Thursday, July 08, 2010
What medicare cuts could mean for physicians and health care

By Dr. Anthony Policastro

Medicare is the lowest paying insurer in the country. It is also the biggest insurer. For those physicians who care for the elderly, it provides a significant percentage of annual income. Any kind of business needs to run on an annual budget and physician practices are no exception. In order to create that budget, you need to know how much income you will be receiving. In most cases, you need to make an educated guess. That is not always so easy to do with Medicare. For several years, there has been a built in cut of 21% in the Medicare program. It comes up once a year, which then requires Congress to provide an exemption, which usually happens in January. This year the exemption did not come until June. The result is that many physicians could not be sure of how much money they would be paid by Medicare until later in the year. During the time they were waiting, their expenses continued to go up. Utilities, salaries and supplies increased. Some physicians responded by seeing fewer Medicare patients and some stopped seeing Medicare patients altogether. However, most continued as they did in the past. They assumed correctly that their income would not be cut by 21%. However, every year now becomes a guessing game. The question is when will Congress fail to give the exemption? When that happens, some physicians will not be able to pay their bills. While there is a lot of waste in Medicare, that is not usually due to the average physician. In order to protect themselves, physicians need to consider alternatives. One is to limit the amount of money they would lose by decreasing the number of Medicare patients that they see. Most physicians would prefer not to do so. However, that approach carries the risk of financial catastrophe. Many stores use what are called "loss leaders." These are sale items that are priced below cost to the store. The idea is to get the customer in the store to buy these items. Once that happens, the customer will likely buy other things to offset the loss. A cut in the Medicare program would make Medicare patients become loss leaders for physicians' practices. Unfortunately, there are not other patients to offset this loss. That is especially true for physicians with a large amount of Medicare patients in their practice. If you look at national statistics, each year more physicians limit the number of Medicare patients they see. Congress directly affects this number. Each year their actions suggest to physicians that more of them should limit Medicare patients.

Nanticoke earns accreditation Nanticoke Memorial Hospital has been granted American Association of Blood Banks (AABB) accreditation for transfusions services. "The AABB's Accreditation procedures are voluntary," President and CEO Steven A. Rose explained. "Nanticoke Memorial Hospital has sought AABB Accreditation because this program assists facilities around the world in achieving excellence by promoting a level of professional and technical expertise that contributes to quality performance and patient safety." Accreditation follows an intensive on-site assessment by specially trained AABB assessors and establishes that the level of technical and administrative performance within the facility meets or exceeds the standards set by AABB. AABB's Accreditation Program contributes to the quality and safety of collecting, processing, testing, distributing and administering blood and cellular therapy products. Established in 1947, AABB (formerly known as the American Association of Blood Banks) is an international, not-for-profit association dedicated to advancement of science and the practice of transfusion medicine and related biological therapies.

Mental health important for seniors As Americans age, it's only natural for people to suffer from stiff joints, frail bones and other health complications. Patients and doctors spend countless hours discussing ways to manage overall physical health. What is often overlooked, though, is mental health among senior citizens, various studies have found. Kay Malone, chief operating officer of La Red Health Center in Georgetown, will be the featured guest speaker at the July meeting of the Sussex County Advisory Committee for the Aging & Adults with Physical Disabilities. Founded in 2001, La Red is one of only four federally qualified health centers in Delaware, serving approximately 6,500 patients - as many as half without any health insurance - each year. Malone will discuss La Red's services that are available to all residents of Sussex County, but will specifically highlight the organization's geriatric services, including a senior mental health program, as well as preventive health and screenings.

La Red's Mental Health Services offers age-specific diagnostic and treatment options for depression, anxiety, and other disorders that put seniors - and their health - at risk. The Advisory Committee invites the public to attend the committee's next meeting at 10 a.m. Monday, July 19, at the Sussex County Administrative Offices West Complex on North DuPont Highway in Georgetown. An open discussion will follow the featured presentation. The committee meets every other month; all meetings are open to the public.

Family caregiver training The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series four times a year in each of Delaware's three counties. Cadbury of Lewes at 17028 Cadbury Circle in Lewes will host the training on Wednesday, July 28, from 8 a.m. to 4 p.m. This training for family caregivers is free and lunch will be provided by Cadbury of Lewes, therefore pre-registration is required by July 21. For more information or to register, call Jamie Magee, branch office coordinator, at 854-9788 or 1-800-272-3900.

Autism Delaware tournament Sign up for Go Fish, a bass fishing tournament to benefit Autism Delaware's southern location and the advocacy, education and support services they provide to improve the lives of people with autism and their families. Go Fish will be held on Sunday, Sept. 19, at eight ponds throughout Kent and Sussex counties, and will be followed by a celebration at Milford's Bicentennial Park. Anglers of all ages and abilities are welcome. Each team of two can register for $40 and will receive an information and fundraising packet. Prizes, including a grand prize of $500 and special youth prizes, will be awarded at the celebration. The public is welcome to attend the celebration which will include fun for all ages with music by Code Blue, food from Go Fish of Rehoboth and kids games. Nominal fees will be charged for games and food for those not participating on a fishing team. Pro bass fisherman Mike DelVisco will fish in the tournament Sunday and participate in the celebration. There are 160 slots for fishing so register today by visiting or calling 422-2255.

Stroke support group Nanticoke Memorial Hospital's next Stroke Support Group meeting is being held on Thursday, July 15, 1:30 p.m. at Nanticoke Memorial Hospital's Mears Rehabilitation, 300 Health Services Drive, Seaford. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. Modeled from the American Stroke Association, the hospital is engaging with speakers to provide education, community resources and emotional support to those who have been affected by this life-altering event. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this FREE support group. For additional information, contact Nanticoke Memorial Hospital at 302-629-6611, extension 8626.

Bereavement support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.