The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity.…

The number of aging American continues to grow, which makes it essential for us to understand the unique gerontological health risks and concerns that exist for the aging population. In view of the staggering and increasing costs of Medicare and Medicaid--much of which is directed toward seniors--older adults would do well to look for ways to curb…

Social justice is a core value to the mission of social work. Older people are among the most vulnerable populations for whom social workers are called on to advocate. Although Medicare prescription drug coverage has been a top legislative issue over the past few years, such a benefit expansion has yet to be implemented. This article examines the…

Reviews literature evaluating appropriateness of Medicare's prospective payment system (PPS) through Diagnostic-Related Groups (DRGs), since its implementation in 1983, for psychiatric care. Cites shortcomings that make the system untenable for mental health care, including lack of homogeneity of DRGs, inability to predict length of stay, and…

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created the Medicare Advantage (MA) program, which promotes the entry of private Preferred Provider Organization (PPO) plans into regions that have not previously had Medicare managed care plans. The assumption that a competitive environment will develop is based on…

Review of a federal court ruling that the University of Mississippi could receive Medicare reimbursement for costs of clinical education but not for classroom nursing instruction identifies gaps in the nursing literature and a need for clearer delineation of program types and allowable costs. (SK)

Medicare's Incentive Payment (MIP) program provides a 10% bonus payment to providers who treat Medicare patients in rural and urban areas where there is a shortage of generalist physicians. Purpose: To examine the experience of Alaska, Idaho, North Carolina, South Carolina, and Washington with the MIP program. We determined the program's…

To curb the epidemic of obesity in the United States, revised Medicare policy allows support for efficacious obesity treatments. This review summarizes the evidence from rigorous randomized trials (9 lifestyle trials, 5 drug trials, and 2 surgical trials) on the efficacy and risk-benefit profile of lifestyle, drug, and surgical interventions aimed…

The political and social development of the Medicare Hospice Benefit combines humanitarian and cost-saving strategies. Although it mainstreamed care of the terminally ill and provided multiple services, four major constraints of the benefit package are identified and explored. It is important that we analyze this policy before we devise new ways…

Examines topics related to delivery of terminal care services: ability of various hospice programs to survive financially, contributions of various models of hospice care, impact of Medicare legislation on hospice movement, demonstration of unique hospice intervention, integration of spiritual care into hospice, and role of hospice in care of…

Discusses the contours of population aging, especially the baby boom generation, and the political and economic changes in regard to the rapidly aging U.S. population. Focuses on entitlements such as social security and Medicare. Seeks to broaden national discourse on the aging of the baby boom cohorts through basic questions and clarification of…

Purpose: This article describes the pattern of change in home-care use and expenditures, the distribution of payments by source, and the mix of skilled versus nonskilled services before and after 1996. Design and Methods: The analysis is based on tabulations of the 1987 National Medical Expenditure Survey and the 1996, 1998, and 1999 Medical…

This national survey examined the job satisfaction of 228 home health social workers in the restrictive reimbursement environment of the Medicare interim payment system. Administrators' helpfulness in resolving ethical conflicts between patient access to services and agency financial priorities contributed significantly to greater satisfaction in…

Critical access hospitals (CAHs) are a federal Medicare category for isolated rural facilities with 15 or fewer acute care beds that receive cost-based reimbursement from Medicare. Purpose: This study examines the role of foreign-born international medical graduates (IMGs) in the staffing of CAHs. Methods: Chief executive officers (CEOs) of CAH…

This is a 1984 annual Senate report on aging which examines the health, income, employment, housing, and assistance problems of older people. In a preface, Senators Heinz and Glenn note the following significant events of l984: (1) Congress reauthorized the Older Americans Act; (2) a strong economy with low inflation helped Social Security and…