Displaced By Michael, Blessed by TwelveStone

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By Chip Sekulich, TwelveStone Chaplain

Many of us have enjoyed the beauty of the Gulf Coast of Florida. As you know, Eastern Panama City, Mexico Beach and Southwest Georgia took the brunt of Hurricane Michael’s wrath. We look at the shattered shore line and realize that many, many lives have been impacted by the devastation in front of us.

We care, but often the suffering is faceless and impersonal unless you know someone or you have direct contact with someone displaced or impacted by the storm. Many of those who have most of their homes in tact are without power. Being without power is an inconvenience for most, but those who depend upon it to run an oxygen concentrator, ventilator or suction machine may find themselves in dire straits. Even if they evacuate, who will supply missing equipment, tanks and service?

This was just a hypothetical question until an older couple who evacuated from the stricken area walked into our Medical Retail space. The wife is an oxygen patient. Neither of them were able to get her oxygen concentrator out of their damaged home. They found themselves more than 450 miles from home and depending upon the remaining tanks that she had on hand to provide oxygen. They had the name of a local provider who will care for them, but had no idea where they were. She was very anxious as to whether she would have enough oxygen on hand.

Maribel was working in Retail and did an excellent job calmly setting about to help them. Though we no longer carry oxygen, a check on the liter flow and number of full tanks they had on hand showed that she had potentially more than enough oxygen.

Maribel was able to find the recommended provider- which incidentally is owned by the same parent company as her service in Florida- less than a mile away! Though we were not able to provide on-going oxygen service we did give them hope, a hug, and prayer for their safety, security and recovery. They were appreciative and we were able to direct them to her local oxygen provider who already had all of her necessary documentation to continue service in our area.

Have you considered that what you do here is being used by God to bless others? Though this precious couple found themselves displaced by Michael, they were blessed by TwelveStone. Thanks Maribel and Cannon.

Please pray for these and so many more who otherwise might just remain a statistic on the news. If you know someone who has experienced a serious loss because of Hurricane Michael, please send their names to me so that we can pray for them (Please don’t “Reply All”). Also, you may wish to consider donating to a relief organization like:

If I can pray with you or be of any service, please feel free to stop by my desk or contact me anytime.

Chip Sekulich
Chaplain and Patient Advocate | TwelveStone Health Partners

Remember…17 years ago, today.

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By Chip Sekulich, Chaplain and Patient Advocate | TwelveStone Health Partners

Seventeen years ago this morning, over the course of several hours, nearly 3,000 people in the Northeastern US left this life unexpectedly and the lives of many millions of the rest of us would be changed forever.

Certainly, we should remember positive events and relationships that have helped to shape our lives. We should also remember those negative events that imprint themselves on our minds. Events where everything slows down and we can remember details about right where we were and what we were doing when we heard or experienced the event. Such was that life-changing Tuesday morning in 2001.

We were glued to the news. We prayed for victims, first responders and their families. Terms like Twin Towers, Pentagon and “Let’s Roll” replaced the weather as common ground for many discussions across the land. We wept. We were angered, we were galvanized together and we were afraid. Were there more attacks coming? Was any place safe? A wave of patriotism and unity swept across the land – along with a profound fear.

What lessons can we learn from 9-11?

1. Even declared atheists may consider prayer in times of crisis.

2. Heroes come in every shape, color and size and often rise from obscurity.

3. In times of crisis, the ordinary can become extraordinary.

4. There will be a last time that you get to talk to or say to those important in your life, “I love you”.

5. With God’s help, the deepest fear can be turned into courage and resolve.

6. Trusting Him brings strength when you face those things that make you afraid.

7. Never take life for granted- it is a gift from God- or as someone said, “That’s why it is called the Present.”

8. Be aware, but don’t live your life in fear.

Where were you on 9/11? What did you learn from that day?

Remember… But don’t walk in fear!

