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Uncategorized

June 20, 2025 By Greg Nicholaides

A Doctor’s Science-Backed Formula for Aging Better

Dr. Eric Topol’s longevity work revealed simple and practical steps to stay healthy. He shares the tips that he follows.

By Amy Dockser Marcus – May 8, 2025

The Wall Street Journal

Dr. Eric Topol, a cardiologist, researched what keeps people 85 and older healthy. He wanted to know if genes were the reason some people live to very old ages without major health problems. Topol, a prominent cardiologist, decided to test the idea. He and his colleagues at the La Jolla, Calif.-based Scripps Research Translational Institute, which Topol helped found, enrolled people 85 years old and above – and healthy – in a research project. The researchers sequenced and scrutinized the participants’ DNA. The results led Topol to a different conclusion.

It turned out there wasn’t much in the genes of these “super agers” that set them apart. But as a group, they were different from many Americans of similar ages. They were thinner. They exercised more. They were better-educated. Even at advanced ages, they continued to volunteer, dance, see friends and pursue activities that gave them purpose and enjoyment.

In the coming years, more people can become super agers, Topol writes in his new book of the same name. Cancer, heart trouble and neurodegeneration can take decades to develop—leaving time to slow, delay or even prevent them, Topol argues. 

A longtime champion of the idea that mobile devices and other digital tech can help people track and improve their health, Topol is a self-described “techno optimist.” He has done tests on himself that measure the biological age of different organs, had his genes sequenced and participated in a research study that assesses people’s immune systems to try to predict their risks to different diseases.

In the future, these strategies, along with improvements in artificial intelligence, may allow for dramatic changes to the way people age. For now, there are some simple and practical things people can do to improve longevity. Topol, who is 70, says, “I am taking my own advice.”

He shared some of his own plan with The Wall Street Journal.

Exercise

I’ve always been an exercise enthusiast. As a cardiologist, I always used to think, do aerobic exercise. But all the studies show resistance or strength training is really important too. I do lots of resistance training and make that part of the routine. You can do resistance training with some very cheap bands.

Sleep

I started tracking and learning what helps me get more deep sleep [a stage that involves slow brain waves, slowed heart rate and non-rapid eye movement sleep]. I was sleep-deficient for decades. The importance of sleep, especially deep sleep, is to clear waste products from the brain. People should aspire to get a maximal amount of deep sleep. 

Many people think they need eight hours of sleep. Studies show seven hours is optimum. I’ve learned how important it is to have a set and early bed time. I’ve been able to increase my average deep sleep substantially by having my data and learning how what I eat and when I exercise affect it. I use both an Oura ring and an Apple smartwatch because the results are often not concordant.

Diet

I am religious about reading labels and getting rid of ultra-processed food. Many things I used to eat, I won’t go near. Each of us has the potential to read labels and shift our priorities as to what we eat. Ultra-processed foods should be reduced to the lowest amount possible. When I read labels for things like whipped cream cheese or different brands of ice cream, they are chock-full of ultra-processed ingredients.

I am very regimented now. I mostly eat salad with oil-and-vinegar dressing and some kind of protein like salmon or chicken. I don’t eat red meat. I eat plain yogurt and add berries and granola. I eat nothing in between meals.

Protein 

I have increased my protein in my diet, though not at the [very high] levels that are advocated by some people. I’ve had marked improvement in muscle mass. The recommended dietary allowance for protein is 0.8 grams per kilogram of a person’s weight for all adults. There are data that support an increase for people aged 60-plus to about 1.2 grams per kilogram a day. For me, at 80 kilograms, I shoot for 90-100 grams a day. If you overdo it with protein intake, that might not be a good idea. Many studies now show that very high protein diets can promote atherosclerosis.

Testing

I am trying to assemble a full stack of data we all need. I have had my genome sequenced, my gut microbiome tested, I have used organ clocks [tests that measure the aging of different organs].  It’s inexpensive to get a polygenic risk-score test [the tests analyze DNA] to tell us about someone’s risk for common diseases, different types of cancers, heart disease, Alzheimer’s and neurodegenerative diseases. There are about eight companies that offer them through their websites or you can get the kits through Amazon.

There are anywhere between 6,000 and 11,000 proteins in your blood that can tell about the aging of organs. Two companies offer tests in the $100 range.  The results can be discussed with a doctor. If you know your risk, it’s much more likely you will do something. I believe the potential benefit of having the results outweighs remote concerns about privacy.

Antiaging supplements and drugs

I don’t think any antiaging supplements have been proven. Taurine is a possible candidate. As we age, we see lower levels of taurine in the blood, and that is correlated with more inflammation. But we need trials.

I think the rapamycin story is really checkered. [Rapamycin, an FDA-approved drug used to help prevent organ rejection in transplant patients, is sometimes used off-label as part of longevity regimens.] Rapamycin suppresses the immune system. The last thing you want to do as you get older is to suppress the immune system. The drugs are out there dangling. They may have a role. We just don’t have the data to help us guide their use right now.

Filed Under: Uncategorized

May 13, 2025 By Greg Nicholaides

A Side Gig Retirement Plan

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.”

Filed Under: Uncategorized

May 13, 2025 By Greg Nicholaides

37% of Hospitals Still Losing Money

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.

Filed Under: Uncategorized

May 13, 2025 By Greg Nicholaides

Does Medicaid Cover Nursing Homes?

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.

Filed Under: Uncategorized

April 18, 2025 By Greg Nicholaides

Most Antibiotics Prescribed to Older Adults Are Unnecessary

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.”

Filed Under: Uncategorized

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