» Elder Law Attorney Agrees Managed Care May Help Quality of Care for California Seniors

Elder Law Attorney Agrees Managed Care May Help Quality of Care for California Seniors

Palo Alto, CA (Law Firm Newswire) June 19, 2013 – California is planning to try a managed health care system to unify Medicare and Medi-Cal.

While dual coverage sounds like a good thing, lower income seniors in California who are eligible for both Medicare and the state's version of Medicaid, known as Medi-Cal, are facing a serious lack of coordinated care. Medicare, the federal program for seniors, is not designed to work in tandem with Medi-Cal, the federal-state program for low income individuals, the way the state is currently using the system. The ensuing mistakes, delays and administrative issues are all costing the state a significant amount of money.

"The state is attempting to combine the services offered by Medicare and Medi-Cal into one streamlined program which would use one administrative hub, hopefully limiting the amount of confusion," says elder law attorney Michael Gilfix. Not only would health care be overseen by one entity, but also social services, and in-home health aides who can assist with mealtimes and bathing, known as "activities of daily living."

California Gov. Jerry Brown has stated that he believes the change in administrative approach will help the more than one million seniors and infirm residents of the state, including the people who spent their savings to be able to qualify for Medi-Cal coverage. Brown also says that he hopes the reforms save big for the state; it is estimated that as much as five hundred million dollars may be saved from the state's health program budget.

Critics have voiced concern that the managed care plans may be overburdened, leaving the patients with substandard care. Medicare pays for medical visits, short-term hospital stays and prescription medications. It is in a patient's hands to find and choose their doctor and get medication. If they are also low-income, Medi-Cal covers the co-payments and deductibles Medicare charges, and pays for the patient's long-term care, such as nursing home care.

But that dual coverage means that if the patient resides in a nursing home, but needs to go to the hospital, or only has a short nursing home stay and then returns home,they will likely not have continuity of care, as different doctors and caregivers work under different systems. And if they also need social services, the amount of mistakes, confusion and conflicting information for care is further compounded: social services is overseen by the county, adding in a third administrative entity.

Managed care will have one health plan which coordinates all of each patient’s services, with financial incentives to keep patients out of nursing homes and hospitals, using in-home care when possible. The shift to managed care is expected after Oct. 1, 2013, starting with a three-year experimental program in Southern California.

To learn more, visit Gilfix & La Poll Associates LLP at http://www.gilfix.com/.

Gilfix & La Poll Associates LLP
2300 Geng Rd., Suite 200
Palo Alto, CA 94303
Telephone: (650) 493-8070
http://www.gilfix.com/

Facebook: Like Us!



  • Avoiding fights over inheritance with revocable living trusts
    When parents pass away without clear instructions in place about how to divide their assets upon their death, they may leave family members battling over inheritance for years. Such fights can cause rifts that are sometimes impossible to heal. A will contains detailed instructions on how a person wants their assets, such as family heirlooms […]
  • Women bear the brunt of costs for Alzheimer’s care, says study
    A study by Emory University researchers has found that women shoulder six times the cost of Alzheimer’s disease care than men. The greater burden in expenses is mainly due to the informal care that women provide to family members who have the degenerative brain disorder. Researchers examined three factors to calculate Alzheimer’s care costs using […]
  • California’s Aging Population: Implications for Elders and Caregivers 
    Today, the population of individuals over the age of 65 in California numbers approximately 4.5 million people. By the year 2050, it will exceed 11 million. These numbers are even more consequential when we consider the portion of the entire state's population represented by older individuals:  About 11% of today’s 40 million Californians are 65 or older. […]
  • Thank You for the Amazing Turnout at Our Estate Planning Seminars!
    Gilfix & La Poll would like to thank everyone who attended our recent Asset Protection and Estate Planning seminars in Palo Alto, California. We also would like to thank our good friend, Len Tillem, for being a part of the afternoon session. (We apologize to all who wanted to attend the afternoon session with Len […]
  • Gilfix & La Poll to hold living trust seminar with special guest Len Tillem
    Attorney Michael Gilfix of Gilfix & La Poll Associates will present a seminar titled “A Unique Living Trust Seminar: How to Protect Family Assets” on October 28 at the Crowne Plaza in Palo Alto, California. Attorney and radio personality Len Tillem has been invited to speak at the event as a special guest during the […]

See other news sources publishing this article. BETA | Tags: , , , , ,



Get headlines from Law Firm Newswire sent right to your inbox.

* indicates required