The Health Insurance Reforms that Enrich Aging Patients’ Quality of Life

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Guest Columnist, Carol Marak By Guest Columnist, Carol Marak 
Editor, SeniorCare.com
Health Insurance Reforms that Enrich Aging Patients' Lives

In 2015, CMS – along with private health care firms – made modest changes on how they cover end-of-life care. The Medicare ruling applies to discussions with a doctor, hospice payments and wages, and routine home care expenses, depending on the person’s length of hospital stay. We hope the changes will enhance our progress to safeguard the individuals with advanced illnesses to live out their days in comfort and quality of life.

The private health insurance firm, Blue Cross Blue Shield of Massachusetts, stepped up big time. They added comprehensive services to relieve the needs of the dying and their family members. The benefits will allow the patients and health care team to discuss the end-of-life concerns and worries with the family, doctors, psychologists and social workers openly. Blue Cross Blue Shield wants patients to talk about their preferences.

From my experience, the modest changes will help families and patients better deal with the death and dying issues. When my parents faced the last stage, Mom was quite lucky compared to my dad. Her doctor followed her end-of-life choice while my dad’s doctor was determined to have it his way. The last week of Dad’s life was living hell for the family, and I can imagine it gravely affected him too. Dad lived with Alzheimer’s and in his final days, the doctor wanted to put him on a feeding tube. The family objected and so did Dad years before. He did not want treatment to extend life. The final days were miserable. Instead of grieving, we were fighting with the medical team. That was 10 years ago, and I’m grateful that we’ve moved this far with the new hospice rulings.

Since the last stage was so difficult for my family, I wonder what other benefits health insurance companies can offer to make it better at the end? Seniorcare.com asked aging experts, “What other services or benefits should health insurance companies provide patients and family caregivers?” Here are a few thought-provoking ideas:

Care Coordination

I believe care coordination should be available to seniors and families. Policy provisions that help families organize and coordinate multiple providers/conditions to identify lifestyle change. These programs could reduce issues like readmissions, emergencies and worsening health. Shannon Martin, Aging Wisely

I believe that insurance should cover geriatric care management services, and, in some cases, they are. Geriatric care managers are a wealth of information, know the local resources. They can also help prevent home accidents by making recommendations for changes to the home to accommodate the senior resident. Shelley Webb, Intentional Caregiver

Caregiver Needs

Insurers and benefits providers are just starting to catch on to the caregiver’s needs. But so far, their approach has been a menu rather than a package. With the data at their disposal, insurers are in a position to better know the needs of consumers and which services are right for them. Family caregivers don’t have the time to do research – they want someone to vet the services and figure out which ones are relevant. Until employers and insurers get that right, the services they offer for caregivers won’t move the needle. Kai Stinchcombe, True Link Financial

Stress Management and Meditation Classes. Seniors and family caregivers suffer from a lot of stress-related conditions. Learning to become more stress resilient could mean fewer trips to the hospital and better outcomes when a health issue arrives. Kathryn Watson, Find Houston Senior Care

Non-medical home care, for the most part, is not covered by Medicare or other commercial health insurance plans. Medicare, in my opinion, is being short-sighted, focusing solely on “reimbursable encounters.” By not recognizing that in-home personal care fosters increased safety, better nutrition, hydration and socialization, they become “penny wise and pound foolish.” Patricia Grace, Home Helpers

Palliative Care          

Palliative Care provides relief from symptoms and stress of severe and chronic illnesses: Cancer, cardiac disease, COPD, kidney failure, Alzheimer’s, Parkinson’s, ALS and more. The goal is to improve the quality of life for the patient and family. Palliative care offers a specially-trained team of doctors, nurses and others who work in conjunction with one’s doctor for an extra layer of support. Rhonda Caudell, Endless Legacy

Medicare is now paying for these conversations, so more providers should be taking advantage of the opportunity to talk with both patients and caregivers about these issues. Since home care services are only available to those with a “skilled need,” there are no covered services for people with chronic illness that need ongoing care such as RN, PT, OT, HHA. Donna Schempp, Family Caregiver Alliance

Preventive Care

Offer preventive care of their senses! Services such as dental care, vision and hearing testing. Help prevent gum disease and tooth loss, which can lead to malnutrition. Seniors need dentures or replacements; glaucoma or macular degeneration screening and treatment plus corrective lenses/glasses and hearing testing, aids and batteries. Senses are vital to the good quality of life, safety and wellness! Kathy Birkett, Senior Care Corner

While some insurance companies do not cover counseling specifically for end-of-life issues, elders and caregivers alike greatly benefit from therapy sessions and treatment for depression and stress. Not only will such services improve the quality of life for all concerned, but can also assist in prolonging one’s ability to enjoy the time with family and loved ones. David Mordehi, Advise and Protect

Insurance companies should do more to encourage seniors to live active and healthy lives, through covered gym memberships and nutritional guidance from dietitians. They should include small, but necessary home repairs, group meal programs (to combat loneliness and ensure seniors are eating healthy), companion services, and do more to protect and advocate against abuse and neglect. Evan Farr, Elder Law Expert

Carol Marak, an elder orphan advocate, columnist, and editor at SeniorCare.com. She writes articles on senior-related concerns for the Huffington Post, About.com, and many other health care sites. Carol earned a Certificate in the Fundamentals of Gerontology from the University of CA, Davis.

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