housing movement in the 1980s and a pioneer of many affordable housing issues until Parkinson’s disease forced her retirement in 2003.

Morris (Moe) Kornbluth, her husband of 42 years is a retired computer programmer who has been her caregiver for more than 10 years.   Moe shares that at first he couldn’t comprehend the changes that were happening to his very successful, vivacious, and popular wife.  “I didn’t respond well because she became so different from the person I knew,” he says, “and the disease progressed so slowly and steadily that it took time to realize that it was altering her personality and cognitive capacities as well as her physical abilities.”  Only at that point, when he recognized that the cause of his frustration and sometimes anger was her disease, was he able to come to terms and adapt to the situation.

Hoping to save people finding themselves in a similar situation – the devastation that he experience – Moe has written “Fran,” a memoir sharing the impact of Parkinson’s disease on a family.  Moe says that he never intended the book to be a love story. “I wanted to write Fran’s story, one about a strong woman who deserved recognition even at the low point of her life.  Maybe other caregivers can learn from my mistakes, recognize their own weakness, and possibly gain strength and understanding,” he says.

In honor of Valentine’s Day and in tribute to his wife Fran, Moe has partnered with the American Parkinson Disease Association (APDA) to offer free copies of the memoir throughout February to anyone who makes a donation of $35 or more to APDA.  “We are privileged to partner with Moe to share this touching story of love and perseverance that illustrates with remarkable clarity the realities of Parkinson’s disease.  With a diagnosis of Parkinson’s disease every 9 minutes, there are too many families impacted and our objective is to do everything we can to Ease the Burden – Find the Cure for the 1.5 million Americans already diagnosed and their families,” said APDA President & CEO Leslie A. Chambers. “We hope this touching story helps other caregivers gain strength and understanding that they are not alone in their efforts to provide care and support to loved ones coping with Parkinson’s disease.”

Visit www.apdaparkinson.org/Fran to get your free copy of the book.  Fran is also available on Amazon.com.

HomeCare Blog for Private Duty

SELF-IMPROVEMENT

Everyday there are advances being made, whether in technology, procedure, policy or legislation.  With changes happening all around us it is important that we stay up to speed with all these changes. Keeping up is harder and harder to do. At ADLware we work hard to keep our software up to date, keeping your company on the competitive edge. 

A Technology Awareness Strategy

A good technology awareness strategy boils down to four simple steps:

1.    Determine your needs.

2.    Assess the resources available to you.

3.    Rank the resources in order of usefulness to you.

4.    Make or allow the time to use the resources.

Let’s take a closer look at each step.

Step 1. Determine your needs. You’ll determine your needs from the type of technology you live and work with, your existing knowledge base, and your learning style.

First, regardless of the technology in question, we all need a better handle on the fundamentals, like electricity, magnetism, light, sound, fluid behavior, and other fundamentals as you need them. These are the building blocks. Knowing these basics will help you understand how an electric motor works, why air conditioning cools, and so forth.

Next, you’ll need to learn more about the specific devices you use. It may seem simplistic at first, but knowing how your cell phone works really can help you.

Step 2. Assess the resources available to you. From books to magazines to the Internet to formal training sessions, you can find technology-related information in a variety of sources. In the next section we’ll discuss the major categories you can look into. Explore your options and figure out which resources work for you.

Step 3. Rank the resources in order of usefulness to you. The good news is that there are a lot of resources. The bad news is that there are a lot of resources. Now you have to weed them out. Choose those resources that have even a small chance of working for you, and then rank them in terms of the subject matter (some will be more important than others), your learning style, and your lifestyle (do you prefer the Internet to the library?).

Step 4. Make the time to use the resources. This is where the rubber meets the road. I promise that it won’t be a big burden, but you must do it! Some resources you’ll read only once and then you’ll move on. Other resources you’ll want to keep for future reference. If you truly integrate your technology education into your daily routine, it will only take a few minutes a day

ADLware does this for your home health care services. Let us worry about the technology, leaving you free to devote yourselves to your clients.

Source: http://entrepreneurs.about.com/cs/beyondstartup/a/keepinguptech.htm

HomeCare Blog for Private Duty

OUR FRIENDS IN GERMANY

Last fall, Sam, an American woman who lives in Berlin, began to experience stomach pain while eating and drinking. She visited her general practitioner, who wrote her a prescription.

