Healthcare Reform and the Elderly

President Barack Obama signed the final Health Care and Education Affordability Reconciliation Act of 2010 in March of this year. This health care reform bill includes changes that will close the Medicare prescription drug plan's "doughnut hole" coverage gap.The following table shows the Medicare benefit breakdown (including the donut hole) for 2009, for 2010 the total TrOOP has increased to $4,550 before catastrophic coverage begins."Total drug spend" represents the actual cost of the drugs purchased, factoring in any Medicare discounts."TrOOP" (true out-of-pocket expenses) represents the amount of their own money that the patient has paid.

The donut hole is shown below in bold.
Obama administration announced on May 27, 2010, under the Patient Protection and Affordable Care Act of 2010, 4 million people who may fall within the donut hole will receive a $250 rebate check starting June 15, 2010. With this passage, the donut hole will be completely phased out by the year 2020.

2009 Medicare Part D payments

Total drug spend TrOOP Out-of-pocket cost Portion covered by Medicare
$0–$295 $0–$295 Deductible is out-of-pocket No Medicare coverage of costs
$295–$2,700 $295–$896.25 25% out-of-pocket 75% covered by Medicare
$2,700-$6,154 $896.25-$4,350.25 All costs are out-of-pocket No Medicare coverage of costs
over $6,154 over $4,350.25 5% out-of-pocket 95% covered by Medicare
(Wikipedia, the free encyclopedia)

"The passage of this final legislation will add to the many benefits that healthcare reform offers older adults," said AGS President Cheryl Phillips, MD. "All told, healthcare reform includes numerous, important provisions that will improve elder healthcare now and in the future and support geriatrics careers. The AGS has long advocated for these provisions."

The Six Public Policy Advocacy Objectives of the AGS (American Geriatrics Society)

* Address the acute and growing nationwide shortage of geriatricians and all geriatrics healthcare
professionals; and ensure that other healthcare providers have training that prepares them to meet the unique healthcare needs of older people
* Strengthen primary and and preventive care and care coordination
* Effect healthcare financing reform to ensures all older adults access to high quality healthcare
* Ensure that value-based purchasing and other quality initiatives take into account the unique healthcare needs of all older patients
* Step-up research concerning healthly aging, the prevention, diagnosis and treatment of age related health problems, and the cost effectiveness of various approaches to care; and ensure that older adults are adequately represented in research trails
* Expands older adults healthcare options to include home care and other care that enables them to live independently as long as possible, help older adults and their caregivers better understand their healthcare needs and make the most of Medicare and other benefits; and provide caregivers with adequate resources and support.

What are some of the specific benefits for the elderly in this reform bill:
-  Reform Medicare payment policy so it more equitably reimburses those who care for older adults
- Offer geriatricians and other primary care providers a 10% Medicare bonus payment
- Initiate a periodic review of physicians' services that are potentially misvalued
- Create a physician "value-based payment program" aimed at improving the quality of care beneficiaries receive
- Establish an "Innovation Center" to test new payment and care delivery approaches aimed at further enhancing the quality of eldercare and improving cost-effectiveness
- Calls on the Department of Health and Human Services to develop a national strategy for improving
the quality of care provided through Medicare and other programs
- Expand geriatrics training programs, including advanced training programs that prepare specialists to
meet the needs of the most complex, frailest older patients
- Establish eldercare training programs for the direct-care workers and family caregivers who provide
day-to-day care
- Provisions in the legislation will improve seniors' health by eliminating Medicare beneficiaries' co-pays
and deductibles for preventive care
-Establishing new programs to lower hospital readmission rates among Medicare patients
(The AGS Foundation)

This is clearly a huge step in the right direction to improving the overall healthcare of the elderly and addresses many long term concerns of each of us who directly benefit from this or who have family and friends that do.