An analysis by Avalere Health, which studied trends in co-pay charges for enrollees in Medicare Part D, found out-of-pocket generic drug costs for seniors on Medicare nearly doubled even though the price of the medications has not risen since 2011, reports the Los Angeles Times . Avalere says the insurers have been shifting many generics into co-pay tiers that require beneficiaries to pay larger portions of the drugs' cost, letting them keep Part D premiums stable. In 2011, 71 percent of covered generics were placed in tier 1, the lowest, carrying the smallest co-pays. By 2015, only 19 percent of covered generics were still in that tier, while about 46 percent had been moved to tier 2 and 35 percent to tier 3 or higher. Total out-of-pocket costs for the same group of generics rose 93 percent from 2011 through 2015, while average generics prices increased only 1 percent and the volume of generics purchased rose only 22 percent. The difference almost wholly stemmed from higher co-pays charged per prescription by insurers. Particularly worrying is that among the generics subject to the up-charges are some of the most widely prescribed and least expensive for seniors, including for chronic conditions such as cholesterol, hypertension, and diabetes.

A bipartisan bill co-written by Sen. Susan Collins (R-Maine) to protect seniors from scammers has been passed by Congress, reports the Portland Press Herald . The measure received House approval on Tuesday as part of a banking reform package, and it will now go to President Trump for his signature. The bill will encourage banks, credit unions, investment advisers, broker-dealers, insurance firms, and insurance agencies to train employees about financial fraud and report suspected abuses. The legislation also will shield these institutions from being sued for reporting suspected fraud, provided they have trained their employees and made their reports on a reasonable basis to the proper authorities. "As Chairman of the Senate Aging Committee, I have been committed to fighting fraud and financial exploitation targeted at older Americans," Collins notes. "The Senior $afe Act, based on Maine's innovative program, will empower and encourage our financial service representatives to identify warning signs of common scams and help prevent seniors from becoming victims." Rep. Bruce Poliquin (R-Maine), who sponsored the bill in the House, praised its passage. "Maine is home to the oldest population in the nation and, unfortunately, so many of our seniors fall victim to financial abuse and fraud," he said. "Maine's seniors ... should have the protections and support they need when financial criminals attempt to do them harm."

A study of 1,280 older adults in the U.K. published in the British Journal of Clinical Pharmacology found medication-related harm affected one in three adults following release from the hospital, of which half were potentially preventable, reports EurekaAlert . Failure to properly administer medications was implicated in 25 percent of cases of medication harm. The cost to the National Health Service of post-release medication harm in older adults was estimated at 396 million pounds, more than 90 percent of which was attributable to hospital readmissions. "As the use of medicines in the aging population is rapidly increasing, it's vital that we improve awareness among clinicians of the harm that medicines commonly cause," says Brighton and Sussex Medical School Professor Chakravarthi Rajkumar. "The risk-to-benefit analysis is particularly complex in the older population. Any decision to prescribe medicines should be made in close collaboration with seniors and carers, with a tentative stop date and with monitoring of correct usage and adverse reactions."

A randomized trial demonstrated that a yoga program for 56 older women with urinary incontinence reduced instances of unintentional leakage by 76 percent after three months, reports MedPage Today . The average number of weekly incontinence episodes fell from 27 at baseline to seven at the end of the study, and no adverse events attributable to the training happened. Participants were randomized into twice-weekly yoga classes and once-weekly home practice of specialized yoga techniques, or into time-equivalent classes and home practice of nonspecific and stretching exercises. The intervention group was instructed in a specialized yoga program developed by consultants experienced in Iyengar yoga. Training included 15 common yoga poses and stressed exact anatomical alignment during practice of poses. Participants also received an instruction manual developed for the study. In the intervention group, the average number of weekly incontinence episodes declined from 27 at baseline to 7.1 at three months. Among controls, the average number of episodes decreased from 23 to 11, a 56 percent decline. The between-group difference in improvement did not realize statistical significance. Seventeen women in the yoga group and 14 in the control group noted a new health symptom or problem during the study, and nine in the yoga group and eight in the control cohort cited a musculoskeletal symptom or problem. None of these were attributed to the yoga or control program.

Seniors at a day-care center in the city of Conwy in Wales are engaging with toddlers as part of an experiment to see if such interaction can help restore memories in people with dementia, reports BBC News . The experiment is being conducted by scientists at Bangor University, who have organized cake-making, singing, and exercise as part of the group activities. "What we want to do is to change the environment, so that they can engage, they can interact without failure," says Bangor University Professor Bob Woods. "And in that way we can draw on the rich vein of expertise and experience and knowledge that's still there." Interaction and friendships are not easy for all of the participants. Woods notes the research is ongoing, but that the children have made a real difference. "They've given us all a new perspective, a new view on dementia," he says. "It's really important to see the person behind the diagnosis."

