Tracking Medicaid Fund Performance Wisconsin

The law makers and administering public entity will be pushing to advance implementation to improve activity directly tied to Medicaid fund performance.  The transformative structure involves the Family Care IRIS 2.0 and the Dementia Care Redesign going statewide.  These transitions move Medicaid funded delivery to a value based practice designed to improve outcomes while diminishing the outflow of money. 

This top down approach has changed the supply/demand outlook.  Existing community providers struggling to forge a practice that will meet the populations needs are becoming absent.  The State wide delivery will present with larger pockets of hard to serve areas. 

The performance of the Medicaid fund is dependent upon administering entities (Integrated Health Agencies) being able to contract with lower cost community providers who can help the individual who is eligible for reimbursed service.

The State of Wisconsin's Department of Health Services will be required to demonstrate efforts to educate the existing population of community providers to be able to better participate in this new value based model.  Community providers will need to align their delivery to better serve the entire system.

Wisconsin's Home Care Path has applied change to their delivery process when helping families with an elder experiencing the undesired symptoms of dementia.  These changes bring value to families who care for an elder with symptoms of dementia by delivering an early phase response- with an affordable service.  Home Care Path brings value to payers by initiating early engagement designed to prevent scary crisis dementia events.  Home Care Path brings value for primary medical providers by collaborating to achieve the care continuum tasks proven most beneficial for attaining the dementia redesign listed outcomes.

Each community provider will be challenged to adjust their process as the public programming that is funded by Medicaid evolves to achieve a value based delivery.  The performance of the Medicaid fund will be closely and thoroughly examined to assure greater value is being experienced by these new initiatives.

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 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

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For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

Home Care Path Platform Supports Senior Care Industry

Home Care Path employs a Microsoft supported information delivery model that enables value by creating more productive interactions between consumers and the service staff.  This approach strengthens the families ability to participate in a more self directing manner. 

Our use of communication technology has eliminated barriers of time and space.  Fostering early engagement to produce better outcomes across the entire external interactive service network.  This assists by facilitating precision to complex family decisions which manifest with the procurement of service to best meet the elder's changing needs.

The service is community focused and structured in a value based economic attribute that calls on service staff to function at the high end of their skill set.  This is an essential piece of tomorrows practice which moves acuity down the care continuum- while moving delivery in to the home setting. 

Home Care Path is a unique non-medical provider of integrated senior living solutions.  Senior support partners have embedded communication, collaboration, and coordination in the service delivered for the senior.  Press on the link below to view the available services :
https://homecarepath.sharepoint.com/Pages/default.aspx

This is the way todays consumers can more efficiently determine and access the resources designed to meet the senior family members progressing needs.

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

Wisconsin Dementia Care Redesign Shift Reimbursement 4 Meaningful Change

Wisconsin Payment Structure Lags Behind Dementia Care Redesign Initiatives

Dementia care redesign lists 3 primary initiatives

1.       Early engagement

2.       Prevent crisis events

3.       Keep at home

 

Dementia Continuum

 

Onset              IADL’s                                  ADL’s

    I-----------------I---------------------------------I

 

With onset symptoms are managed with tech sensors and recorded reminders

Cognizant of family’s tolerance for risk which moves support to scheduled staff visits

 

With dementia the elder’s needs present differently in a very predictable way.

The instrumental activities of daily living being more complex disassemble in the earliest phase of dementia.

 

With dementia the senior will stop bathing because they do not know how to work the shower long before they are physically functionally unable to bathe.

 

With dementia the senior will stop making toast because they do not know how to work the toaster long before they are physically functionally unable to make toast.

 

With dementia the senior will stop dressing in laundered varied outfits because they do not know how to choose appropriate wear long before they are physically functionally unable to dress.

 

With dementia the senior will stop shaving because they do not know how to work the electric clipper long before they are physically functionally unable to shave.

 

Assessment tools utilized do not capture these needs and effectively communicate the tasks to result in eligibility for reimbursed supportive care service.    Public and private pay sources deny claims until the senior’s experience is immersed in the later dementia phase where the (ADL’s) activities of daily living clearly demonstrate physical functional deficits.

