Health care reform must encourage options - East Valley Tribune: News

Health care reform must encourage options

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Posted: Tuesday, September 15, 2009 9:42 am | Updated: 1:15 am, Sat Oct 8, 2011.

Chuck Bongiovanni: As we age, we naturally utilize more health-care services. Fortunately, “The Affordable Health Choice Act” has provisions in it that can increase patient choice, deter wasteful spending and drive down costs.

As the national health care reform debate heats up, I am reminded that no matter what plan is put in place, patient options and care costs will always being the driving force. However, sometimes our patient options are not given to us effectively, which in turn, drive health-care costs up dramatically. This is extremely true for the senior population in Arizona.

As we age, we naturally utilize more health care services. Fortunately, “The Affordable Health Choice Act” has provisions in it that can increase patient choice, deter wasteful spending and drive down costs. For example, medical records would be computerized so seniors won’t have to take the same test over and over or relay their entire medical history every time they see a new provider. Also in the bill is a provision for advanced care consultation with their doctor paid for by Medicare once every five years, or more frequently if the patient has a life-threatening disease.

These consultations include "an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title."

A Harvard study released earlier this year directly linked end-of-life counseling with lower health-care costs and better quality of life for patients with advanced cancers. These consultations give seniors the choice in how or if they want their life extended during an end-of-life situation. This is not euthanasia. It is an individual’s choice in his or her health care.

Another choice that I feel has been limited in the past to our Arizona seniors is where they want to reside if out-of-the-home placement is required. Our Arizona form of Medicaid, or ALTCS, provides for nursing home or assisted living placement for seniors if they need an increased level of care that cannot be safely maintained in their home. The minimal cost for this care averages $160 per day in a nursing home and only $80 per day in one of Arizona’s assisted living homes.

The problem with any health care reform is oversight. For example, I have seen too many seniors that have needed a short-term stay in a nursing home develop into a permanent stay because they cannot go back home. However, are they being told of the less restrictive, less costly assisted living home option?

What about those seniors who are currently living in nursing homes under the Medicaid/ALTCS payer system? Are they being evaluated frequently to see if they are appropriate for a less costly service option? Anyone could walk into any Arizona nursing home and evaluate the ALTCS patients using the Department of Health Services criteria for appropriateness of admission into an assisted living home and find a large majority of patients could legally reside in the less restrictive and more cost effective assisted living home. With thousands of seniors in nursing homes across Arizona, the cost savings and increased quality of life would be staggering.

Whichever health care reform bill is presented to us, we must first be able to control, identify and eliminate the wastefulness of our current health-care spending. It’s all about choice they say, but are our Arizona seniors permanently living in nursing homes who are appropriate for a less restrictive environment getting their voices heard?


Chuck Bongiovanni is the founder and CEO of CarePatrol, a national company headquartered in Gilbert that offers free senior housing referral services.

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