Care Managers Saving Seniors Money


A Cost Savings : Hiring a Geriatric Care Manager

from the National Association of Professional Geriatric Care Managers

A professional geriatric care manager (PGCM) can help families realize cost savings, but the biggest advantage is the emotional peace of mind knowing that a relative or loved one is being cared for with the most appropriate level of care as recommended by the PGCM. Regarding the average savings from hiring a GCM, The National Association of Professional Geriatric Care Managers (NAPGCM) does not generate projectable data across the country. Every case is unique. What we can tell you are areas that have resulted in savings when a professional geriatric care manager is in the picture. Here are some of those that we often see:

1. Saving in Care Costs – Recommending live-in care when appropriate in place of (more expensive) shift care. Recommending free or low-cost products and services that may be available in local communities. Understanding today’s medical system can save clients money while ensuring the appropriate level of care.

2. Making the Most of Insurance – Ensuring that secondary insurance had been given and billed for medical bills coming to a senior's home. Avoiding paying unnecessary bills. Realizing benefits from public programs including those from Veterans Administration (VA) benefits and from programs like Medicare and Medicaid. Helping clients enroll in the most appropriate Medicare Part D (pharmacy benefit) plans for their state (and there are many in each state from which to choose).

3. Avoiding Expensive Duplication – Ensuring that seniors aren't paying for duplicative insurance, aren't donating repetitively to a charity (when the senior forgets they just donated last week or last month), or aren't buying duplicative clothing or food when the senior forgets what they already have in the home.

4. Saving in Travel Expenses – Supervising care including medical appointments, operations of in home staff can postpone expensive travel to a relative.

5. Avoiding Lost Wages – Some adult children take leave from work after vacations have been exhausted, to check on Mom or Dad. A GCM can be the person on site to monitor the caregiving level.

6. Saving in Household Expenses – Identifying cost saving programs. Utility companies or other providers offer discount programs for seniors. PGCMs are aware of these programs and can recommend and sign up these services for the loved one.

7. Making Better Financial Decisions – Encouraging clients to speak with financial planners about whether annuities are really good investment choices, especially when clients in their 80's can't access their funds without large withdrawal penalties. Curtailing compulsive spending from shopping on line or on TV.

8. Discovering Unoticed Assets - For instance, when a house is cleaned and put in order, often hidden money and valuables are found.

9. Savings in Time and Efficiency – While information is available (and NAPGCM recommends that consumers educate themselves), a PGCM is experienced in the wide range of resources available and can do the job in half (or less than half) the time.

Other Scenarios: Care Managers Saving Seniors Money

1. Correct Coding/Insurance – When an elder had a terrible accident, was in a coma, hospitalized and then transferred to a rehabilitation hospital, her elder husband was overwhelmed with her care. She was transferred to a skilled nursing facility (SNF) near only child. The PGCM was hired when the decision was made to transfer her for long term care near her husband. Upon admission to the SNF, the son had signed a private pay agreement for following her Medicare days. He was eventually presented with a bill for $15,000 and the promise of future bills. After the PGCM discovered they had counted her rehab hospital days as SNF days (even though they had, of course, received referral from hospital), she urged the son not to pay the bill, which was clearly in error. Though receiving a couple of pretty threatening calls from the SNF wondering why I was giving such advice, the PGCM was right and the family did not pay. Also, this was accomplished without an attorney.

2. Telling Families of the Benefits from the VA system. Saved one son $1,600 per month (he was paying out of this money before VA). Also, VA provides free hearing aids and other services to veterans.

3. Recommending Most Cost Effective Level of Care. Spouse who had her husband in a nursing home plus 24-7 care. Moved him to a small residential family home owned by a nurse. Cut the costs to the family in half. Wife didn’t know he could be at a lower level of care.

4. Helping Families Chose the Most Cost Effective Care Plan (caregivers, agencies, care management)

5. Helping Families Advocate for Lost Items in Skilled Nursing Facilities. Ombudsman comes into to play and it is the facilities responsibility to replace them.

6. Helping Families with Supplies – like incontinent supplies – finding sources on-line at less the drug store costs with free delivery.

7. Advocating for More Time in Acute Care or skilled care by pointing out new diagnosis that give clients more days of care.

8. Telling Families about Free Items – like hearing enhanced phones or other communicationdevices for the telephone company.

9. Helping Spouses Understand that Medicaid will Pay for Skilled Nursing – they don’t have to sell the farm. But, they do need to qualify. Advising working with an Elder Law attorney to help.

10. Telling Families about Free Services that are Location Specific. We have a hospital that has a volunteer helping/companion service and another small city that provides free shoppers for seniors.

11. Understanding Servies, such as  “Meals on Wheels” which can often be free or donation only.

12. Getting Clients “Transportation” systems that are either a van with low costs or taxi scripts.

13. Signing Clients up for Low Cost Rates at the gas & electric company.

Published on May 24, 2013.