A Stone Given, A Stone Returned

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Hand holding stone with a number 12 printed on it, referring to the 12 differentiating factors TwelveStone offers.It started out as a day like any other, walking through the capital, mentally reviewing the day’s agenda when a gentleman approached me. “Mr. Reeves, you don’t know me, but my father was one of your patients. He passed away in November.” The man reached into his pocket, sharing something personal—“He gave this to me just before he passed away.” In his hand was a small, smooth stone with the number “12” on it.

We had given his father the stone as a symbol of our commitment to serving him with integrity and the highest quality of care as a hospice patient of TwelveStone Health Partners.

Making a difference in others’ lives for the glory of God is the highest calling one can have. It’s the foundation upon which our company was built, and the goal we strive to reach each day. Our name, TwelveStone, represents the Biblical story of Joshua leading the Israelites to the Promised Land. As they came upon the Jordon River, God told Joshua to have the priests step into the water. As they did, the waters parted and the priests, carrying the Ark of the Covenant, walked across on the dry river bottom. Once on the other side, they took 12 stones, representing the 12 tribes of Israel, from the river and laid them out as a monument to let passersby know the power of God. This is the impetus for our giving each patient a stone – to let them know the power of God in their lives.

As we get busy with our daily routines, it can be easy to get swept up in the details of the business of healthcare and state government, family obligations, and the news of the day. What a blessing it is to be reminded of why we are here, and that the work we do is making a difference.

With gratitude,
Shane Reeves
Chief Executive Officer (and State Senator)

Women and Heart Disease: Know the Differences

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Heart disease does not discriminate. Heart disease and stroke cause 1 in 3 deaths among women each year and women are only half as likely to survive a heart attack. Why?

The Hollywood Effect

Many women don’t know what a heart attack is supposed to feel like. Hollywood has skewed the perception. It’s not a falling on your knees clutching your chest kind of thing. In reality, most women tend to experience other symptoms along with some chest pain, which often goes ignored. Their symptoms are subtler, often resulting in discovering heart disease too late.

Staggering Statistics

  • Women age 45 and younger are more likely than men to die within a year of their first heart attack
  • Only 65 percent of women said the first thing they would do if they thought they were having a heart attack was to call 9-1-1
  • 70 percent of women having a heart attack took longer than an hour to get to a hospital

Symptoms and Timing

Women experience different symptoms of a heart attack than men. Extreme fatigue, shortness of breath, nausea and neck and shoulder pain, as well as disturbed sleep patterns as much as a month or two before a heart attack.  During a heart attack, only about one in eight women reported chest pain, described it as pressure, aching, or tightness rather than pain.

Women have different types of heart attacks than men. While the majority of men suffer heart, attacks caused by severe arterial blockage, women can have milder blockages, and they can be hard to detect with traditional testing. Women can also have heart attacks caused by intense spasms of the heart arteries. SCAD (spontaneous coronary artery dissection) is responsible for 40% of heart attacks in women under 50. Women who present with SCAD are healthy, thin and don’t have any of the standard risk factors. To complicate diagnosis, SCAD has no special warning signs.

The Importance of Cardiac Rehabilitation

Women lag far behind men when it comes to heart attack recovery. Cardiac rehabilitation, proven to vastly improve the quality of life of heart attack survivors, has failed to reach more than 80 percent of women who are eligible. Heart disease, like any other chronic illness, requires ongoing support for complete and lasting recovery.

  • 31% of women are referred for cardiac rehabilitation compared to 42% of men
  • Once referred, attendance rates for women are 50.1%, compared to 60.4% for men
  • Only 54% of women who start cardiac rehabilitation complete 25 or more sessions

Medication Management

Surviving a heart attack and managing heart disease means taking a handful of medications on a daily basis. Why? Heart disease does not have a one-size-fits-all magic pill. And for a lot of women, this can lead to a missed dose or several. Medication management solutions, like MEDIpack simplifies medication management and improves adherence. Medications can’t do their jobs if not taken correctly.

