Benefits Of A GCM

Examples of Cost Savings after hiring a Professional Geriatric
Care Manager

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. Savings in care costs –Recommending free or low-cost products and services that may be available in local communities. Understanding today’s medical system saves our 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 – Monitoring caregiving. Some adult children take leave from work after vacations have been exhausted to check on Mom or Dad. A PGCM 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 arrange 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 assets the loved one might not have realized existed in the home. 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

Patient Advocate – 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 their 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 signed a private pay agreement for care 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 the referral from the 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 the PGCM was giving such advice, the PGCM was right and the family did not pay. Also, this was accomplished without an attorney.

• Helped families advocate for lost dentures and/or glasses in skilled nursing facilities. The Ombudsman came into play – it is the facilities’ responsibility to replace them.
• Advocated for more time in acute care or skilled care by pointing out new diagnosis that gave clients more days of care.
• Helped family negotiate for PGCM services with the parent’s long term care insurance company.
• Advocated for more in home care services paid for by the county Area Agency on Aging office.

Identifying the Right Level of Care to Meet the Families Specific Needs - After being assessed, a spouse who had her husband in a nursing home plus 24-7 care was able to move her husband to a small residential family home owned by a nurse. It cut the costs to the family in half. His wife didn’t know he could be maintained at a lower level of care.

Identifying the Most Cost Effective Solutions – PGCM’s help families choose the most cost effective care plan (caregivers, agencies, care management). We can recommend what services are needed to age in place, often times less expensive, and provide these options to the Family. The family can then choose the best situation for their needs.

• Health Care Supplies – like incontinent supplies – finding sources on-line at less than drug store costs with free delivery.
• Medicare and Medicaid – Helped spouse understand that Medicaid will pay for skilled nursing – they don’t have to give up their house. But, they do need to qualify. Advised working with an Elder Law attorney to help.

Educating Families about Little Known Benefits - One family saved $1,600 per month. This was money being paid out of pocket for home care services by the elder client’s son. For instance, the Veteran’s Administration may provide free, top of the line, hearing aids and other services to veterans.

• Free items like hearing enhanced phones or other communication devices from the telephone company.
• Free services that are location specific. For instance, one neighborhood provides free transportation to seniors for shopping at the grocery store, pharmacy, etc. There is a hospital that has a volunteer help/companion service and transportation to physician appointments.
• Assisted family in collecting required information and completing a Medicaid Application

To find a PGCM in your area please visit our “Find A GCM” page or www.caremanager.org for a searchable database by state or zip code.