» 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!



  • Mark Gilfix Discusses Estate Planning With the Star of the Investigation Discovery Show, “Reasonable Doubt”, Melissa Lewkowicz
    Mark Gilfix recently sat down in the offices of criminal defense attorney, and cable TV star, Melissa Lewkowicz, to discuss the 3 key estate planning documents that every American needs. Watch the Facebook video below. You can watch Melissa Lewkowicz in Reasonable Doubt on Investigation Discovery or see clips at https://www.investigationdiscovery.com/tv-shows/reasonable-doubt/.
  • Why a durable power of attorney is a valuable estate planning tool
    A Durable Power of Attorney (DPOA) allows an individual to give a designated person — known as an “attorney in fact” — authority to sign documents and act on their behalf. The legal document is particularly beneficial for individuals who are worried about mental or physical incapacity in the future. For example, an elderly person […]
  • California couple’s eviction highlights dangers of elderly financial abuse
    The elderly can be vulnerable to various forms of elder abuse, one of which is financial exploitation. Financial exploitation involves unauthorized use of an elderly person’s finances or property, either by a family member, caregiver or an unknown scammer. The media recently reported the case of an elderly California couple who faced eviction from their […]
  • ‘Finding Dory’ puts spotlight on children with special needs
    Pixar’s recent film “Finding Dory” will have resonance for parents who have children with special needs. The animated film is the sequel to the 2003 blockbuster “Finding Nemo.” It tells the tale of a blue tang fish named Dory who suffers from short-term memory loss. She cannot remember names, faces or even her way back […]
  • Thank You For Making our 13th Annual Special Needs Seminar our Best Yet
    Gilfix and La Poll wishes to thank the hundreds of attendees, and wonderful nonprofit co-sponsors, for making our 13th annual Special Needs Seminar our best yet! We were overwhelmed with the response, and with all of the kind comments we received from seminar attendees. We were also thrilled to see many attendees connecting with co-sponsor […]

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



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

* indicates required