Living A Full Life with A Healthy Heart

Understanding heart disease, the differences and the roles that personalized therapy and medication plays mean the difference between hospital readmission and the choice of healing at home and living a full life with a whole heart.

“Nevertheless, I will bring health and healing to it; I will heal my people and will let them enjoy abundant peace and security.” Jeremiah 33:6


  1. Coronary Artery Disease-Coronary Heart Disease, American Heart Association, heart.org, April 26, 2017.
  2. https://health.usnews.com/health-news/patient-advice/articles/2016-03-14/heart-attacks-are-different-in-women-and-its-time-we-treat-them-that-way
  3. What Drugs Should I Avoid if I Have Heart Disease?, WebMD Medical Reference, Reviewed By, Suzanne Steinbaum, MD, on October 29, 2017
  4. https://www.goredforwomen.org/about-heart-disease/living-with-heart-disease/managing-your-heart-medications/
  5. Medication Effects Women, Prevention, Sarah Klein, October 8, 2105
  6. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease—Coronary-Heart-Disease_UCM_436416_Article.jsp#.WnnVoGaZOL8
  7. https://cvquality.acc.org/docs/default-source/h2h/3-med-management-evidence-slides.pdf?sfvrsn=3cd58fbf_2

Heart Disease: Facts that Save Lives

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February is Heart Month. Beyond Valentine’s Day, it’s the time of year we bring awareness to:

  • Heart disease
  • Best-practice prevention protocols
  • Heart disease medications and drugs to avoid
  • Dosing factors and
  • Solutions for simplifying medication adherence

There is a Difference between Coronary Artery Disease (CAD) and Coronary Heart Disease.

Patient’s often interchange the terms Coronary Artery Disease (CAD) and Coronary Heart Disease (CHD). However, CAD and CHD are different.

  • CHD is the result of CAD, which is plaque growth within coronary artery walls. Plaque builds until it limits blood flow to the heart’s muscle
  • CAD begins in childhood; and by teenage years, there is evidence it stays for life in most people

The bottom line CAD is preventable. Proactive measures instituted early have greater lifetime benefits.5

Best-Practice Prevention

Men aged 45 and older, post-menopausal women, and family histories of heart disease are examples of risk that increase the likelihood of heart disease. Proper nutrition, weight management, exercise, and stress management habits developed during childhood can delay progression of CAD.1 Data also suggests that heart-healthy lifestyle changes made later in life can regress CAD before it turns to heart disease.

Which Drugs Are the Right Ones?

In addition to lifestyle habits, there are six drugs that aid patients with CAD and CHD. These include:

  • Statins
  • Aspirin
  • Clopidogrel bisulfate
  • Warfarin sodium
  • Beta-blockers, and
  • ACE inhibitors

The American Heart Association’s Cardiac Medication List lists drug uses and vital information to discuss with your doctor and pharmacist.

Be Safe

With flu complications and fatalities making daily headlines, it is essential to be familiar with medication safety for CAD and CHD. Some medications can cause adverse reactions such as increased blood pressure or can prevent heart medications from working as efficiently as they should.2 At every doctor visit, provide a list of all medicines; both prescription and over-the-counter. Seek advice from both doctors and pharmacists before taking over-the-counter medications, homeopathic remedies, vitamins, or other nutritional supplements.

Simplify Medication Management

Medication management errors contribute to 65% of all hospital readmissions and add to the deaths of more than 125,000 Americans each year. Patients with complicated chronic conditions such as CAD or CHD need a higher level of medication management and adherence support. Solutions, like MEDIpack simplifies the management and adherence to multiple medications, their doses, instructions, and rules. Drugs can’t do their job if not taken correctly. Working with doctors and pharmacists together ensures all prescriptions prescribed do not contain ingredients that are risky people with CAD or CHD.

Living A Full Life with A Healthy Heart

Heart disease does not discriminate. Women, men, young and old, ethnicity, genetics and family history all play a role in considering which medications and doses are needed to treat and manage heart disease accurately.3

Understanding heart disease and the role medication management plays means the difference between hospital readmission and the choice of healing at home and living a full life with a whole heart.


