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April 28, 2025

Judy Faust Hartnett, CNN

Two-thirds of retired Americans wish they had a side gig to support their ideal retirement lifestyle and 93% of those retired that have gig jobs, work because they enjoy it.  Americans will be living longer in coming years, but they may not necessarily be working longer to earn income for those additional years of living. That’s one of the takeaways from a financial resilience and longevity report from John Hancock Retirement that draws on its U.S. retirement plan participants and a separate panel of retirees.

According to the study, 62% of retirees surveyed left the workforce sooner than expected, both shortening their time to save in a workplace plan and extending their financial needs in retirement. Many retired Americans find themselves struggling to support the retirement lifestyle they once envisioned. According to a survey by financial services firm D.A. Davidson & Co., 41% of retirees say they currently can’t afford their ideal retirement.

Of those who work side jobs because of financial reasons, 20% turned to part-time work or side gigs to pay off existing debts, and 17% wanted to financially support their ideal retirement lifestyle. Their financial shortfall can be attributed to factors such as inadequate planning for the financial realities of retirement. As a result, many are rethinking what retirement looks like, with some turning to side gigs to fill the financial gap.

Yet, the number one reason D.A. Davidson survey respondents said they took on a side gig in retirement is that staying lightly employed doesn’t have to be a burden. Ninety-three percent of retirees with a side gig say they enjoy it. Beyond enjoyment, over half (55%) say they chose their gig to stay mentally or socially engaged, showing that for many, it’s about more than just extra income – it’s about fulfillment.

“The definition of – and classic timeline for – retirement is changing,” said Andrew Crowell, financial advisor and vice chairman of wealth management at D.A. Davidson. “While many retirees might picture never working again, a side gig in retirement can be a fun and meaningful way to stay engaged in the community while supporting a more ideal retirement overall.”

Laura Dyrda

Thursday, Feb. 27th, 2025

Thirty-seven percent of U.S. hospitals are still losing money despite big initiatives to recover from the COVID-19 pandemic, according to Kaufman Hall.

Hospital and health system C-suites have been identifying ways to cut costs and become more productive, relying less on expensive contract labor and instead growing a talent pipeline from within. They’ve also incorporated digital technologies and artificial intelligence to support the workforce and become more efficient. But inflation and rising salaries have kept expenses high and reimbursements haven’t kept up.

Last year, Kaufman Hall reported 40% of hospitals were losing money; the three-percentage point drop shows slow progress toward financial stability but the 37% of hospitals still losing money are faced with tough decisions. In recent weeks, multiple hospitals have announced layoffs or restructurings; others are ending service lines or outsourcing administrative functions.

Kaufman Hall has also followed the chasm between high and low performing hospitals, which continues to grow. Even as some hospitals reduce staff, others are providing widespread raises and bonuses. They’re investing in AI-driven technologies to boost the workforce and streamline operations, giving them a further advantage over poorly performing hospitals.

The average hospital margin last year was 4.9% by the end of December, buoyed by a 7.8% average margin for the last month of the year, according to Kaufman Hall’s “National Hospital Flash Report.” Operating revenue per calendar day was up 9% year over year, with both inpatient and outpatient revenue growing in the high single digits. Expenses per calendar day grew 6% year over year, with supply and drug expenses per calendar day each rocketing 9%.

Observation days as a percentage of patient days dropped 13%, reflecting the work hospitals have been doing to make patient flow more efficient.

Hospital C-suites are focused on increasing revenue streams as supply costs and expenses are expected to continue increasing. They’re also looking for ways to combat physician burnout and improve quality care as well as retention. Value-based care is also accelerating, and hospitals are finding ways to provide more care at home or outside the main campuses.

“Navigating these challenges requires a balanced approach that prioritizes financial sustainability, clinician well-being, and technological advancement while maintaining our core focus on delivering high-quality patient care. Success in 2025 will depend on our ability to innovate, adapt, and implement data-driven solutions across all aspects of healthcare delivery,” Ebrahim Barkoudah, MD, system chief and regional chief medical officer at Springfield, Mass.-based Baystate Health, told Becker’s late last year.

Medicaid can cover nursing home care if you meet certain income and health requirements. Here’s what you need to know.

By David Levine and Elaine K. Howley, U.S. News

May 5, 2025

Most states also have multiple Medicaid programs, each with different eligibility criteria.