 

Said another way – the medical delivery system does not claim the needs created from dementia until the later phase presentation of physical functional inability to perform activities of daily living.  The later phase dementia symptoms create physical functional needs described as activities of daily living which facilitate a medical pay source with reimbursed in home care.

The value based approach will require a shift in payment to conform to delivery that facilitates a more coordinated community management approach.  How does the State of Wisconsin create meaningful change by applying reimbursement to the services that support the important values embedded in the dementia care redesign outcomes. 

 

-          Early engagement

-          Prevent crisis events

-          Keep at home

Reimbursement must facilitate the earlier implementation of dementia focused services to attain the goals described with Wisconsin's redesign efforts.

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This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

What The Heck Would IADL's Have 2 Do With Dementia

What the heck do IADL's (instrumental activities of daily living) have to do with dementia.  Dementia involves memory loss and is caused by biological changes in the brain.  We can examine this by considering an individuals need for daily meals.

Instrumental activities of daily living (IADL's) encompass the more complex tasks of procuring and properly storing groceries, preparing and serving a meal.  This involves a greater reliance on cognition using the mind to plan and perform throughout these roles.

Activities of daily living (ADL's) encompass the motor physical functional ability to consume the food and fluids that have been prepared. 

The senior has always had toast  with jelly for breakfast at the start of every day.  The supportive care agency places an electric use monitoring device on the toaster wall outlet so we can tell if the senior has had their morning toast.  The sensor indicates the toaster is not being used and likely the senior is not eating toast for the morning meal. This seems odd to the family cause the senior can walk around and use both hands just fine and verbalizes having toast every day.

The senior affected by dementia will stop making toast because they do not know how to work the toaster long before they are physically functionally unable to make toast.  Inability to properly use the familiar kitchen appliances to prepare a meal is a deficit - specifically incapable of independently performing the instrumental activity of daily living called meal preparation.

The Track Memory 2 Zero care coordinators original model
https://homecarepath.sharepoint.com/Pages/TrackMemory2Zero.aspx explains with early phase dementia symptoms the ability to independently perform the instrumental activities of daily living falls away first.  The Track Memory 2 Zero is a model forged from real world insight.  Home Care Path announces the value of applying the Track Memory 2 Zero for collaborative problem solving is much more important than clinging to exclusivity as if to protect the proprietary embedded ideas.

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

Dementia Early Phase Sensor Devices Converging Service

The use of sensors in the earliest phases of dementia is becoming more acceptable as the awareness of the disease process raises across communities. There are four primary attributes to be considered when planning to implement sensor devices in the seniors living space.  The four are listed below:

1. sensor- creates information for the receiver

2. receiver- provides a digital view for the responder

3. responder- evaluates to determine if more is needed

4. risk tolerance- length of time - before family demands stronger intervention

One example would be placing a motion sensor between the senior's bed and the bathroom.  No motion sensed would indicate the senior is still in bed.  The responder is challenged to determine if a staff visit is needed to help the senior up in the morning.

By placing an electric use monitoring device on the toaster wall outlet we can tell if the senior has had their morning breakfast toast.  If the toaster has not been used the responder is challenged to determine if a staff visit is needed to help the senior with a morning meal.

An electronic medication box with a beep alarm and opening slot as reminder to take medication.  A visit will help better understand if the pills removed from the slot have been swallowed by the elder.

Any of the sensors can include the use of timely audio announcements- a tape recorded message that would say " ok is now time to get up and go use the bathroom" - or "remember to have your favorite toast with peanut butter for breakfast" - or "it is now time to take your water pill". 

The sensors can be involved in over lap fashion when family is called in to help more often.  If beneficial for the family care giver the sensors could remain in place.  This helps clarify the need and speaks to risk tolerance.  The sensors provide real time data that helps inform the families decision to have supportive staff make regular visits. 