  1. Coronary Artery Disease-Coronary Heart Disease, American Heart Association, heart.org, April 26, 2017.
  2. What Drugs Should I Avoid if I Have Heart Disease?, WebMD Medical Reference, Reviewed By, Suzanne Steinbaum, MD, on October 29, 2017
  3. Sex Matters, 60 Minutes, CBS, Correspondent Lesley Stahl, February 9, 2014
  4. Medication Effects Women, Prevention, Sarah Klein, October 8, 2105
  5. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease—Coronary-Heart-Disease_UCM_436416_Article.jsp#.WnnVoGaZOL8

Lipscomb University trip to Nicaragua aided by Rx4HIM

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“Whoever is kind to the poor lends to the Lord, and he will reward them for what they have done.”

— Proverbs 19:17

Lipscomb University aid trip to Nircaragua with assistance from Rx4HIM, a TwelveStone Health Partners OrganizationRecently, Lipscomb University took a team of 22 students and medical professionals to Nicaragua on a medical mission trip over the winter break. The team visited four cities: Yali, Pantasma, Apanas, and Jinotega, setting up a clinic in each.

The team was able to serve over 350 patients medically across the region, using medications provided by Rx4Him. The team ordered in bulk from Rx4Him numerous medications that they could not get from any other source. The team plans to return again next year to continue the relationships built with the children and patients in the region.

We are honored to have facilitated such a worthy cause.

Thanksgiving Blessings

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We all remember learning about Thanksgiving in grade school. Besides making hand turkeys, many of us reenacted the Thanksgiving meal when pilgrims and Wampanoag Indians sat down together to celebrate the bountiful harvest. It’s hard to believe that nearly 400 years have passed since the first Thanksgiving in 1621. We can thank Abraham Lincoln for making it an official national holiday in 1863.

Fast forward to today where we’re experiencing a surge of societal tensions, finger-pointing, and us-against-them attitudes. It can be sad and even overwhelming to watch the evening news. And while it’s our duty as citizens of our great country to stay informed, we can’t lose sight of the many blessings we have around us every day, such as our families, our faith, our great economy, and our wonderful middle Tennessee community.

At the same time, we know this time of year makes us cognizant of the opportunity to show special compassion to those living with chronic health conditions who struggle in their daily lives. At TwelveStone, our focus has been to find ways to relieve some of the stress associated with the medication side of chronic care management. Daily, as we speak with patients, and pray with patients we have the opportunity to deliver kindness, instead of the exasperation.

For those fortunate enough to enjoy good health, I suggest taking a moment to not only celebrate it, but to create a preventative plan to maintain it; we often don’t appreciate our health until it’s gone. A good place to start is a Thanksgiving Day race such as the Turkey Trot or Borodash. A great way to start your day so that you can enjoy the bounty of Thanksgiving without concern.

However you choose to spend this Thanksgiving, lets all slow down a bit and be present with our families, to share our many blessings, and to remember those no longer with us.

With gratitude,
Shane Reeves

Chronic Condition Patients Require More than The Corner Pharmacy

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When was the last time you went to the doctor and came away without a prescription?

If you’re like most people, it’s probably been a while. In fact, nearly 75% of doctor visits result in a prescription, and nearly a forth of us take 3 or more prescriptions on a regular basis. * That’s a lot of medications to manage! And a lot of trips to the pharmacy.

The process for getting prescriptions filled hasn’t changed much over the past few decades: Go to the pharmacy and stand in a long line of (potentially contagious) people just to drop your prescription off. And those lines can move slow as pharmacy techs have to gather insurance information, birthdays, and other personal information – all in earshot of others in line. On a good day you can wait for your prescription, wandering the store for 20 – 30 minutes listening for your name to be called. But today’s pharmacies are typically too busy to fill your prescription while you wait. It requires another trip to the pharmacy later that day, or the next day, or even a few days later if they don’t have your particular medication in stock. And then there’s another long for pick-up.