Key Takeaways

• Most adults need some type of long-term care and support later in life, and this care can get very expensive.
• The cost of nursing homes can range from $9,277 to $10,646 per month, depending on factors such as geographic location and level of care.
• Medicaid covers nursing home care for those who qualify.
• To be eligible for Medicaid, you must meet strict income and asset limitations. If you don’t, you’ll have to spend down your assets until you meet these requirements, which vary by state. An elder law attorney or other Medicaid eligibility expert can help you navigate this process.

Health care at any level is expensive, but at the top of the list is nursing home care. The national annual median cost of care for a resident in a private room in a nursing home is now $127,750, according to Genworth and CareScout. A semi-private room clocks in at a similarly staggering $111,325 per year.  Footing the bill for nursing home costs is a financial challenge for most people.

“Nursing homes are one of most expensive levels of care, and most people don’t have that money,” says Amie Clark, a senior care expert and creator of AgingToday.com, a company specializing in geriatric care management and senior housing advisory.

There is, however, one option for older adults who don’t have the funds to pay for a nursing home: Medicaid.

Does Medicaid Cover Nursing Home Costs? 

The short answer is yes. Medicaid, not to be confused with Medicare, is a federal health insurance program for low-income individuals, and is administered at the state level. Medicaid kicks in when there are no other options available to a senior who needs nursing home care.

“Medicaid was built to be the payer of last resort for people in poverty,” says Chris Orestis, a Maine-based senior care advocate and expert in retirement, long-term care and specialty senior living funding solutions.  Data from KFF, an independent source of health policy research, shows that Medicaid is the primary payer for nursing home care, covering 63% of nursing home residents.

How to Get Medicaid to Pay for Nursing Home Care

Securing Medicaid coverage for nursing home care takes some effort, and requirements for eligibility can be complex. However, you may qualify for Medicaid nursing home care even if you previously have not been eligible for other Medicaid services.

Income requirements

Eligibility is usually based on modified adjusted gross income, or MAGI, which is your taxable income plus certain deductions, including nontaxable Social Security benefits, individual retirement contributions and tax-exempt interest. It’s usually the same or quite close to your adjusted taxable income that’s listed on your tax return.

Most states also have multiple Medicaid programs, each with different eligibility criteria. However, generally speaking, if you make less than 100% to 200% of the federal poverty level and are elderly, disabled or a parent/caretaker, for instance, you probably qualify for a Medicaid program.

If you make less than 133% of the federal poverty level, you’ll most likely qualify for a Medicaid program in your state. In 2025, the federal poverty level is $15,650 annually for a single person and $21,150 for a couple in all 48 contiguous states and the District of Columbia. In Alaska, the rates are $19,550 for a single person and $26,430 for a couple. In Hawaii, the rate is $17,990 for a single person and $24,320 for a couple.

Asset requirements

For a single person, your assets can’t be greater than one house, one car and $2,000 or less in all accounts combined. For a married couple, assets can’t exceed one house, one car and approximately $3,000 in all accounts.

If you have more than that, you likely won’t qualify for Medicaid benefits, unless you go through an involved spend-down process to reduce your assets, says Kelsey Simasko, an attorney with Simasko Law in Mount Clemens, Michigan.

It can be a challenging process, though, especially because the state will review your assets and income over the prior five years to evaluate your eligibility. This is called the “look back” period. If Medicaid determines that you moved some assets in violation of its rules, you may lose some or all of your nursing home coverage. So, it’s a good idea to work with an elder law attorney to make sure you’re doing it right.

Care requirements

Each state sets its own criteria for how much care you may need, a measure called Nursing Home Level of Care, or NHLOC. Assessment tools vary but typically focus on determining the individual’s physical functioning, cognitive ability and medical and behavioral health needs. People who don’t meet these criteria won’t qualify for nursing home coverage under Medicaid.

Medicaid-certified facilities

Medicaid-certified facilities accept payment from Medicaid. This is an important designation to look for when considering which facility is the right one for your needs, especially if you anticipate needing to rely on Medicaid for payment in the future.

Are There Limits to What Medicaid Covers?

Although Medicaid can be a lifeline for seniors in nursing homes, there are some limits to what it covers. For example, it doesn’t cover amenities or nonmedical services.  Medicaid also doesn’t pay for medical services rendered outside the nursing home, such as going to a doctor or a specialist’s office. Look to Medicare Part B to cover most of those costs.