The problem hadn't gone away several days later, so the doctor referred her to a specialist for a gastroscopy. Her issue wasn’t deemed an emergency, though, so she had to wait about two weeks for an appointment.

“But man, was I impressed with the exam itself!” she later told me in an email. “Went to the hospital, filled out a few papers, was knocked out for a bit while they looked in my stomach, and was home again a few hours later. Everything was very efficient.”

The best part: Sam paid exactly nothing for the experience.

Instead, the bill was paid by the Barmer GEK sickness fund, one of about 160 such nonprofit insurance collectives in the country. Every German resident must belong to a sickness fund, and in turn the funds must insure all comers.

They’re also mandated to cover a standard set of benefits, which includes most procedures and medications. Workers pay half the cost of their sickness fund insurance, and employers pay the rest. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket expenses, so it’s rare for a German to go into debt because of medical bills.

Sound familiar?

It should, since this is very similar to the health-insurance regime that Americans are now living under, now that the Affordable Care Act is four years old and a few days past its first enrollment deadline.

All Americans are now required to have health insurance or to pay a fine, and insurers cannot deny coverage to anyone, regardless of pre-existing conditions. Obamacare has also created subsidies for those who can’t afford to buy health insurance and has implemented limits on out-of-pocket costs.

There are, of course, a few key differences. Co-pays in the German system are minuscule, about 10 euros per visit. Even those for hospital stays are laughably small by American standards: Sam payed 40 euro for a three-day stay for a minor operation a few years ago. Included in that price was the cost of renting the TV remote.

And nearly five million Americans fall into what’s called the “Medicaid gap” in states that aren’t expanding the government health insurance program for the poor. These individuals make too much to qualify for the state’s existing Medicaid program (typically just a few thousand dollars a year for childless adults), yet too little to qualify for the federal government’s subsidies to buy health insurance on the new exchanges, so they will remain uninsured. In Germany, employees' premiums are a percentage of their incomes, so low-wage workers simply pay rock-bottom insurance rates.

The sickness funds are Germany's version of a “public” health insurance system, and it covers nearly everyone. But a small segment (13 percent) of the population, generally the very wealthy, can opt-out and instead go with the private Krankenversicherung, which follows rules more similar the pre-Obamacare U.S. individual insurance market.

But those differences aside, it’s fair to say the U.S. is moving in the direction of systems like Germany’s—multi-payer, compulsory, employer-based, highly regulated, and fee-for-service.

You can think of this setup as the Goldilocks option among all of the possible ways governments can insure health. It's not as radical as single-payer models like the U.K.’s, where the government covers everyone. And it's also not as brutal as the less-regulated version of the insurance market we had before the ACA.

“I think you’re moving more in the direction of international standards,” Dirk Göpffarth, head of risk adjustment at the German Federal Social Insurance Office, told me. “The U.S. was always the odd one out with not regulating healthcare until everyone goes into Medicare.”

Germany actually pioneered this type of insurance—it all started when Otto von Bismarck signed his Health Insurance Bill of 1883 into law. (It’s still known as the “Bismarck model” because of his legacy, and other parts of Europe and Asia have adopted it over the years.)

But that’s not to say that the Bismarck model is without its problems. In fact, Germany shares many healthcare woes with the U.S., and it’s tried some intriguing solutions that Americans might look to, as well.

So, with our healthcare system looking decidedly more German, here’s what we have to look forward to.

***

All things considered, it’s good to be a sick German. There are no network limitations, so people can see any doctor they want. There are no deductibles, so Germans have no fear of spending hundreds before their insurance ever kicks in.

There’s also no money that changes hands during a medical appointment. Patients show their insurance card at the doctor’s office, and the doctors' association pays the doctor using money from the sickness funds. "You don’t have to sit at home and sort through invoices or wonder if you overlooked fine print,” Sophia Schlette, a public health expert and a former senior advisor at Berlin’s National Statutory Health Insurance Physicians Association, told me. That insurance card, by the way, is good for hospital visits anywhere in Europe.

