Thursday, July 21, 2011

Status of Healthcare - A Nurse's Perspective

We have all been hearing about the healthcare reform that is needed in our country, and it has been the subject of much debate between our Democratic and Republican leaders. It is true that healthcare costs have risen dramatically, and in its current state, our healthcare costs will bring our country to its knees if left unchanged. I do not intend to discuss how that should be done, but rather how you the consumer, and my patient should plan for success in the unsettled times ahead.

What do we know?
Physicians: We know that beginning with this decade, there will be a large number of physicians retiring, and according to a recent Dartmouth College study, it will result in a future physician workforce will be smaller and younger. This shortage will create strain on our current systems, and will require physicians to change practice models in order to keep up with the increased demands.
Nurses: According to the American Nurses Association, there is currently a national shortage of approximately 120,000 RN’s. This number is expected to grow to 1.5 million by the year 2015, and peak in 2020. This will require hospitals, and medical practices to do more with less RN support.
Hospitals/Nursing Homes: Both hospitals and nursing homes are facing significant Medicare cuts, and will need to change their operational models, and reduce expenses in order to remain viable. One major way for these institutions to reduce costs is to shorten length of hospitalizations/admissions to the shortest possible time, while still ensuring safe care.

What does this mean to you?
Our healthcare model as we know it will need to change. The physician to patient, and RN to patient ratio’s will worsen, and you will have less time with the professionals that can best manage your care. Hospitals and nursing homes will, as a necessity to survive, look to minimize their costs, and will shorten your hospitalization/admission times if possible. You will have to assume more responsibility for managing your health/recovery in the outpatient or home setting.

What can you do?
While these above mentioned scenarios are ominous, I believe if you are prepared, and educated, you can make good decisions, and help your medical providers continue to provide you with excellent care.
1. Be prepared when you see your doctor: Understand that their time is limited, and they can best manage your care if you have pertinent data with you at your visit. Medication lists, blood glucose readings, weights, or blood pressure readings are some examples of things that you should have when you see your doctor. This will help them best manage your care.
2. Know the hospitals/nursing homes in your area. Understand that Medicare is now basing their payments to these organizations based on their quality, and knowing which facilities are best can be critical to your recovery. Some web resources:
www.healthgrades.com or www.medicare.gov/nhcompare
3. Plan for handling some of your rehabilitation in your home and know the ranges of services that can be provided. Understand how Home Health, In Home Care and Hospice work, and how they can help you in your home.

Angela Estrada Wins Honorable Mention for Dorland Health Silver Crown Awards

The Silver Crown Awards seek to honor industry-leading organizations like assisted living facilities and home health agencies, as well as individual practitioners across a range of disciplines like geriatric care managers, facility directors and hospice and palliative care professionals.

The Silver Crown Awards also recognize the best in adult and senior-specific programs, such as Alzheimer’s care, and coverage entities like those that provide Medicare Advantage or pharmacy benefits.

Dorland Health, the publisher of the Case Management Resource Guide, the National Directory of Adult and Senior Services, the Senior Services Report, Case In Point magazine and other resources for those in medical management, has provided information and development tools for those who care for adults and seniors for over two decades.

The Silver Crown Awards also recognize the best in adult and senior-specific programs.