Jan. 23 Looking Ahead Into 2023

On Jan. 12 Dr. Rekha Bhandari, CMO of The MedElite Group, posted to her LinkedIn page the following piece about the dangers of social isolation among seniors:

Stemming the tide of avoidable transfers from nursing homes to hospitals is a significant challenge for the healthcare industry. There are questions about just how significant – one study said as many as half could be avoided, another 60 percent, another 70 percent – but suffice it to say that some measures are in order, given the threats to patients’ physical and psychological well-being such transfers represent.

It might be as complicated as improving the manner in which card studies (i.e., surveys about the manner in which any given patient receives care) are performed. Or it might be as simple as a text chain.

Both measures are in the works.

Click the link above to read her full piece.


In an attempt to streamline providers’ workflows, boost cost-effectiveness and improve patients’ care journey, the Centers for Medicare & Medicaid Services (CMS), in conjunction with the U.S. Department of Health and Human Services (HHS), introduced on Dec. 19 a rule proposal entitled “Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard (CMS-0053-P).”

The rule, if finalized, would establish standards for electronic signatures used in transactions involving medical charts, X-rays and provider notes, according to a news release. It would also modify transactions consummated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and according to an estimate by the CMS, save $454 million a year in administrative costs.

As CMS administrator Chiquita Brooks LaSure said in the release:

The proposed rule further aims to streamline the healthcare-claim process by “providing structured, standardized electronic data to payers.” Additionally, it “proposes to adopt a modification to the standard for the referral certification and authorization transaction, thereby reducing potential barriers to adopting value-based payments,” which, again, will reduce administrative costs and burdens on providers.

The issue of standardizing electronic transactions has been one that has been under consideration since HIPAA was enacted by Congress, in 1996 – specifically, another CMS release said, through a codicil that called for “Administrative Simplification.” And indeed, there were attempts, in 1998 and 2005, to standardize electronic signatures. In 1998, stakeholders did not believe such technology had reached maturity, and in 2005 they could not reach a consensus on how best to use that which was available.

The Affordable Care Act, passed in 2010, includes a requirement that the Secretary of Health & Human Services adopt standards for healthcare claim attachments.

The rule can be reviewed here, and according to the release, the CMS welcomes comments from all interested parties, particularly “patients and their families, providers, clinicians, consumer advocates, health plans, and health care professional associations.” The deadline for doing so is March 22, 2023.


The holidays are over; so now what? Everyone’s mood is bound to drop, just like the temperatures. The website Visitingangels.com asserted that seniors are especially susceptible to the winter blues, due to limited social contact, lack of sunlight and/or inactivity.

What starts as the blues could devolve into Seasonal Affective Disorder (SAD), an affliction that impacts some 10 million American adults and is characterized by fatigue, lethargy, weight gain and irritability (among other symptoms), and can only be treated by a trained clinician.

So the question is, how can we help seniors through this difficult time? Here are some tips:


Natural light is often the tonic for the blues, for scientific reasons: Vitamin D helps improve one’s mood. As a result, we would do well to make sure seniors’ blinds are open during the day, to let in as much sunlight as possible. And it wouldn’t hurt to venture outside on occasion, though bundling up is crucial, given their susceptibility to the cold.

Exposure to Vitamin D, albeit that which can be consumed through one’s diet, was also the subject of a University of Georgia study cited by Visitingangels.com. The study drew a correlation between mental health and a deficiency of this vitamin, meaning seniors (and, well, everyone) would do well to load up on foods like eggs, seafood and the like.


Doesn’t mean they have to venture outdoors; that’s what treadmills are for. But it is crucial to move one’s bones. There is not only the physical benefit, but also the emotional one, courtesy of the endorphin release. Whether that’s through walking, biking, dancing or even gardening, it doesn’t matter. The net effect is the same


There is no shortage of ways to engage one’s creative side. Maybe it involves baking or photography. Maybe it involves knitting or scrapbooking or crafting. The point is, it activates the brain and relieves stress, including that which can result from the winter doldrums.


This is crucial not only in wintertime, but all the time. The deleterious effects of social isolation have been well-documented. And while it might be more difficult in the colder months, it is vital that we make sure seniors mingle.

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