» 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!



  • Michael Gilfix, National Experts Form Trump Policy Analysis Group
    THE TRUMP POLICY ANALYSIS GROUP (TPAG) – FOCUSING ON OLDER AMERICANS AND THOSE WITH SPECIAL NEEDS The Trump Policy Analysis Group (TPAG)1 has convened to consider probable changes in law that will affect older Americans and those with special needs. Initial TPAG focus is on entitlements, public benefits, tax, special needs planning, and veterans’ benefits. […]
  • Three mistakes parents of special needs children should avoid
    Parents of special needs children hope to provide their offspring with financial security and the care they need. However, even with the best of intentions they risk making mistakes that could have costly, long-term consequences for their child. One such estate planning mistake involves disinheriting the child to ensure their eligibility for key government benefits […]
  • National Gilfix & La Poll Article on Multigeneration Strategies and “New Economy” Services
    At Gilfix & La Poll, we take pride in innovating new ways to serve our estate planning clients. We recently published an article in Estate Planning magazine covering two ways in which we build beneficial relationships with our clients that address modern, timely issues. The first is helping clients take advantage of “new economy” services. […]
  • Study reveals misconceptions about long term care costs
    Planning ahead for long term care and how to fund it can seem daunting. The average American underestimates in-home care costs by nearly 50 percent, according to the Genworth Financial 2016 Cost of Care Study. The findings indicate many adults risk being unprepared for their future needs. The cost of receiving care has continued to […]
  • How fear of death can present a hurdle to retirement planning
    A new study has found that many people fail to make necessary decisions about the future because they are too scared to think about death. According to researchers from Boston College in Massachusetts, fear of death causes individuals to avoid preparing financially for old age. The anxiety can affect choices about managing savings for retirement, […]

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



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

* indicates required