Tag Archive for: Aging and Long-Term Care

Caregiving for elders

Costs of Caring for an Aging Loved One

Many adult children care for a parent in their golden years. Some are surprised by the costs of caring for an aging loved one. Family caregivers spend an annual average of $7,400 of their own money on caregiving expenses. In combination with a possible loss of income due to time away from work, it can sometimes be a financial strain for families.

Here are three steps you can take to reduce out-of-pocket caregiving expenses and recover some financial costs.

1.  Create a budget and track expenses.

Caring for an elderly loved one includes many expenses that you may not think of. Keep track of these expenses. After a few months, you can better predict what your caregiving expenses will be and adjust your budget accordingly. If you have siblings or other loved ones who may share the caregiving costs with you, it is a useful tool to split costs evenly. If you haven’t already, consider asking your loved ones for help with these caregiving expenses.

Possible Recurring Caregiving Expenses Possible One-time Caregiving Expenses
·         Groceries

·         Medical co-payments

·         Travel to and from doctor’s appointments

·         Incontinence supplies

·         Clothing

·         In-home professional care

·         Housekeeping

·         Mortgage

·         Home modification (railings, shower seat, etc.)

·         Medical alert system

·         Vehicle modifications

2.  Research tax implications of caregiving.

Understanding IRS guidelines for caregiver and senior filing can save you money and help you recoup some of your caregiving costs. If you meet these seven requirements outlined by the IRS, you may be able to claim an elderly parent as a dependent on your tax return. You may also be able to deduct medical expenses and home modification costs up to a certain amount. If you’re not sure about IRS rules and guidelines, talk to a tax professional to make sure you qualify for these benefits.

3.  Consider professional support.

For caregivers who want to keep their loved one at home, participating in a local Program of All-Inclusive Care for the Elderly (PACE) can provide professional medical care and significantly reduce the costs of caring for an aging loved one.

PACE provides eligible seniors the following services, typically at no added cost:

  • Preventive care and routine screenings
  • Dental and vision care
  • Transportation to medical appointments
  • Medical supplies, home safety modifications, and much more

PACE participants have a team of health care professionals that work to develop a customized care plan for each individual.

To learn more about WelbeHealth’s PACE services, visit welbehealth.com.

Medi-cal changes for California seniors

What is PACE? How can it help me stay independent?

What is PACE, and how can it help me stay well and independent?

Too often, elders and their caregivers struggle to get the help they need in their homes. Maybe you’re experiencing this challenge yourself. If so, you may not realize that WelbeHealth provides an affordable alternative to nursing home care, called PACE. PACE is a program that keeps seniors with complex health conditions living safely in their homes and gives families the support they need. But, what exactly is PACE? What are the benefits of the program? Below, we’ll explain.

What is PACE?

PACE (Program of All-Inclusive Care for the Elderly) is a healthcare option for seniors whose health issues may affect their independence. This program is a great alternative to nursing home care and gives seniors the support they need to continue living safely in their homes.

WelbeHealth provides PACE in a way that participants and their families often say seems almost “too good to be true.” We are committed to unlocking the full potential of seniors through our courage to love, pioneering spirit and shared intent. The program is funded by the federal government, and WelbeHealth is a licensed PACE provider in the state of California. When you enroll in PACE with WelbeHealth, we provide your care, and are also financially responsible for your care. Essentially, the program is your health care provider and health insurance combined.

Fun Fact: As of June 2021, 139 PACE programs were operating in 30 states, serving nearly 56,000 older Americans.

What does the PACE program do?

Once enrolled in the program, participants get access to preventive, coordinated care. A personalized care plan is tailored to each participant’s unique physical and emotional needs. Most coordinated care is administered at the day center. Here are some of the healthcare services provided by the program:

Transportation

For seniors who no longer drive, transportation can be a hassle and a burden for families. PACE provides transportation from your home to the day center and to medical appointments. Rides are wheelchair accessible and comfortable. In addition to taking you from place to place, the highly trained drivers deliver medication and medical supplies to your home when needed.

Dental, Vision and Hearing

Hearing aids, eyeglasses, and dentures are not always covered by Medicare. Participants of PACE receive these medically necessary items at no cost. As a program participant, you’ll have access to a dentist, mental health specialist, ophthalmologist, and more.