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This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

Wisconsin Dementia Bills Pass Senate Rep Mike Rohrkaste

Wisconsin State Representative Mike Rohrkaste on March 16, 2016 published the announcement the 3 Dementia bills have passed the Senate.  The 3 Bills:

- AB 786 Dementia crisis unit

- AB 787 Adds 1 million dollars to Dementia Family Care Giver Support Program

- AB 790 250k train for dementia crisis response

Track Memory 2 Zero https://homecarepath.sharepoint.com/Pages/TrackMemory2Zero.aspx
is a value based structure delivered digitally as an effort to leverage efficiencies (right support at right time) to help manage consumption of our limited public and private resources while maintaining a standard quality of care.  Home Care Path is a strong community partner communicating what is next in the managing of dementia's undesired symptoms.

Track Memory 2 Zero is a new integrated risk management tool with embedded decision support applications.  A robust, resource relevant, tool for participating in the management of a complex disease process of dementia.  This is evidence structured insight to help drop health spending.

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/ 

Value Based Coming 2 Wisconsin Medicaid Reimbursed Care

Value based is outcome driven and moves delivery to a new approach that employs the most effective supports rather than the most expensive.  This is a top down policy authorized shift that will be seen in all efforts to proactively manage at risk populations.  The prescribing of medications, the implementation of treatments, and the delivery of supportive care will all involve using the most effective rather than the most expensive.

Home Care Path is an evolving value based resource for providers and payers who will be expected to transition to a value based reimbursement system.  Track Memory 2 Zero is a copyright non-medical supportive care information for use across advancing (digital) communication technology.
https://homecarepath.sharepoint.com/Pages/TrackMemory2Zero.aspx

Track Memory 2 Zero is a new integrated risk management tool with embedded decision support applications.  A robust, resource relevant, tool for participating in the management of a complex disease process of dementia.  This is evidence structured insight to help drop health spending.

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/

Consumers In Difficult Position To Lower Health Care Costs

A recent study conducted by the (HCCI) Health Care Cost Institute and results published by Kaiser Health News acknowledges shoppable medical procedures and treatments do not have a significant mass to reduce overall health care system cost.

The current delivery model does not lend itself to the consumer driven opportunities to force area procedural prices down.  The analysis captures out of pocket opportunities embedded within varied deductibles and coinsurance listed in the health insurance plan. 

The study seems to reinforce the continued effort of Federal and State regulatory authorities (CMS-DHS), fund administrators (insurance), contracted providers, and large employee groups to move the entire health care system toward a value based reimbursement model remains important.

Across Wisconsin we are seeing the smallest of non-medical providers moving their practice to effectively deliver service in an emerging value based model
https://homecarepath.sharepoint.com/Pages/Service4AdminstrationofBigDementiaPopulations.aspx

Managing household spending for family health care is a personal finance task.  Teaching families how to experience the most value is an important role of public and private health care system participants.

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This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/

FCC Selling Spectrum Channels Used By Hospital 4 Telemetry

The (FCC) Federal Communication Commissions is adopting rules to expand the economic and innovative opportunities of spectrum through incentive auctions.  This lends insight in to the need for traditional service models who have to adjust for technological driven up grades.  The Federal Communications Commission is selling licenses auction style for much of the 600 MHz Spectrum.

Inpatient- outpatient medical providers who use wireless telemetry in the delivery of their service fear this will contribute to increased use of unlicensed devices on channel 37 - the favorite of wireless medical telemetry systems.  The function of the patients prescribed telemetry monitor could be compromised by an unlicensed device experiencing a connection on the same channel. 

Unlicensed devices could be competing with wireless medical telemetry systems disrupting the benefit across outpatient and inpatient settings.  The Federal Communication Commission has defined a 380 meter (about 1246 feet) zone around medical settings where the use of unlicensed devices is prohibited.

The staff of Home Care Path invite readers to watch as innovation disrupts traditional models of  service. 

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/

Wisconsin Dementia Care Redesign DHS Defines Change

With dementia care redesign efforts the Wisconsin Department of Health Services is committed to a change.  This change is described on the DHS website as care for the elder and family throughout the entire course of the disease. 