There Has to be a Better Way

All of this may have been fine back in the 90s, but no longer. We’re all busy people today, which is one reason why subscription services have become so popular over the last few years. Can’t remember to buy more dog food? You don’t have to – just subscribe with Amazon Prime. Forgot to pick up a movie at the video store for Friday night? (Wait! What video store?!) No big deal. Just open up Netflix.

Subscription services save us time and relieve us of a lot of the mental energy that goes into our busy lives. But, ultimately, dog food and Friday night movies aren’t life-and-death scenarios. Your prescription medications, however? Now, that’s a different story. Forgetting to take your prescribed medication can result in getting sick and going back to the doctor, or even to the hospital. And the result can be fatal; close to 125,000 people die in the U.S. each year because they don’t take their prescriptions as prescribed – or at all.

Even the packaging of prescription medications is decades old. Trying to open those “childproof” orangey-brown prescription bottles can be tough for a lot of adults, especially those with arthritis or reduced grip strength. Sadly, for many adults living alone or facing the early stages of dementia, simply remembering whether or not they’ve taken their medication can be difficult. And following a complex pill schedule day after day can be a major challenge.

It’s Time for a Change

So, we started to wonder, what if receiving, opening, and remembering to take your prescription medications could be as easy as getting a movie off Netflix?

What if we could all just admit that the current prescription management method isn’t working any more? What if the whole system could be easier in the same way that smart TVs have made it easier to rent movies, and that Uber has made it easier to get a ride?

Meet MEDIpack® – Medication Made Simple

With MEDIpack, getting the prescription medications and OTC (over-the-counter) pills you depend on for your health is easy.

  • No driving to the pharmacy. We deliver to your home.
  • No difficult-to-open pill bottles.
  • No more worrying about missing a refill.

MEDIpack offers personalized patient care that’s built around your lifestyle. Each MEDIpack box you receive includes personalized medication (prescription and over-the-counter drugs), as well as vitamins and supplements that are clearly organized by day and time. If you ever have questions, pharmacy experts are available 24 hours a day, 7 days a week to take your call.

With MEDIpack, patients receive a monthly check-in to help you:

  • Ensure medication compliance
  • Refill prescriptions to prevent gaps
  • Manage doctor appointments
  • Coordinate with your insurance company

Simply put, MEDIpack is medication made simple. Learn more.


* https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm

Either the Worst Luck or the Greatest Miracle: Lee Golden Chooses ‘Miracle’

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Just over a year ago, Chief Pharmacy Officer Lee Golden thought he had a sinus infection. The weekend before, the competitive marathoner and father of two had just completed a 20-mile training run. But something wasn’t right. Within just a few days, he was admitted to the hospital with suspected meningitis. But other than a severe headache and some blurred vision, everything looked normal. They were ready to discharge him.

“I said no – something is happening,” says Lee. “Even though a spinal tap had come back clear, my gait was off. Thankfully, they listened, and a neurologist ordered an MRI, which showed nerve damage.”

The MRI results showed the myelin sheath, which insulates nerve cells and allows electrical impulses to be transmitted from the nervous system to the rest of the body, were damaged through the upper two-thirds of Golden’s spinal cord. It was as if he had developed ALS – commonly referred to as Lou Gehrig’s disease – overnight. Things moved swiftly – and dramatically – after that. From St. Thomas Rutherford in Murfreesboro, Golden was transferred to St. Thomas Midtown in Nashville. He wasn’t able to walk or move his arms very well, and from the neck down, he could only move his fingers and toes. To make matters worse, Golden’s second child was about to be delivered in Murfreesboro while he struggled to breath in Nashville.

Five Months in Atlanta

The mystery of his illness deepened. Neurologists ruled out Guillain Barre Syndrome, and then settled on transverse myelitis, which was also eliminated as a cause. He continued to decline. After a month, a neurologist at St. Thomas arranged for him to transfer to Shepherd Rehabilitation Center in Atlanta, which specializes in spinal cord injuries. For five months, Golden had a ventilator to breathe, a tube to feed him, was catheterized and had a jugular central line. “I found myself using every service available from TwelveStone — it was a very strange place to be.”