Germany is in the middle of the pack among developed countries when it comes to healthcare spending per capita, according to a report released by the Commonwealth Fund last fall.Commonwealth Fund

But of all of the countries studied, Germans were the most likely to be able to get a same-day or next-day appointment and to hear back from a doctor quickly if they had a question. They rarely use emergency rooms, and they can access doctors after-hours with ease.Commonwealth Fund

And Germany manages to put its health-care dollars to relatively good use: For each $100 it spends on healthcare, it extends life by about four months, according to a recent analysis in the American Journal of Public Health. In the U.S., one of the worst-performing nations in the ranking, each $100 spent on healthcare resulted in only a couple of extra weeks of longevity.

Then, of course, there are the drawbacks. Since there are no provider networks in Germany, doctors don’t know what other providers patients have seen, so there are few ways to limit repeat procedures. In fact, Germany is facing quantity-control issues similar to America’s, but the U.S. is more of a vanguard in attempting to limit waste. The ACA created Accountable Care Organizations, voluntary groups of doctors and nurses that can share in the savings if they manage to treat Medicare patients more efficiently.

The German government is similarly trying to push more people into “family physician” programs, in which just one doctor would serve as a gatekeeper. But that’s an idea the Germans borrowed from the American HMO model of the 1980s.

And like the U.S., Germany may see a shortage of primary-care doctors in the near future, both because primary-care doctors there don’t get paid as much as specialists, and because entrenched norms have prevented physician assistants from shouldering more responsibility, Schlette said. There are so few nurses available to provide geriatric care that Germans have started importing their own home health aides from Eastern Europe or the Philippines.Raquel Lopez Leon carries a tray at the SenVital elderly home outside Berlin. Facing a shortage, German institutions increasingly turn to southern European countries for nursing jobs. (Thomas Peter/Reuters)

The German government is also currently trying to lure more primary care doctors to rural areas, where staffing issues are much worse than in affluent towns and cities—just like in, well, you guessed it.

The mandatory German insurance can also get rather expensive. Sam pays 355 euros a month for her sickness fund because as a freelancer, she’s responsible for both the employer- and employee-paid portions. And in one 2010 survey, nearly as many Germans (16 percent) as Americans (17 percent) said they spent a lot of time on medical paperwork or disputes.

With limitations on how much they can charge, German doctors and hospitals instead try to pump up their earnings by performing as many procedures as possible, just like American providers do.

“Is the system good?” Schlette said. “Well, maybe, but there is a lot of oversupply of care and poor care coordination.”

With few resource constraints, healthcare systems like America's and Germany's tend to go with the most expensive treatment option possible. An American might find himself in an MRI machine for a headache that a British doctor would have treated with an aspirin and a smile.

Similarly, “In Germany, it will always be an operation,” Göpffarth said. “Meanwhile, France and the U.K. tend to try drugs first and operations later.”

***

Perhaps the biggest difference between our two approaches is the extent to which Germany has managed to rein in the cost of healthcare for consumers. Prices for procedures there are lower and more uniform because doctors’ associations negotiate their fees directly with all of the sickness funds in each state. That's part of the reason why an appendectomy costs $3,093 in Germany, but $13,000 in the U.S.

“In Germany, there is a uniform fee schedule for all physicians that work under the social code,” Schlette said. “There’s a huge catalogue where they determine meticulously how much is billed for each procedure. That’s like the Bible.”

In the U.S., meanwhile, a trip to the doctor or hospital is still a roulette of billing discrepancies and not-covered expenses.

Obamacare, meanwhile, has tried to cut healthcare costs primarily by taking aim at the number of unnecessary procedures. Medicare’s payments to hospitals are now partly tied to readmission rates, and last year Medicare punished more than 2,000 hospitals for not doing a better job of keeping patients out of the ER. There have also been 114 Accountable Care Organizations created, but so far only 29 have saved enough money to qualify for bonus payments.

And there are still more cost-cutting measures to come, like taxes on “Cadillac,” or very generous, health plans. Some experts think American customers might become more cost-conscious as they move onto stingier healthcare plans.

