Touchstone Health

Touchstone Health - Breaking Health and Medicare News

'Trying a new approach to primary care: Prevention'

A budding model for primary care that encourages the family doctor to act as a health coach who focuses as much on preventing illness as on treating it has shown promising results and saved insurers millions of dollars.  Growth in emergency room visits and hospital admissions slowed and prescription drug costs have been tamed with this approach, known in the industry as patient-centered medical homes, or just medical homes.

The current health care system pays doctors to see patients and largely attend to their immediate needs. Patients may get treatment, advice, a prescription and a follow-up appointment.Patient-centered medical homes focus on keeping patients healthy, which saves money by reducing hospital visits, especially for chronic conditions such as diabetes.

Patients, including many Medicare beneficiaries, say they like the greater involvement of their doctors.
Richard Smith of Vidor, Texas, who has multiple sclerosis and knee and ankle problems, once struggled to walk to his mailbox. Now, he walks three to four miles a day. He's dropped 40 pounds in two years, and his blood pressure and cholesterol are down.

Read more about how patients are benefiting from these programs.

By: Tom Murphy - July 20, 2011
Associated Press

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'Why Medicare Is the Toughest Vote for Democrats'

House and Senate leaders from both parties will meet at the White House for what are expected to be substantial negotiations over how to raise the nation's debt ceiling. The chances of both sides finalizing a deal during the meeting are slim. But, according to congressional staffers, it's expected to produce some specifics on the proposals which, for now, have been mentioned in press leaks or whispers during the standoff.

For anxious Democrats, the meeting might finally answer some nagging questions: How much will the party give up in the face of Republican demands? How much will the party's traditional constituencies be hurt by possible cuts to social programs? And, perhaps most important to their political careers, what will happen with Medicare? While any vote to cut social spending is hard for a Democrat, there are some reasons why a vote to cut or overhaul Medicare is a particularly tough vote right now for left-leaning lawmakers.

In a way, cuts to Medicare could be more substantial than cuts to Social Security, the famed third rail of American politics—touch it and you'll die, the saying goes. But at least Social Security is a relatively simple program. Workers pay in, retirees get the benefits, and actuaries can make realistic guesses about what changes the program might need to continue in the future. But Medicare, which experts say is the single biggest contributor to the nation's long-term debt, is tied into the rising costs of the nation's healthcare. Beyond long-held Democratic policy positions on how to cut Medicare spending, including allowing the program to negotiate on prescription drugs and cutting Medicare fraud, the options for restraining the program's future growth get trickier. Solutions the Democrats would prefer—cutting the overall cost of healthcare rather than cutting benefits—get into the overall debate on healthcare reform. It's a debate that Democrats, still scarred from the 2009 and 2010 battles over the Affordable Care Act, would rather put behind them.

By: Alex M. Parker
US News and World Report - July 10, 2011
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Y0064_H3327_THPSMK_2060 Approved
Touchstone Health HMO, Inc. is a Medicare-approved Health Maintenance Organization with a Medicare Advantage Prescription Drug contract with the federal government and a contract with the New York State Medicaid program. The plan is available to anyone enrolled in Part A and Part B through age or disability and who continues to pay their Medicare Part B premium. Copayment, service area, and benefit limitations apply. Members must use contracted providers to receive plan benefits, except in an emergency, urgent care, and for out-of-area dialysis. The Touchstone Health Medicare Advantage and Prescription Drug plans are Total, Prestige, Power, Clear and Freedom. Enrollment in Touchstone Health depends on contract renewal.