If the PACE care team determines that you need to see a specialist to treat a complex medical condition, they will coordinate the visit. Treatment for COPD, dementia, kidney disease, diabetes, and heart disease are all accessible through the program’s network of specialty physicians. And all the transportation is coordinated for you!

FYI: The average PACE participant has 6 chronic conditions. The PACE team is experienced in caring for seniors who have multiple diagnoses.

Social Engagement

Science has proven that social interaction does wonders for our mental and physical health. That’s why PACE has a team of activity specialists who coordinates social activities. Whether it’s board games at the day center, themed meals, or group exercises, there is always plenty going on at the PACE center.

In-Home Assistance

Upon enrollment, we will do a safety assessment in your home. We’ll look for trip hazards, like cluttered walkways and loose rugs. Next, we will make improvements to your home to make it safer, such as installing wheelchair ramps and grab bars if needed. Educating seniors and their caregivers is an important step in preventing falls.

If your PACE care team determines that it is medically necessary, you may also receive medical care in your home from registered nurses and certified nursing assistants. This may include incontinence care, injections and blood draws, as well as wound care.

Telemedicine

PACE participants gain access to telehealth services. You’ll be given a tablet that allows you to access your care team on-demand. Many participants enjoy the comfort of knowing someone is always available if an emergency should occur. Via telehealth, participants can check in with nurses, track their vitals and medications, and participate in virtual activities.

Medication Management

Over 20 percent of older adults report not taking medication as prescribed due to the high cost of their medication. Did you know cutting pills and skipping doses can actually worsen health conditions? When enrolled, your team of healthcare professionals will make sure you take the right medication at the right time each day, which keeps you healthy and living independently.

Additionally, PACE offers Medicare Part D prescription drug coverage. Once you become a program participant, you’ll get your Part D-covered drugs and all other necessary medication from PACE.

Will I have to change my doctor?

Upon enrolling in the program, you’ll begin seeing a doctor at the PACE center. All your healthcare services will be provided by PACE. The doctors and medical staff are highly experienced in caring for seniors with complex medical conditions, so you can trust you’re in good hands.

What are the benefits of PACE?

Interdisciplinary Team

Many parts work together to keep a car running well. Likewise, you need many healthcare providers working together to keep you living well. The PACE interdisciplinary team (IDT) is made up of senior healthcare experts whose top priority is providing you with personalized, coordinated care. They work together, meeting regularly to make sure your needs are met.

The PACE care team consists of:

  • Primary care physician
  • Nurses
  • Physical and occupational therapists
  • Dietitian
  • Social worker
  • Recreational therapist
  • Home care coordinator
  • Transportation professional

Caregiver Support

Because the interdisciplinary team handles all the complicated details of your care, family members and caregivers are relieved from many stressors. Transportation, refilling medications, and coordinating appointments are all done by PACE, significantly reducing caregiver burden. Caregiver training, support groups, and respite care also keep family members supported and educated.

Fast Fact: 97.5 percent of family caregivers would recommend PACE to someone in a similar situation.

What are the PACE eligibility requirements?

Prospective participants must meet the following criteria to be eligible for the PACE program:

  • 55+ years of age
  • Live in the designated service area
  • You are certified by the state as meeting the need for nursing home level of care
  • You can safely live in the community when you join

How much does PACE cost?

What you pay depends on your financial situation.

If you are: Cost (out-of-pocket):
Eligible for Medicaid No cost
Eligible for Medicare and Medicaid No cost
Eligible for Medicare only Pay Medicaid portion, plus monthly premium for Medicare Part D
Not eligible for Medicaid or Medicare Self-pay rate
  • 90 percent are dually eligible for Medicaid and Medicare
  • 9 percent are eligible for Medicaid only
  • 1 percent pay a premium

PACE focuses on you and your care.

The goal of PACE is to provide vulnerable seniors in our communities with the care, medical treatment, and support they need to safely live in their homes for as long as possible. Seniors benefit from personalized, coordinated care, as do their caregivers. With many healthcare services and benefits to the program, it’s a good alternative for many seniors who want to safely age in their homes and community. To learn more, contact us today.

 

UC Berkeley Study Reveals WelbeHealth’s Rapid Adaptation To COVID-19 Eldercare Yielded Exceptional Results And Saved Lives

As policy momentum grows toward home and community-based services, study recommends that policy choices focus on the Program of All-Inclusive Care for the Elderly (PACE), and it’s 45-year track record of success in serving the most complex elderly patients.

