Category: Medicare

Medicare is for: •People 65 and over •People of any age who have kidney failure or long term kidney disease •People who are permanently disabled and cannot work Medicare is applied for at the local Social Security office. Some people qualify for both Medicaid and Medicare, Medicaid is sometimes used to help pay for Medicare premiums. People who qualify for both programs are called 'dual eligible'.

Learn about Medicare's History in Seven Minutes

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The arrival of my 50th birthday is prompting me to post this zippy video about  Medicare. It  is written and produced by the Kaiser Family Foundation staff and serves as a visual timeline of Medicare’s history. It cleverly presents the debate that led to Medicare’s creation in 1965 and subsequent changes, such as the passage and repeal of... Read more »

Medicare 72-Hour Rule Still Frustrates and Confounds

I first began writing this post in April of 2012, but  quickly abandoned the effort because I became certain that everyone knew about this issue and was planning accordingly. How wrong I was! In retrospect, it should not surprise that topics like this are evergreen. Eldercare is an island with its own customs, rules and... Read more »

Quality Care for the Older Adult Living at Home in Illinois - Part II

At the conclusion of my last blog post I posed the question that since State Medicaid programs are currently deficient in assuring compliance with quality standards in the delivery of HCBS in ALF settings, is it reasonable to assume that MCOs will be better suited to not only that task, but also with regards to... Read more »
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Reducing Costs for Dual Eligible Medicaid and Medicare Beneficiaries is Tricky

It is impossible to write about elder care in America, without consistently revisiting the subject of caring for dual-eligible beneficiaries. Older adults (those +65 years of age) account for 61 percent of this population of 7 million who are eligible for full benefits under the Medicaid and the Medicare program. The remaining dual-eligible beneficiaries are  younger... Read more »

Chronic Conditions No Longer Barrier to Medicare Services

On October 16, the US Department of Health and Human Services and disability rights attorneys entered into a proposed settlement of a class-action lawsuit (Jimmo v. Sebelius), that if approved by the Court will clarify the so-called “improvement standard” used in the past by Medicare providers (i.e. skilled nursing homes (SNFs), home health providers, or other... Read more »

Reducing Unnecessary Hospital Readmissions

Despite my self-imposed pledge to not publish partisan political posts, I am unable to contain my enthusiasm for one of the of  President Obama’s Affordable Care Act: the creation of the Center for Medicare and Medicaid Innovation.  The Center seeks to: help transform Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) through improvements in... Read more »
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Seeking High-Quality Care for Dual Eligibles

Who are dual eligibles? Dual eligibles are those beneficiaries who are enrolled in both the Medicare and Medicaid programs. They are a population of nine million and includes some of the sickest and most vulnerable individuals covered by the two programs. Not surprisingly, they have on average, greater health and long term services and support needs... Read more »

Representative Ryan's Medicare and Medicaid Proposals Stun

The selection of Representative of Paul Ryan as the presumptive Republican nominee for the office of Vice President, prompts me to repost this blog (originally posted in March) surveying Ryan’s plans to deconstruct the existing Medicare and Medicaid programs. ” To understand the profound implications of the Ryan proposals to deconstruct Medicare and Medicaid, it  bears... Read more »

Bill Keller Confronts The Entitled Generation: Baby Boomers Beware

For those of you who are not regular readers of the New York Times, it is worth reading Bill Keller’s op-ed column, published on July 29, on baby boomers and the need for entitlement reform. The column unleashed a brouhaha garnering over 450 comments, and so he continued the discussion on a blog post, generating an additional 250 comments:... Read more »
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Happy Anniversary Medicare and Why Thomas Friedman Frets

Monday is the 47th anniversary of the enactment of Medicare and we should celebrate how this government program continues to transform the lives of seniors and people with disabilities by making healthcare available to these two vulnerable populations. Nevertheless, the program has always been challenging to manage. Almost since its inception, the Hospital trust fund which is... Read more »
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    Bruce

    Bruce Lederman has over 25 years experience in the senior care field as a direct care provider and thought leader. Bruce was CEO and president of his own firm that operated skilled nursing facilities in Illinois. He is a former nursing home administrator and has consulted to numerous elder care providers on planning for strategic growth as well as process improvement. Recently he served as board chair of CJE SeniorLife, a leading non-profit elder care provider in the Chicago area. Bruce is currently employed as chief strategy officer for a company providing skilled nursing services in communities throughout Illinois and Missouri.

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