With no diagnosis and no clarity on what the future held, Lee was at a low point. But there was one bright spot, and perhaps the first sign that things were changing for the better. Lee’s wife Diana delivered a healthy baby boy, Jacob, just four days after Lee was admitted to St. Thomas Rutherford. Baby Jacob joined 3 year-old Scarlett. “My family was staying with my sister in-law in Atlanta, and it really helped to have them nearby. At that point, my biggest concern was the impact on Scarlett. When I was in the ICU, she couldn’t see me, and at her tender age I didn’t want her to think I had abandoned her,” says Golden.

At Shepherd, Golden’s condition slowly began to improve. “I went from being one of the sickest patients at St. Thomas to being one of the healthiest at Shepherd – it was a crazy transition.”

After three months in-patient and 2 months of outpatient physical therapy, Golden walked out of Shepherd (cautiously) and returned to Murfreesboro.

Back at Work and Moving Forward

Today, Lee is back at work and tackling his professional, athletic and personal goals just as he did before. Bolstered by support from family, friends and his co-workers at TwelveStone Lee has continued with therapy including a rigorous walking regime that is slowly advancing and has

included participation in the Atlanta Peachtree Road Race whose path goes right past Shepherd. Doctors still don’t know the cause of his illness. A Shepherd physician speculates that the combination of the 20-mile run, starting a new job, and baby Jacob’s pending arrival could have triggered some sort of dysfunctional autoimmune response (“a perfect storm”, so to speak). “I have never slept a ton-about 5 hours a night-maybe it all added up,” says Golden.

His odyssey gave him a renewed perspective on a number of fronts:

Healthcare: “There are a crazy amount of bills, as you can imagine. While I knew this as a provider, it was as a healthy, young man. It really opened my eyes as to how things work, especially for chronic care patients. I have a lot of empathy for those that struggle with skyrocketing expenses, and I truly identify with the TwelveStone mission to simplify healthcare delivery and make every patient’s healthcare journey a little bit easier.”

His work family: “I can’t say enough about how much TwelveStone, and especially Shane (Reeves), have stood by me and my family throughout this ordeal. He visited me in Nashville and Atlanta and provided encouragement and support to my wife where he could. But everyone stepped up to help. We’d invested a lot in training our clinical directors,and I really saw that pay off. They stepped up to the plate and made sure everything continued to function smoothly. What’s more, the company stopped operations several times to pray for me. If you’re going to have something like this happen to you, it certainly helps to work for a faith based organization like TwelveStone.

On faith: “I know it’s a cliché to say but there truly is nothing more important than having faith. If you don’t know God, then being at a place like Shepherd, and not knowing what’s wrong with you, could be a very dark time. I recall one caregiver I got to know well there (as a patient and fellow healthcare provider) asking me – ‘Do you think these things happen randomly, or is there a reason?’ My response was, there definitely is a reason. If you start thinking it is random, then you have no Hope.”

Run Again: “Some of my running buddies made regular trips to Atlanta to see me at Shepherd. One of their sons made a card for me, and written on the front was “Run Again”. My sister in-law saw that posted on the wall in my hospital room and she loved it. She created a wristband referencing some scripture and “Run Again” on it to be a constant reminder of at least one of the goals ahead of me. At Thanksgiving, a lot of my TwelveStone colleagues ran the Boro Dash wearing their Run Again shirts. That was certainly inspiring, and it meant a lot to me. Since then I’ve walked a 5K and 10k, and I hope to get back to running soon.”

Lee Golden believes that hard work is a key component for recovery, but you can’t make your own miracles. For that, he has his Faith, and the support of his family, friends, and TwelveStone.

