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Liz Seegert

NP Delivery of Primary Care for Homebound Elderly Threatened by Proposed Medicaid Cuts

By Liz Seegert

July 18, 2017

As our population lives longer with more chronic conditions, an an estimated two to three million end up homebound, unable to leave their homes to receive primary care in a physician’s office.  It means they often go without care or end up in crisis in the emergency department, driving up costs and further affecting their quality of life.

 

There are programs and services that deliver quality home-based care, but they face looming cuts in reimbursement, or even outright elimination, thanks to the Senate’s health care bill. It would slash Medicaid by $700 to 800 million. A shortage of primary care physicians further strains efforts to deliver high-quality home-based care.

 

Nurse practitioners can help meet these challenges, said Denis Tarrant, NP, who runs a primary care house calls practice in New York City. He thinks the proposed health legislation will only make it harder and harder to serve his patients, and others like them around the U.S.

 

“We don’t have the ability to meet the primary care demand without nurse practitioners,” Tarrant said in a phone interview. He’s right — nurse practitioners are becoming an increasingly a more viable option around the country to make up for the shortfall of primary care MDs. Research from Kaiser Family Foundation, the Robert Wood Johnson Foundation, and elsewhere confirm that independently practicing NPs play a key role in solving the primary care shortage.

 

The Senate’s proposed cuts to Medicaid threaten not just primary care delivery but also home and community based care for our nation’s most vulnerable, and medically-needy older adults. The only place left to pick up the slack is the emergency department, Tarrant said.

 

The Senate is still scrambling for the necessary votes to pass legislation that will adversely affect tens of millions of people. Meanwhile, patients and families, along with those who care for them, remain in limbo.

 

You can listen to the full interview with Denis Tarrant below or subscribe to the podcast on iTunes.

 

Liz Seegert
Liz Seegert is a health care journalist and directs the media fellows program at the Center. She serves as topic editor on aging for the Association of Healthcare Journalists, writes for a variety of print and online publications and coproduces HealthCetera Radio on WBAI-FM. She tweets @lseegert. 

Reporting about nursing: our media fellow reflects on challenges, opportunities

By Liz Seegert

July 6, 2017

In many ways, the state of Kentucky is a microcosm of the challenges in today’s health care system. Tens of thousands of people, many in rural areas, now receive regular health care thanks to Medicaid expansion under the Affordable Care Act. But delivering that care poses its own dilemmas.

 

You may recall reading CHMP Media Fellow Melissa Patrick’s three-part series earlier this year. Patrick looked into how nurses are meeting the increasing demand for primary care in the community and in schools, at the same time the state faces a serious shortage of qualified RNs.

 

She recently spoke with Media Fellows program director and HealthCetera co-producer Liz Seegert about her reporting, lessons learned, and why full scope of practice matters.

 

Liz Seegert
Liz Seegert is a health care journalist and directs the media fellows program at the Center. She serves as topic editor on aging for the Association of Healthcare Journalists, writes for a variety of print and online publications and coproduces HealthCetera Radio on WBAI-FM. She tweets @lseegert. 

HealthCetera Celebrates Pride Month: Luna’s Story: How one health center cares for the transgender community

By Liz Seegert

June 12, 2017

In celebration of Pride Month we are reposting this HealthCetera show produced by Liz Seegert and previously aired in March 2017.

 

 

The American Health Care Act, the proposed Republican health plan, would deal a major blow to Medicaid funding for the states. The Congressional Budget Office projects that if it passes, Medicaid cuts will total about $800 billion over the next decade, and leave 24 million more people uninsured—including many in the LGBT community.

Under the ACA, health plans cannot refuse coverage based on pre-existing conditions, such as HIV, substance abuse, or a transgender medical history. There are non-discrimination protections based on sex, which  include gender identity and sex stereotypes, in any health program receiving federal funds (including Medicaid and in state marketplaces). This also includes sexual orientation.

The Center for American Progress found that among lower income LGBT individuals (making between $15,000 and $22,000 annually), the uninsured rate dropped 18 points since the ACA’s Medicaid expansion.

Luna Hernandez is among those benefitting from enhanced Medicaid coverage. She is a transgender woman who receives care through Community Health Center, Inc. in Middletown, Conn. Thanks to the Center’s Project ECHO program, an education program for safety-net providers, Luna’s care team is knows more about prevalent health issues among the transgender community and understands how to best interact with their patients.

Luna discusses her struggles and triumphs, her focus on staying healthy and the importance of the care CHC provides. I also speak with Wanda Montalvo, PhD, an advance practice nurse at the Weitzman Institute the policy arm of CHC that oversees Project ECHO, about what the real-world ramifications of Medicaid funding cuts mean to vulnerable populations.

 

You can also listen to the interview here.

Liz Seegert
Liz Seegert is a health care journalist and directs the media fellows program at the Center. She serves as topic editor on aging for the Association of Healthcare Journalists, writes for a variety of print and online publications and coproduces HealthCetera Radio on WBAI-FM. She tweets @lseegert.