And certain U.S. states have tried a more German strategy, attempting to keep costs low by setting prices across the board. Maryland, for example, has been regulating how much all of the state’s hospitals can charge since 1977. A 2009study published in Health Affairs found that we would have saved $2 trillion if the entire country’s health costs had grown at the same rate as Maryland’s over the past three decades.

Now, Maryland is going a step further still, having just launched a plan to cap the amount each hospital can spend, total, each year. The state's hospital spending growth will be limited to 3.58 percent for the next five years.

“We know that right now, the more [doctors] do, the more they get paid,” John Colmers, executive director of Maryland’s Health Services Cost Review Commission, told me. “We want to say, ‘The better you do, the better you get paid.’”

Two other small, left-leaning states, Vermont and Massachusetts, are experimenting with similar measures, but some experts doubt that this sort of top-down thriftiness can be imposed in every state, or even in most states. As we’ve seen from the bitter fight over Medicaid expansion, conservative states tend to balk at government directives.

“These states are all unabashedly in the new (or rediscovered) category of states who recognize that the authority of government is an essential ingredient to finding a sustainable level of total health spending,” John McDonough, a professor at the Harvard School of Public Health, told me. “The red states are unlikely to follow their lead. The notion that government may be a big part of the solution, instead of the problem, is anathema, and Republican controlled legislatures, and their governors, would find it too substantial a conflict to pursue with any vigor.”

What’s more, no other state has Maryland’s uniform, German-style payment system in place, “so Maryland starts the race nine paces ahead of the other 46 states,” McDonough said.

In a 2012 report on the German and American healthcare systems, Göpffarth pointed out that though the U.S. and Germany are both desperately trying to make healthcare less expensive, the unique spirit of each country is what ultimately gets in its way. Germany’s more orderly system can be too rigid for experimentation. And America’s free-for-all, where hospitals and doctors all charge different amounts, is great for innovation but too chaotic to make payment reforms stick.

In fact, Göpffarth thinks rising health costs will continue to be the main problem for Americans as we launch into our more Bismarckian system.

“The main challenge you’ll have is price control,” he said. “You have subsidies in health exchanges now, so for the first time, the federal budget is really involved in health expenditure increases in the commercial market. In order to keep your federal budget under control, you’ll have to control prices.”

And though we’ve followed the lead of Germany and other European systems to get where we are now, no country has quite figured out that last part yet.

Source: http://www.theatlantic.com/health/archive/2014/04/what-american-healthcare-can-learn-from-germany/360133/

HomeCare Blog for Private Duty

ALZHEIMER'S AND ADLWARE

While reflecting on this month’s focus on Alzheimer Awareness, I wanted to share some basic knowledge surrounding this disease that truly is mind-boggling in scope and overall effect.  The article posted below outlines some interesting effects that we bet you didn’t know about Alzheimer’s.  Home care is in a unique position to help provide services to those afflicted by this challenge, and ADLware is just the configurable home care software that you need as an agency to best service, monitor, and improve your own services for the client’s benefit.

“In the latest on the U.S. Budget Battle front, the Obama Administration recently published its long term projections for the 2015 Budget. One good bet is that whatever projections exist for long term healthcare costs, unless we get on top of the Alzheimer's crisis, those projections are likely to be way understated. Due to the near perfect correlation between aging and Alzheimer's, the longevity miracle of the 20th century is yielding a health crisis for the 21st. The analysts at OMB might factor in twelve things about Alzheimer's, which neither they nor few others of us know, but would be part of a serious analysis of what is to come:

Alzheimer's is a fiscal nightmare. It consumes an incredible 1% of Global GDP per year, roughly $604 billion. That figure is greater than the total GDP of all nations except the 20 richest. The costs are so extraordinary in large part because of the intensive caregiving that is required. By midcentury, the total number of people requiring care will triple. Private sector innovation in caregiving may help stem this tide.

Rates will quadruple. In the next 35 years, cases of Alzheimer's are going to quadruple, reaching 135 million by mid-century. If you're over 65, you stand a one-in-eight chance of getting the disease. Once you pass 85, your odds jump (or fall) to nearly one-in-two. And, prevalence in today's developing/poor countries will skyrocket at even more rapid paces than in the developed world, including the U.S.