The U.S. Government Accountability Office (GAO) says the Centers for Medicare and Medicaid Services (CMS) has not authorized the continuation of prior authorization experiments despite the fact that they could save Medicare billions of dollars, reports Modern Healthcare . The experiments stipulate that CMS only covers some items and services after providers and medical product suppliers have shown they complied with coverage and payment rules. The agency uses prior authorization in Medicare for non-emergency ambulance rides, hyperbaric oxygen therapy, home health services, and power wheelchairs. GAO estimates that CMS may have saved up to $1.9 billion due to prior authorization since it started the experiments in 2012. However, most of the experiments have concluded or soon will, and CMS has not announced plans to continue most of these efforts, with the exception of those involving power wheelchairs. "By not taking steps, based on results from the evaluations, to continue prior authorization, CMS risks missed opportunities for achieving its stated goals of reducing costs and realizing program savings by reducing unnecessary utilization and improper payments," GAO warns. The office determined providers and suppliers have had problems with prior authorization, noting it can take months to secure required documentation from referring doctors and others before submitting a prior authorization request, while clinicians lack financial incentives to furnish that information. CMS officials say the agency was assessing the prior authorization programs and would consider GAO's findings and recommendations. CMS has hinted it is considering new experiments for items such as hospital beds and oxygen concentrators, given their high usage or improper payment rates.

Legislation to reform the Department of Veterans Affairs (VA) and improve healthcare services for veterans in Nevada and other states is approaching a Senate vote this week, reports the Las Vegas Review-Journal . Key senators on Tuesday met with leaders of 38 veterans service groups in Washington, D.C., just prior to the Senate's 91-4 vote to limit debate and allow a vote on the VA Mission Act as early as today. Sen. Johnny Isakson (R-Ga.) said the measure would streamline community care programs, improve healthcare delivery, and expand caregiver programs. Meanwhile, Sen. Jon Tester (D-Mont.) called the bill the best defense against privatization, describing the current VA Choice Program, which lets veterans get care from community providers if the VA cannot deliver such care in a timely manner, as "a wreck." Sen. Dean Heller (R-Nev.) concurred that the Choice Program has failed, while the VA Mission bill would provide revisions that would better serve veterans, especially those in rural areas. The measure also would expand caregiver programs to serve those wounded while in service before Sept. 11, 2001, the current cutoff date for existing programs due to budgetary limitations. Tester and Isakson dismissed criticism of the bill over its $52 billion price tag. "Taking care of veterans is the price of war," Tester noted.

The U.S. Supreme Court on Monday decreed that businesses can prohibit their workers from banding together to complain about pay and workplace conditions, reports the Washington Post . The justices ruled 5-4 Monday, with the court's conservative members in the majority, that businesses can force employees to individually use arbitration to resolve disputes. Approximately 25 million employees work under contracts that prohibit collective action by employees who want to raise claims about some aspect of their employment. The White House backed the businesses, reversing the Obama administration's position that was in favor of employees. The Supreme Court was tasked with reconciling federal laws that seemed to point in different directions. On the one hand, New Deal labor laws explicitly gave workers the right to band together. On the other, the older Federal Arbitration Act encourages the use of arbitration instead of the courts.

The White House announced last week that President Trump has donated his salary for the first quarter of 2018 to the Department of Veterans Affairs (VA), reports The Hill . White House press secretary Sarah Huckabee Sanders said Trump's quarterly salary will go toward the VA's caregiver programs. Acting VA Secretary Robert Wilkie said the contribution will be channeled into mental health and peer support programs, financial assistance, and research to help veteran caregivers. "The president's gift underscores his promise to do all he can for vets, which includes supporting those who care for veterans," Wilkie said. "Not just those of us at VA, but the husbands, the wives, the families, and the community caregivers who are out there day in and day out." The VA currently lacks a full-time director since Trump's March firing of former VA Secretary David Shulkin. The president nominated Adm. Ronny Jackson as Shulkin's replacement, but Jackson withdrew in April amid allegations of improper conduct.

Transitioning to electronic systems is proving to be a boon for senior living communities, reports Health Data Management . For example, Senior Housing Companies' Joy Laudick saw a lack of standardization and manual paper processing as hindrances when she became the company's director of clinical management. "We wanted to have a single electronic health record along with revenue cycle management and customer relationship management software," she notes. The organization ultimately opted for the PointClickCare EHR, which features revenue cycle management and CRM software to help support senior living operations. "Moving from paper to electronic is a huge system change for nurses," Laudick says. "We knew we had to have a lot of handholding, assess each community, and then help them go live." Younger nurses had less difficulty adjusting to the change, while older nurses eventually grew to understand that automated information systems let them spend more time with residents and less time on paperwork. Senior Housing's EHR software also is improving senior incident reportage to the Iowa Department of Public Health. Previously when an incident occurred, a nurse would read a report to Laudick, and Laudick would seek more information to determine if the incident was reportable; now, EHR data that includes information on state reporting criteria is used to evaluate if a report should be disclosed to state agencies.