SILICON VALLEY, Calif., July 14, 2021 — A new study from UC Berkeley’s Berkeley Roundtable on the International Economy (BRIE) features WelbeHealth in a case study illustrating how this California eldercare PACE provider responded early and decisively to the COVID-19 crisis with exceptional results.

“By rapidly transforming its care model, WelbeHealth had exceptional results: as COVID-19 cases rose across the country — and in particular within nursing home populations — WelbeHealth did not have a single COVID-19 death during the first 8 months of the pandemic. The first WelbeHealth loss from COVID-19 occurred on November 21, 2020 and 10 WelbeHealth participants died of COVID-19 since the beginning of the pandemic.”

-UC Berkeley

READ THE STORY: 

Welbehealth: Case Study of Adapting PACE Under COVID-19

Key findings:

  • WelbeHealth and the PACE community overall had lower death rates than nursing homes; the national PACE COVID-19 death rate was 3.8%, nearly one-third the 11.8% death rate in nursing homes. WelbeHealth calculated a death rate of 2.4%.
  • WelbeHealth acted early and decisively to minimize exposure with an Incident Command response strategy, dispersing tablets for telehealth visits, PPE, thermometers, food, medication, and other essentials into participants’ homes, and providing nearly all care remotely, which proved effective.
  • PACE’s capitated payment model moves the risk from payor to care provider, aligning incentives and encouraging innovation and efficiency in keeping patients well.
  • Technology provided an important amplification to PACE’s model of care — it allowed for regular check-ins and informed decision-making on care needs. However, the social aspect of the PACE day center cannot be replaced by technology, and it is clear that in-person visits are vital.
  • With America’s senior citizen population set to double by 2040, the demand for long-term care will skyrocket. The pandemic underscored that work must begin now to meet the needs of present and future vulnerable elders.
  • Existing home and community-based services (HCBS) such as PACE demonstrated profound success during the pandemic leading to fresh momentum among policymakers to expand these options further.

PACE’s person-to-person, fully integrated approach maintains the participant’s highest level of independence and quality of life[i]; PACE participants experience an 80% drop in rates of depression after joining.[ii] At a time when America is searching for a better way forward in eldercare, PACE is a proven approach for this vulnerable group.

 

“While PACE has a 45-year track record of success, it remains optional in Medicaid while nursing home benefits are required — it’s time for every vulnerable elder in the country to have access to this gold standard of long-term care,” said Elizabeth Carty, Chief Regulatory Affairs Officer of WelbeHealth.

 

Many PACE participants reside in medically underserved areas like San Joaquin County, California, where WelbeHealth’s creative problem-solving and speed to action kept seniors safe in their homes when resources for the elderly were relatively scarce.

 

“As other healthcare organizations were assessing the potential impact and spread of the pandemic, the WelbeHealth team had already taken its crisis response to the next level, ” said Amy Shin, former CEO of Health Plan of San Joaquin. “I was impressed with how nimbly this team charted out a plan not only to keep seniors safe and vaccinated but to vaccinate the community as well. This study’s findings should alert legislators that this style of home and community-based services is the ideal model of care for frail seniors.”

 

What is PACE?
PACE (Program of All-Inclusive Care for the Elderly) serves low-income seniors who meet their state requirement for nursing home level care allowing them to live independently in their own homes and communities while receiving fully coordinated medical and dental care, physical and occupational therapy, transportation, meals, day programs, home care assistance and more, managed by an 11-person integrated care team. The “one-stop-shop” PACE day centers are the hub of the program, offering seniors a pleasant place to receive care, socialize and enjoy meals within a state-of-the-art facility.

About WelbeHealth
WelbeHealth is a physician-led healthcare organization that provides seniors with high-quality, compassionate care so they can live in their own homes and communities rather than a nursing home. To accomplish this, WelbeHealth uses the PACE (Program of All-Inclusive Care for the Elderly) model. WelbeHealth currently operates four programs in the Stockton/Modesto, Pasadena/Burbank, Long Beach, and Fresno communities of California.


[i] Center for Consumer Engagement in Health Innovation, “Care That Works: Program for All-inclusive Care for the Elderly.” https://www.healthinnovation.org/resources/publications/care-that-works-pace

[ii] National PACE Association, “COVID Data Demonstrates That the PACE Model Is Safer Than Nursing Home Care.” https://www.npaonline.org/about-npa/press-releases/covid-data-demonstrates-pace-model-safer-nursing-home-care

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