Alzheimer's is the third deadliest disease in the U.S. Each year, Alzheimer's takes nearly a half-million American lives. But, as Alzheimer's is nearly perfectly correlated with age, it is today's developing/poor countries that as we approach mid-century will see the greatest impact.

Alzheimer's is endlessly destructive. Most people think that Alzheimer's destroys people's ability to remember. But it's far worse than that. The dementia struggles of legendary UNC basketball coach Dean Smith, which have recently gone public, illustrate the point. This long ESPN article discusses the icon's jaw-dropping deterioration. Incredibly, he no longer enjoys watching basketball; the games are too confusing and move too fast. Not long ago, upon his retirement, Coach Smith had won more games than all but three coaches in the history of the game. Its impact on society is even greater, albeit at different levels.

There may be many kinds of Alzheimer's. We might be thinking about Alzheimer's all wrong. When John Wayne had cancer, it was called "the cancer." Now there are dozens of kinds of cancer. Some very smart people think that's exactly the situation today with Alzheimer's. We think it's one degenerative disease, but there may be countless different forms -- which will require different treatments, preventions, and care methods.

You can be a "dementia friend." The UK has started a program that trains citizens in retail, banking, and other customer-facing jobs to be "dementia friends." There are too many ugly stigmas around Alzheimer's that cause people to act poorly when dealing with someone with dementia. These mistakes are easily corrected.

High-tech solutions are coming. Technologies may re-write the possibilities of life with dementia. Houses are becoming dementia friendly with the help of digital technologies -- like fall sensors, "smart" reminders, etc. These technologies will drastically extend a person's capability of living a life of independence -- or even semi-independence. One of the greatest advocates, George Vradenburg, has begun to talk about how Google Glass can be a prosthetic for Alzheimer's.

There is even progress on Diagnosis. The only definitive diagnosis for Alzheimer's disease is a brain biopsy. But there are new tools that are improving rapidly: The use of blood tests, enhanced cognitive screenings and imaging capabilities. But with serious, applied commitment and incentives there is no reason we cannot apply our growing technological capabilities to this challenge. Indeed, let's start demanding the innovative combination of low tech softer monitoring in care settings, especially home environments with caregiver and family attention, with "big data" analytics to advance our knowledge base around early detection and diagnosis.

"Big data" may uncover solutions and help solve some of these issues. We hear the rallying cries around big data with everything from unsynchronized stoplights to the war on terror. Leading organizations are bringing "big data" to help unlock the mysteries of Alzheimer's. The prospects are promising. Consider what we might learn if we use big data to analyze some of our most serious data sets like the Framingham Heart Study or several of those Dutch, UK or German studies increasingly collecting data for pricing and insurance schemes. Or, even more creative would be the use of big data to bring innovative pharmaceutical clinical trials into the 21st century by ongoing monitoring and analysis of results in real-life settings.

New Care Models for the 21st Century. As private sector models of home care such as Home Instead Senior Care extend their Alzheimer's Care Training, we are learning more about Alzheimer's than often had been achieved in more traditional 20th century analytical constructs. The applications here are not only for more effective and better Care. But, equally interesting might be the ability to marry technology with this private, targeted and personal home care to mine data for greater and deeper knowledge about this disease that conventional analytical and clinical approaches are not yielding.

Prevention Before Cure. New studies are teaching us more about prevention of Alzheimer's even before we learn how to cure or adequately treat the dreaded disease. Amazing, but let's celebrate this one!

An unexpected advocacy push: Quite recently, irreverent Hollywood comedian Seth Rogen delivered an impassioned plea for greater action against Alzheimer's disease before a U.S. Senate committee. And in London, Alzheimer's Disease International has begun a global petition to put Alzheimer's on the G20 agenda. After getting significant recognition by the G8 under David Cameron's leadership, Alzheimer's advocates are rightly setting their sights on the G20 meeting in Australia. But even as the star of 40 Year Old Virgin and Knocked-Up works toward the same goals as Alzheimer's Disease International, it remains curious how little of the disease - and its consequences - that we actually know about the world's most difficult, tragic, and costly diseases.

To learn more about how ADLware can help you in your efforts to provide better care to those dealing with Alzheimer’s, contact us today to view a free demo.