Who Is Medicaid Nursing Home Coverage For?

Nursing home care is designed for individuals with medical conditions or physical disabilities that are too severe for them to live at home but not acute enough to require hospitalization.  In many cases, nursing home care involves rehabilitation services, such as physical therapy, occupational therapy and other services designed to help restore some level of mobility and independence.  Keep in mind, Medicaid should have no bearing on the quality of care you or your loved one receive.  “The people providing the care probably have no idea what the payer source is,” Clark says. “So once you’re in there, I don’t think it has any effect on the kind of care they give.”

Finding Nursing Home Facilities Accepting Medicaid

If you expect you might need to rely on Medicaid in the future, it’s best to find out whether that’s an option at any nursing home you might be considering. Not all nursing homes accept Medicaid payment, and those that do may limit the number of beds available, meaning you may get put on a waiting list until space opens up.

You can start your search for nursing homes that accept Medicaid via the compare tool on the Centers for Medicare and Medicaid’s website. Put in your location and filter by “Medicaid-certified” to see only facilities that accept Medicaid.

You can also look for the best nursing homes near you, whether you’ll be relying on Medicaid or not, with U.S. News’ Best Nursing Homes 2025 rating. U.S. News looked at almost 15,000 facilities throughout the country and rated them in two different areas: short-term rehabilitation and long-term care.

By Lisa Rapaport

Updated April 28, 2024

Many people prescribed antibiotics in the U.S. don’t need them, and a study suggests this is particularly true for Black and Hispanic individuals.

Three in four antibiotics prescriptions for patients 65 and older aren’t needed, a recent study found.

Two-thirds of antibiotics prescribed to Black people are unnecessary, as are more than half of such prescriptions for Hispanic individuals, according to preliminary results from a study presented at the European Congress of Clinical Microbiology and Infectious Diseases in Lisbon.

“Our results suggest that Black and Hispanic/Latinx patients may not be properly treated and are receiving antibiotic prescriptions even when not indicated,” said an author of the study, Eric Young, of University of Texas Health Science Center in San Antonio, in a statement.

Particularly for elderly patients, the stakes of these unnecessary prescriptions are high, Young said. “In older adults, inappropriate prescribing in primary care is associated with a wide range of adverse outcomes, including emergency hospital attendances and admissions, adverse drug events, and poorer quality of life,” Young said.

For the study, researchers examined data from the Centers for Disease Control and Prevention (CDC) on prescriptions written during outpatient visits for more than 5.7 billion adults and 1.3 billion children between 2009 and 2016.

Overall, 11 percent of these patient visits resulted in antibiotic prescriptions, the analysis found.

Antibiotics should be prescribed only for bacterial infections, which can include strep throat, bloodstream infections, bacterial pneumonia, urinary tract infections, and some types of ear infections. Antibiotics are ineffective against viral infections, such as the flu, and shouldn’t be used for viral illnesses.

Most often, when antibiotics were used inappropriately in the study, doctors had offered these medicines to treat viral infections, bronchitis, or skin conditions unrelated to bacterial infections, the analysis found.

One limitation of the study is that it looked only at outpatient visits, not at antibiotic use inside hospitals. Another drawback is that researchers lacked some data that might have influenced prescribing decisions, such as patient allergies or certain diagnoses that might warrant use of antibiotics. The results have not been published in a peer-reviewed medical journal, a process that typically involves an independent verification of the findings.

While the study wasn’t designed to determine why so many patients got antibiotics they didn’t need, it’s possible that clinicians made decisions based at least in part on whether they thought people might be able to return to the doctor if their condition took a turn for the worse, Young said.

“We know that physicians typically send patients home with antibiotics if they suspect their symptoms may lead to an infection,” Young said. “This practice becomes more common when patients are unlikely to return for a follow-up visit or have no established care within a clinic or hospital system, which more frequently happens in minority populations.”

By Becky Upham

Jan. 31, 2025

New study finds that being active 30 minutes a day, 5 days a week can help prevent falls and injuries in older women.

Older women who exercised the equivalent of 30 minutes a day, five times a week were up to one-third less likely to hurt themselves in a fall, according to an Australian study published today in JAMA Network Open.

