Budget talk is confusing, but Alzheimer’s advocates MUST pay attention!

Is all this budget talk making you dizzy?  While the federal, state, and local government analysts huddle behind closed doors dissecting numbers and developing spreadsheets, politicians are spouting opposing ideas; it’s hard to separate the truth from the fiction, isn’t it?  But, there’s a reason for us to pay attention. 

I’ve recently read – as I am sure you have too — conflicting reports regarding how to reduce the federal deficit.  One opinion says that in order to protect social programs, we need to dismantle the “entitlements” which take up the largest chunk of change.  Well, personally, I’m not willing to toss “entitlement” programs such as Medicare that can be the only support keeping some older adults — including those with Alzheimer’s and other forms of dementia — on the other side of poverty.  So, I wonder whether we shouldn’t be focusing on far simpler solutions; can’t we examine what we’re doing that can actually save some dollars?

Advocates instinctively know that helping folks stay at home costs far less than the alternative – a long-term residential facility.  That’s precisely the argument we use when trying to convince state lawmakers not to eliminate the Adult Day Health Center programs.

We also now know, thanks to a just-published study by the California Discharge Planning Collaborative, that millions of dollars a year are expended because hospital patients are discharged far too often without the proper planning and without clear instructions that can be easily followed.  Readmissions result to the tune of unnecessary expenditures.

This problem affects everyone – including, and maybe even especially — those with Alzheimer’s disease or another type of dementia.  Just think how much more difficult it is for someone whose cognitive impairment is compromised to be able to adhere to the discharge instructions and medication regimens after a hospital stay, and are hard pressed to know what to do if complications occur.  Remember, too, that many people live alone without nearby social supports to help them.  As reported on Feb. 16 in the San Francisco Chronicle article Released hospital patients’ many unhappy returns, “reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.”  Wow!

Alzheimer’s advocates have long known that this illness represents special challenges for discharge planning and now we have economic proof that unnecessary readmissions often occur, resulting in not only poor health outcomes for the individual, but financial waste.  So, if we’re looking for potential health care cost savings, wouldn’t it be a good idea to focus on avoidable hospital readmissions?

You might wonder what all this has to do with advocacy.  Well, for one, the new federal health care law permits the federal Centers for Medicare & Medicaid Services to actually penalize hospitals with higher than expected rates of readmissions, beginning in 2012. Providing such incentives (or in this case “disincentives”) can often drive behavior.  It’ll be worth watching for.

 

Another potential solution, according to those who put the study together, would be to make discharge planning services available, and reimbursable – by Medicare and Medi-Cal.  We can all anticipate the likelihood of support for such a program right now, but we must continue to develop ideas that better serve our folks, and are economically sound.

In my opinion, we need more studies like this one just released that can show us just where wasteful dollars are being spent.  Then, armed with innovative ways to correct the situation, we can be sure we have a reasonable platform to present to policymakers.