7 Ways a Trump Presidency Impacts Post-Acute Care

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By Shane Reeves, CEO of TwelveStone Health Partners

With a Trump administration well into its first 100 days, those involved with post-acute care are busily reading the tea leaves brewing in Washington. Here’s a look at the likely changes coming to the post-acute care landscape:

  1. Hospitals are in the hot seat; post-acute care must be ready for the downstream effects
    Congress is unlikely to fully repeal the ACA, but the individual mandate is certainly on the chopping block. These and other anticipated legislative changes will lead to a rise in the uninsured seeking charity care at hospitals.

    Readmission penalties will likely increase as a cost and quality control measure. With 11 percent of readmissions driven by medication non-adherence alone, hospitals should look to post-acute care to provide the necessary on-site care coordination needed to keep readmissions in check.

  2. The move to value-based care continues unabated; bundles and risk reimbursement models are here to stay
    According to Modern Healthcare’s1 post-election health care CEO survey, the vast majority of executives are confident the ACA-driven march to value-based care will continue. By some estimates, value based and bundled payment systems will replace the fee-based system in less than 15 years. By 2018, the Center for Medicaid Services announced2 it wants half of all payments to be delivered through alternative payment models like bundles. With private plans following in Medicaid’s bundled payment footsteps, acute and post-acute care providers must work even more closely together to align patient care plans.
  3. Home based care, and the demand for telehealth, will explode
    An aging population, many with long term care insurance, will choose to receive in-home care for their chronic care needs, and if indicated, for hospice care. Some of these services, especially for those in rural areas, will be provided via telehealth. Look for new policies to establish authority for non-physician practitioners to certify Medicare coverage, as well as create a stand-alone telehealth benefit for remote monitoring of home-based patients.
  4. The patient as consumer gains momentum
    If the individual mandate goes away, Congress will have to devise a way for people to buy insurance and avoid risk plan issues. “If you don’t have an employer mandate and an individual mandate, the market would self-destruct,” says Jim Lott3, a professor of health policy at the University of Southern California and Cal State Long Beach. Allowing insurers to cross state borders to widen their risk pools is one regulatory change under consideration. Tax deductions for health insurance policies and tax-free Health Savings Accounts are also part of the mix. All of these changes drive the patient further into the role of managing their own healthcare spending. As an example, customized packaged pharmaceuticals delivered to the doorstep will change the game by giving patients a new tool that will assist them in adhering to complicated medication regimens and staying out of hospital emergency rooms.
  5. Increasing access to cross-border medication
    When US citizens cross the Canadian border to fill prescriptions at half the cost of comparable drugs in their home state, the case for reasonable pricing of drugs comes into sharp focus. On the campaign trail, Trump indicated his support for allowing international medication purchases, which could help moderate pricing in the US.
  6. Scales tip from skilled nursing homes to assisted living and home health
    The number of skilled nursing homes in the United States has flat lined at about 15,000. The National Investment Center for Seniors Housing & Care4 reports that skilled nursing home occupancy experienced a significant decline, down to 86.8 percent in 2016. That’s the lowest since 2005. It’s predicted that by 2021, the number of skilled nursing homes could shrink by 20 percent.

    Currently, 90 percent of skilled nursing home revenues are from Medicare and Medicaid. Look for Medicare and Medicaid to cut costs by shortening patient stays and consolidating or bundling reimbursements. They’re also likely to shift reimbursement to lower cost models such as home care and assisted living facilities.

  7. Pharmacists address medication non-compliance
    Pharmacists, especially those serving the post-acute care sector, must demonstrate their value along the care continuum. That won’t be too difficult. Nearly 50 percent of all medications aren’t taken as prescribed, and by some estimates a third of all prescriptions are never filled. Pharmacists are on the front lines of containing medication non-compliance, which is estimated to cost $100-$289 billion annually.

    There’s much more to be deciphered once a Trump administration is fully underway. One thing is clear: acute and post-acute providers will need to coordinate care more than ever before. Beyond that imperative, the only certainty is a continuation of change—and a lot more of it.

    1. Email Us. We welcome your comments.