Source: http://www.huffingtonpost.com/michael-hodin/alzheimers-research_b_5035238.html

HomeCare Blog for Private Duty

NUMBER OF CAREGIVERS IS RISING

One of the biggest booming industries in the United States is In-Home Care. As the baby boomers continue to reach retirement age and beyond, more of them need assistance with daily tasks in the home. This has caused a great need for more care givers. An article in the SpringField News-Sun titled Jobs for In-Home Care Booming talks about this increase of more caregivers.

“An aging population and changes in health care delivery are leading to a rising demand for jobs in home health care and other services designed to allow people to remain in their homes longer.

An estimated 1.2 million people in the U.S. worked as personal care aides in 2012 and that figure is expected to increase 49 percent over the next decade, according to the Bureau of Labor Statistics…”

With such a large increase in the number of caregivers it can be difficult to manage all the work that goes into having people apply and keeping track of their information. ADLware is the perfect solution. ADLware is a home care software that does everything from billing to scheduling and even sending texts to anyone from the system. In the case of hiring new caregivers it can help in multiple ways. ADLware provides a way to integrate a hiring form directly into your website where people can apply. Once they submit their application you will be notified that you have a new application and you can now track your steps in the process of hiring. These steps might include a background check, interviews, reference check, etc. When you are ready to hire them, just simply click the “Hire” button for that particular applicant and all their information has automatically generated a caregiver profile in the system. No re-entry of data needed! Now that that caregiver is in the system, you can do so many things. You can match them to client shifts based on their skills and interest. You can even set specific pay rates for that caregiver for specific tasks. Contact ADLware today to see how we can best help you and your company manage the vast number of caregivers and clients you have or want to have! ADLware is the perfect software to manage large or small companies and to help the companies grow!

HomeCare Blog for Private Duty

APRIL IS PARKINSON’S AWARENESS MONTH

Did you know approximately 1.5 million Americans and 6.3 million people worldwide are living with Parkinson’s Disease?  Of course, the community affected by Parkinson’s in terms of caregivers, family members, and the medical profession is substantially larger. As the second largest neurological disease, it is important to know the facts about Parkinson’s, as all in the senior health care industry are affected.

Parkinson’s disease (PD) is a progressive, neurodegenerative disease that belongs to the group of conditions called motor system disorders. PD cannot yet be cured and sufferers get worse over time as the normal bodily functions, including breathing, balance, movement, and heart function worsen.

Parkinson’s disease most often occurs after the age of 50 and is one of the most common nervous system disorders of the elderly. Those diagnosed with Parkinson’s between the ages of 21-40 are referred to as “early onset.”

The disease is caused by the slow deterioration of the nerve cells in the brain, which create dopamine. Dopamine is a natural substance found in the brain that helps control muscle movement throughout the body.

At ADLware, we strive to provide all the technological resources caregivers might find useful in performing their activities of daily living for all patients, including those with Parkinson’s. In our Family Portal, caregivers can log whether it was a good or bad day for mom or dad, and ensure medications are well-stocked and up-to-date. This month as we strive to raise extra awareness for Parkinson’s Disease, we hope you know that at ADLware, the health and well-being of your clients matters to us.

HomeCare Blog for Private Duty

HOT COFFEE

A few years ago there was an uproar in the media about “frivolous lawsuits” and they targeted one lawsuit in particular, you may remember.  McDonald's was sued by a woman who spilled her coffee and burned herself.  At face value that seems like a joke, however a documentary explored her story and others similar to hers and revealed it to be no laughing matter.  Legislation was passed to limit the effectiveness of these lawsuits, this legislation was called Tort Reform.  The documentary shows how dangerous uninformed voters can be.  The reason for this particular story today is the need for people to be active in what is going on in government today. There is a lot of change occurring in the healthcare industry and we need to make sure that we can be responsible voters so that our loved ones get the proper care they need and deserve. “Hot Coffee” is a documentary that illustrates how our political power as citizens could be overridden by uninformed voters. It is important for us to stay informed, so that we can protect our rights and the rights of our loved ones.

HomeCare Blog for Private Duty

HEALTH CARE INDUSTRY IS GRATEFUL TO CONGRESS

Congressional leaders are considering a potential solution to Medicare home health benefits reductions implemented under the Affordable Care Act, to the great relief of home health industry groups including the Partnership for Quality Home Healthcare. 