The Department of Health Services challenges providers to implement solutions to help manage the undesired symptoms.  Without early onset identification and support the symptoms progress to produce crisis like events that rapidly consume a huge amount of community resources.  These crisis like disruptions can be scarey for all involved. 

Home Care Path has developed an innovative strategy to communicate evidence of need
http://homecarepathseniorcare.blogspot.com/2016/02/baraboo-adrc-sauk-county-gets-funds-4.html

The IADL's instrumental activities of daily living are the more complex tasks that fall away first.  Although these needs created from the progressing memory loss are immediate and real, the medical system has traditionally been limited help with these difficulties. 

The medical system diagnose need from the late disease process manifestation of symptoms.  The medical system perceiving the later appearing needs requiring help for ADL's activities of daily living will suggest care from a hospital owned memory care facility.  In this practice the elder goes from seemingly needing no extra help to immediately needing a more costly geographical move in to an assisted living facility. 

Said another way the primary provider at the medical clinic has no effective support until the elders needs require placement in a memory care facility.  The dementia disease process does not officially become a medical condition until the later experienced undesired symptoms can be used to craft a diagnosis and functional needs match inpatient delivery.

The family understands the senior needs the help of another long before the medical system can organize the office visit derived data and conclude more support is important.  This is the Department of Health Services calling out to innovative providers to expand the existing definitions of care and better serve this growing population.

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/

Is New Wisconsin Family Care IRIS 2.0 Value Based???

WISCONSIN FAMILY CARE IRIS 2.0 COST IMPACT

With the New Family Care IRIS 2.0 the value being paid for is an increased ability to anticipate and respond to needs.  Public Health Care dollars are paying for this value.   The coming change will create new structures placing more risk across the system participants. 

The Wisconsin Family Care IRIS 2.0 implementation will need to facilitate a broad internal realignment.   These differentiated services will need to be measured distinctly and explicitly as part of the overall performance of the Family Care IRIS 2.0 Program.   This is arranging performance and contracting with partners who can profit from the relationship.

The success of the Wisconsin Family Care IRIS 2.0 Program is dependent upon construction of a foundation for performance and operating from a market position competitive to the model being replaced.    Conducive to this will be the side by side strength and quality of the relationships between the risk bearing participants:

-The Centers for Medicare and Medicaid and The Wisconsin Department of Health Services referred to as the Health Authorities. 

-The Integrated Health Agencies referred to as the key agencies.

-The Service Providers referred to as the contracted vendors.

Adequate numbers of contracted vendors will be directly related to traditional measures of success:

-          Growth an ability to experience gain

-          Profitability an ability to hold on to the gain

The Health Authorities will need to document evidence of value realized from the re-shaping of capabilities to facilitate implementation of meaningful innovations.

The Integrated Health Agencies will need to demonstrate the administrative support:

-          Policy to strengthen outcome within consistent operation

-          Outcome defined allocation

-          Transitional strategies

-          Internal links rapidly communicate best practice

-          Consistent claims process that works to retain vendor contracts- and pull new talent in

The appeal is to determine if Wisconsin Family Care IRIS 2.0 is a natural evolution of past practice or a whole new model of value based delivery. 

Wisconsin Credit Repair Nerds delivers a service that fixes an individuals credit report to improve their borrowing outcome.  Wisconsin Credit Repair Nerds works with the information on file to improve the presentation of an individuals credit report.

This simple link facilitates immediate access to a trusted credit repair service
 https://homecarepath.sharepoint.com/Pages/PrestageStudyWisconsinCreditRepairNerds.aspx

Wisconsin Credit Repair Nerds Provides:

- pre-staging process to save consumers time
- incremental pricing to better fit your budget
- each individual receives their own secure online portal
- person to person help from down to earth staff

email: lkutzke.crn@gmail.com

For a blog with free access that delivers credit repair information
http://homecarepathseniorcare.blogspot.com/