Posts tagged 'emergency room'
We have written and discssed some o the positives involved in home health care. There are a lot of home health care agencies who make home visits - especially elderly patients and/or those who have a very difficult time getting around. These agencies do a great service and are so valuable to the people they serve. The only negative is that if a patient needs extensive care, tests, or medical care by a physician most of the home health care companies do not have physicians available, which can often result in individuals ending up in the emergency room, which is always an expensive situation. However, if there is a doctor available, much of the care - and many times, all of it - can be taken care of at home, on the spot and without causing extra stress and strain on the patient.
It used to be very common for doctors to make house calls, but expense and other factors all but eliminated. That situation has started to change in the last few years for quite a few reasons. When looking at the changes that have taken place in the past decade or more, portability has made it possible for doctors and other healthcare professionals.
Which would you choose if you were elderly or disabled or both and had to keep going to the doctor? Would you rather have the doctor come to you once every 3 to 6 weeks and keep you healthier and more comfortable and, in addition have the capacity to perform most tests and procedures from the patient's home, fax or send information by computer and receive results without the patient having to go through the difficulty, inconvenience, and sometimes, discofort of having to get to the doctor's office.
In addition, research shows that most of the patients served in their homes stay healthier, live longer, stay out of the hospital and emergency room, and it is all because they are getting regular care. If they didn't have regular care, studies show that they would end up seeing the doctor much less often and end up in the emergency room or hospital mor often. With changes in healthcare and with improvements in Medicare and Medicaid coverage, it is possible for many more people who need care at home to receive it.
If you are in a situation that would make it better for you to get treatment at home, checkk with Medicare, Medicaid and any other health coverage you have to see if you can receive care by a physician at home. Then talk to your physician and see if he or she proides that type of care or can recomment a colleague who makes house calls. It may take a little time finding a doctor to make house calls, but there are more and more who are willing to do so.
Once you are able to make the arrangements and get started you will likely feel much more relaxed about seeing the doctor. So, which would you choose? Look at your circumstances and see if you would rather get out of the house, see the doctor, go to the grocery store or go to lunch - which many people do, and it makes them feel better - or if it would be easier for you and more comfortable for the doctor to make a house call to you. Either way, do what you think is the best for your situation and will keep you healthy.
Just when we are talking about going back to the basics of house calls on one end of the spectrum, the other end of the spectrum is beginning a pilot program in telemedicine.
House calls will begin being expanded soon and paid for by Medicare for those with multiple serious conditions and other situations that make house calls the best form of care for them.
Now, with that out of the way, Medicare is still looking for ways to provide effective and adequate treatment to patients while containing costs. They are finally looking at telemedicine.
Telemedicine has been around for quite some time now. Some private insurers have paid for certain treatment by telemedicine. For example, I have a nephew who was born with serious heart problems and had a pacemaker installed when he was younger, nearly a decade ago. Once his initial treatment was completed, telemedicine was used to keep him in sync of his heart surgeon and keep his heart surgeon abreast of his condition.
At the time, what would happen was that we would call a particular phone number and use our phone and another instrument to measure my nephew’s heart rate, heart rhythm, blood pressure and other vitals, as well as whether the pacemaker was working. The doctor would get the reports and then we would have a conference by phone. If there were problems or complications we would go to the local emergency room where my nephew’s doctor would communicate with the emergency room doctor by phone and computer. If things got too serious, we would get my nephew up to the Children’s Hospital where his doctor was on staff.
Today’s telemedicine is more advanced than it was a decade ago. There are cameras and TV screens that allow doctors and patients to see one another. Patients have some of the instruments such as stethoscopes, so that they can be instructed by the doctor when and how to use them so he can help them remotely. There are also touch screens patients can use to answer doctor’s questions to aid in a diagnosis.
Now that insurance companies – and Medicare – have realized what doctors and patients have been saying for years, they are finally trying telemedicine out. Doctors and patients have been telling insurers that it is better for everyone that telemedicine evaluations, where appropriate, cost under $1,500 on average as opposed to a hospital admission or other tests that often add up to somewhere between $2,500 to $15,000.
It is good news that Medicare is now looking at ways to see if telemedicine will work well for certain patients. If it only keeps a few patients out of each hospital, Medicare can save potentially over $100,000 per hospital while patients receive quality care. This is an issue to keep an eye on.
There have been many debates recently as to how to handle the situation of healthcare for individuals who are living in the United States but are not U.S. citizens. With elections around the corner, this issue has become an intense topic for discussion on all sides of the aisle.
There are many varied opinions regarding healthcare for these individuals and families. Studies have shown that the money they generate in the economy and sometimes in taxes offsets most or all of the medical expenses they incur. Other studies say the opposite.
With Medicare and Medicaid budgets and services struggling financially there have been questions raised as to how these individuals receive medical care and what it costs the system.
In Ohio, the Columbus Dispatch Newspaper stated in an article that the poor and/or undocumented in central Ohio, line up at the free health clinic near Ohio State University. The lines begin to form hours before the clinic – which is staffed by volunteer doctors and nurses - opens for services.
There is now a proposed bill requiring Clinica Latina and other clinics that serve undocumented residents to check for immigration status and turn away any individuals who do not have documentation. The bill states that the reason is that part of the funds for this particular clinic and some others come from Ohio State University. If the clinic were to receive funds only from private sources, they could continue treating these individuals without checking their status.
The issue that this leaves could have a huge financial impact on Medicare, Medicaid and the healthcare system because it would leave undocumented citizens with only the hospital emergency room for treatment. Unlike clinics, federal law states that hospitals cannot deny services to individuals based on various issues, including immigration status. As a result, seeing a doctor at the free clinic and receiving a $5 prescription for blood pressure or diabetes medication could now cost hundreds of dollars at the emergency room, and Medicare, Medicaid and taxpayers would have to absorb those costs.
The issue of undocumented residents in this country is not a simple one, nor will it be solved simply or quickly, however, it is important for lawmakers and administrators to look at the big picture and the overall costs before eliminating programs that could save an already struggling system money just to prove a point.
