State Medicaid Director Letter: Three New Opportunities to Test Innovative Integrated Care Models for Individuals Dually Eligible for Medicaid and Medicare

As a 2019 strategic priority, Centers for Medicare & Medicaid Services (CMS) is redoubling efforts to better serve older adults and people with disabilities dually eligible for Medicaid and Medicare. The goal is to create a more seamless experience across the two programs while ensuring that incentives are aligned and pointed toward lower cost and better outcomes.

On April 24, CMS sent a letter to State Medicaid Directors inviting states to partner on testing innovative approaches to better serve those who are dually eligible for Medicare and Medicaid. Many of these 12 million beneficiaries have complex healthcare issues and often have socioeconomic risk factors that can lead to poor outcomes. This letter opens new ways to address those needs, align incentives, encourage marketplace innovation through the private sector, lower costs, and reduce administrative burdens.

Full story at acl.gov

Older Americans Month: Connect, Create, Contribute

Every day, all around us, older adults make a positive impact in our communities. As employees, volunteers, mentors, and advocates, they are an integral part of America’s social fabric. Their experience and insights enrich and strengthen our neighborhoods, workplaces, and families.

That’s why ACL takes time each May to honor their valuable contributions and celebrate Older Americans Month (OAM). People of all ages can celebrate OAM and help older adults thrive. With the 2019 theme, Connect, Create, and Contribute, ACL invites you to:

  • Connect with friends, family, and services that support participation
  • Create through activities that promote learning, health, and personal enrichment
  • Contribute time, talent, and life experience to benefit others

Full story at acl.gov

As Sense of Smell Fades, Does Death Come Closer?

They say the nose knows, but can a loss of smell signal impending death?

Possibly, researchers say.

They discovered that a poor sense of smell was associated with a nearly 50% higher risk of death within the next decade for adults older than 70.

While the study didn’t prove cause and effect, that association is enough to make some experts wonder whether seniors’ sense of smell should be tested alongside their other vital signs.

“I would not be surprised if someday the sense of smell was included as a simple checkup, to see if this important human sense is affected,” said senior researcher Dr. Honglei Chen, a professor of epidemiology and biostatistics at Michigan State University.

Full story at US News

Tailoring Exercise to Your Age

Exercise is a great way to stay youthful and even turn back the clock on aging. If you’re new to exercise or simply want a fitness reboot, here are ideas by the decade.

In Your 20s: Experiment with different workouts to find what you enjoy. Make exercise a regular habit that you won’t want to give up, even when career and family make heavy demands on you.

In Your 30s: Short on time? Try three 15-minute walks spread throughout the day. To stay fit and retain muscle, do cardio just about every day and strength training two or three times a week. If you’re new to exercise, take classes or have a personal trainer create a program for you.

In Your 40s: Enhance your weekly routine by doing both low-intensity exercise, like yoga for stress relief and flexibility, and high-intensity workouts, like interval training or a spin or kettlebell class, to boost calorie burn and muscle elasticity. Expect longer recovery times after high-intensity workouts, so make sure to get enough sleep.

Full story at US News

Drugs to prevent stroke and dementia show promise in early trial

Treatments that prevent recurrence of types of stroke and dementia caused by damage to small blood vessels in the brain have moved a step closer, following a small study.

The drugs — called cilostazol and isosorbide mononitrate — are already used to treat other conditions, such as heart disease and angina.

This is the first time they have been tested in the UK for the treatment of stroke or vascular dementia.

A study involving more than 50 stroke patients found that patients tolerated the drugs, with no serious side effects, even when the drugs were given in full dose or in combination with other medicines.

Full story at Science Daily

A machine learning device, meant to monitor the chronically ill, moves into homes

A wearable device that uses machine learning to remotely track and analyze multiple vital signs has been cleared by the Food and Drug Administration, expanding the scope of home monitoring systems intended to keep chronically ill patients out of the hospital.

Current Health, based in Edinburgh, Scotland, announced Wednesday it received clearance for an upper-arm wearable that measures a patient’s respiration, pulse, oxygen saturation, temperature and mobility. The product is capable of delivering continual updates on a patient so doctors can intervene quickly if the data signal an emerging problem.

The device, called Current, is already used in hospitals, and the clearance means it can monitor patients at home, in between visits with their doctors. It uses machine learning to analyze the data it collects and notifies doctors of problematic changes on their mobile devices or in electronic health records.

Full story at STAT

Should I Get Involved in Helping a Neighbor With Dementia?

I live in a large co-op apartment building in Manhattan. Our staff is lovely and caring. A staff member told me that a resident is getting very forgetful and that she likes to spend her time in the lobby. I asked if she had family and was told she had only one brother in Japan. I was probably chosen as a confidante because I cared for my husband who had Alzheimer’s at home. Despite that experience, I was at a loss to give advice.

One day, I got on the elevator with this lovely, forgetful neighbor. She could not remember the number of the floor on which she lived. I offered to accompany her downstairs to learn her apartment number. She thanked me but was naturally embarrassed at the need for help and declined. She acknowledged that she was getting forgetful, and I told her my husband had the same problem and I understood.

I now find myself very worried about what will happen to this nice lady who has no one to help her. The thought has also crossed my mind that she may be a danger not only to herself but also to others living in the building. I am aware of the right of an individual to age in place versus the need for assistance, but this can’t be a unique problem. Is there a protocol for managing agents of buildings to follow? Linda, New York

Full story at The New York Times

Many ‘Gen Xers’ Desolate as They Navigate Adulthood: Study

Despair runs rampant through Generation X as these Americans struggle through middle age, a new study reports.

So-called indicators of despair — depression, suicide, drug and alcohol abuse — are rising among those in their late 30s and early 40s, and it’s occurring across-the-board, researchers say.

“These are getting worse as people age through their 30s,” said lead researcher Lauren Gaydosh, an assistant professor with the Vanderbilt University Center for Medicine, Health and Society. “For example, heavy drinking is really peaking again, almost to levels equivalent to where they were at college age.”

Previous studies have drawn attention to these “deaths of despair,” but initially it appeared they were occurring mainly among poorly educated whites, Gaydosh said.

Full story at US News

Hospitals Chafe Under A Medicare Rule That Reduces Payments To Far-Flung Clinics

Eric Lewis’ plans of expanding his community hospital’s reach have been derailed.

As CEO of Olympic Medical Center, he oversees efforts to provide care to roughly 75,000 people in Clallam County, in the isolated, rural northwestern corner of Washington state.

Last year, Lewis planned to build a primary care clinic in Sequim, a town about 17 miles from the medical center’s main campus of a hospital and clinics in Port Angeles.

But those plans were put aside, Lewis says, because of a change in federal reimbursements this year. Medicare has opted to pay hospitals that have outpatient facilities “off campus” a lower rate — equivalent to what it pays independent doctors for clinic visits.

Full story at npr.org

Increased muscle power may prolong life

Increasing muscle strength is good, but increasing muscle power may be even better for enjoying a longer life, according to a recent study.

Professor Claudio Gil Araújo, who is the director of research and education at Exercise Medicine Clinic — CLINIMEX in Rio de Janeiro, Brazil, led the new study.

Muscle power differs from muscle strength in that it relies on generating force and velocity while coordinating movement. For example, lifting a weight one time requires strength, but lifting it several times as quickly as possible requires power.

Full story at Medical News Today