Brisk walking and moderate or moderate-to-vigorous activity were also all associated with lower risk, the authors wrote.

The findings are encouraging, though not necessarily surprising, says Deborah Kado, MD, a geriatrician at Stanford Health and co-director of the Stanford Longevity Center, both in Palo Alto, California.

“It’s good to see data that suggests that getting more physical activity is associated with a lower risk of falling. Although we often take mobility — the ability to move safely from one place to another – for granted, when you lose it, you really lose your ability to be independent,” says Dr. Kado, who was not involved in the research.

3 Million Older Adults Go to the ER Each Year Because of a Fall

The Centers for Disease Control and Prevention estimates that about 1 out of 4 older U.S. adults fall each year, and about three million are treated in the ER, making it a major health concern.

Falls resulting in hip fracture are especially concerning – one meta-analysis suggests that about 3 in 10 older adults who break their hip die within the next year.

More Than 1 in 4 Participants Reported Falling Within the Past Year

The evidence on whether physical activity reduces fall risk has been inconsistent, and it’s also not clear how much exercise is required, according to the authors. To find out more about how physical activity impacted both injurious and non-injurious falls, researchers recruited over 10,000 women between the ages of 45- and 50-years old back in 1996. Over 7,000 participants, with an average age of 67 years old, completed follow up questionnaires between 2016 and 2019.

Participants self-reported their weekly amount of three types of physical activity:

• Walking briskly, for recreation or exercise or to get from place to place
• Moderate activity, such as social tennis, moderate intensity exercise classes, and recreational swimming
• Vigorous exercise that made them breathe harder or puff and pant, like aerobics, vigorous cycling, running, and swimming

The subjects were then placed into groups according to the number of minutes they logged: none, less than 150 minutes, 150 to 299 minutes, and 300 minutes or more.

Those amounts were chosen to align with the World Health Organization (WHO) guidelines on physical activity. “Any amount of physical activity is better than none, and more is better,” advises WHO. The organization recommends at least 150 to 300 minutes of moderate or vigorous aerobic activity per week.

Participants in the 2019 survey answered three questions about falls in the past year:

• Did they have a fall to the ground?
• Were they injured because of a fall?
• Did they seek medical attention for a fall-related injury?

About 2,000 women reported falling in the last 12 months, with about half leading to injury and half not.

Being Active for 2.5 Hours a Week Cut Fall Risk

After adjusting for factors that could influence risk, researchers found that doing 150 to 300 minutes of exercise per week reduced fall risk that didn’t cause injury by 26 percent and injurious falls by 30 percent. Exercising for more than 300 minutes – five hours – cut the risk by 34 percent for injury-free falls and 23 percent for falls that caused injury.

These findings support multiple exercise trials that show a link between physical activity and reduced fall risk, says Kado. “For example, tai chi has been shown to help older adults reduce their risk of falling,” she says.

Tai chi originated as an ancient martial arts practice in China, and the modern practice incorporates slow movements and physical poses with controlled breathing. A meta-analysis of 24 randomized controlled trials published in September 2023 found that tai chi “can effectively reduce the risk of falls in older adults” and improve balance and walking speed.

Walking Reduced Fall Risk by 17 Percent

Brisk walking lowered the risk by 17 percent compared with no exercise at all, according to the authors.

This supports earlier research that shows that walking can help prevent falls. A Japanese study of 90 older adults found that a walking intervention reduced the risk of falls more effectively than balance training.

The Good News: You Don’t Have to Exercise 3 Hours a Week to Get Health Benefits

Although the study didn’t find any reductions in fall risk in the group with less than 150 minutes a week of activity, that doesn’t mean that there’s no benefits to small chunks of movement, says Kado.

“The WHO guidelines are terrific, but to tell people they need to get 150 minutes of physical activity a week – I think that can be a deterrent for some people,” she says. In the real world, most people aren’t getting between 2.5 and 5 hours of exercise a week, says Kado.

But you don’t have to meet that threshold to make meaningful improvements in your health, she says. “The truth of the matter is, if you look at data, even the smallest amount of activity has benefits. And the biggest bang for the buck is at the early part of the curve. So basically, if you’re a couch potato and don’t do any physical activity, if you just increase a little bit, like get up and down and walk around the house every 15 minutes, that will decrease your risk of dying early,” says Kado.