The ACA calls for a 14% cut to Medicare home health funding in the next four years, which began on January 1.

Congressional leaders are now considering a home health rebasing relief and reassessment provision for potential inclusion in the Sustainable Growth Rate legislative package that would provide “targeted relief” to 3.5 seniors designated who rely on home health, along with the 1.1 million healthcare professionals who provide them with home health services.

Another aspect of the provision directs the Secretary of the Department of Health and Human Services to reassess the ACA cut by analyzing its impact on small businesses and underserved areas, and report her findings to Congress.The relief and reassessment provision is fully self-funded and would contribute net savings to the Sustainable Growth Rate package.

“We are deeply grateful to leading Members of Congress for considering home health rebasing relief and reassessment as part of the SGR package,” said Eric Berger, CEO of the Partnership for Quality Home Healthcare. “The 14 percent home health re-basing cut poses a dire threat to millions of vulnerable seniors, women, and working Americans. As a result, Congress’ work on home health re-basing relief and reassessment is of enormous importance to so many people across the U.S.”

Source: http://homehealthcarenews.com/2014/03/industry-group-commends-congress-on-home-health-action/

HomeCare Blog for Private Duty

HOW YOUR AGENCY CAN BENEFIT FROM YOUR LOCAL HOSPITAL

With regulations increasing for hospitals across the country, home care agencies have a chance to benefit. Hospitals since October of 2012 have been eligible for penalties based on patients being readmitted into the hospital within 30 days of discharge. By October of 2014, Hospitals can receive a maximum penalty of 3% of regular payments. In 2012, Medicare penalized hospitals across the country for a total of $280 million. This number will only increase unless hospitals can find a way to keep patients from continual re-admittance.
 
This is where home care agencies can benefit. Hospitals are more eager to place an elderly patient with a home care agency that will take great care of them. As an agency provides quality care for those patients discharged from the hospital, the hospital is more likely to refer more patients to the home care agency. Now, it is important for the home care agency to keep track of when their clients were last in the hospital. ADLware is ahead of the game in thinking of ways to help home care agencies. We have a feature called “Hospitalization” that tracks when the agency’s clients have been discharged from the hospital. The next time an employee from that agency visits the hospital, they will have an easy way to show the progress of that client and how long they have been out of the hospital. ADLware has given home care agencies an easy way to gain the trust of hospitals and ultimately help the agency gains more clients! Contact ADLware today to see how the “Hospitalization” feature works and how the rest of the software can help your agency thrive!

HomeCare Blog for Private Duty

ALIVE INSIDE

Did you know that the part of the brain affected by music is the last part of the brain to be impacted by Alzheimer’s Disease? This is one of many nuggets revealed in a powerful new documentary titled “Alive Inside,” which follows one man’s journey to awaken the music lover in Alzheimer’s patients, and in turn, to restore their memories associated with music.  Go to http://aliveinside.us/ to watch an excerpt from the documentary and learn how music can be such a powerful tool in connecting with patients with Alzheimer’s.

We at ADLware care about all programs impacting the improved care and connection with seniors. If you know of a film or program that brings attention to a worthy cause, let us know about it and we’ll feature in here in our blog.

HomeCare Blog for Private Duty

CAREGIVER NOTIFY

Have you ever had difficulty keeping track of all your different commitments? In the past I have had difficulty keeping my schedule straight. I had employers that would update the shifts of the staff with little notice and then forget to tell everyone of the relevant changes.  With caregiver notify this problem is eliminated, everyone is informed of their shift.  At the rate that the home health care industry is growing most caregiver providers will start to have more clients on their schedule than they can keep track of easily. 

ADLware is, once again, making it simple. Caregiver Notify provides caregivers a daily email of their upcoming shifts and client needs.  No need to guess or make calls to double check your schedule, it is delivered to you automatically on a daily basis. Maps, shifts and caregiver notes are just a click away. This great feature also allows you to cut down on the amount of printouts, calls, and trips to the office. All you need to do is create the shift and assign a caregiver, ADLware will do the rest.

HomeCare Blog for Private Duty

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