Aproximadamente 2,8 millones de habitantes de Carolina del Norte reciben beneficios de Medicaid, y muchos están pasando a planes de atención médica administrados.

Eso significa que la atención ya no será coordinada a través del Departamento de Salud del estado, sino por proveedores regionales de atención administrada. El cambio es especialmente significativo para 200.000 de los beneficiarios más vulnerables que serán cambiados a lo que se denomina Planes de salud personalizados.

Cassidy Estes-Rogers es una abogada del Center for Legal Advocacy con sede en Charlotte. Ella dice que estos planes están dirigidos a personas con graves problemas de salud mental.

"Personas que tienen trastornos intelectuales y del desarrollo, abuso grave de sustancias o enfermedades mentales, así como lesiones cerebrales traumáticas," explicó la entrevistada.

Ella menciona que una transición tan grande pone en riesgo la atención de los destinatarios vulnerables, y les aconseja a ellos o a sus cuidadores que se comuniquen con el estado para evitar interrupciones cuando se implementen los planes personalizados en abril.

Los planes personalizados son la siguiente fase en la transición de Carolina del Norte a la atención administrada, que comenzó en julio de 2021 cuando alrededor de 1,6 millones de beneficiarios de Medicaid vieron que la cobertura pasó de ser administrada por el estado a ser supervisada por organizaciones de atención administrada.

Estes-Rogers añade que los nuevos planes personalizados también requerirán que los proveedores de atención médica hagan más. Hasta ahora, solo se han encargado de gestionar las necesidades de salud mental de los pacientes.

"Pero ahora, el estado más bien les está diciendo a las organizaciones de atención administrada, que solo han estado involucradas en la atención de salud conductual de estas poblaciones, que también encuentren una manera de administrar su atención de salud física," comentó también la abogada.

Estes-Rogers recomienda que los beneficiarios actuales de Medicaid presten especial atención a la correspondencia del estado con respecto a un cambio en su plan, y dice que el sitio web de NC Medicaid Ombudsman puede responder preguntas sobre cómo cambiará su cobertura bajo los nuevos planes personalizados.

People who are part of the Deferred Action for Childhood Arrivals program, known as DACA, will be dropped from their CoveredCA health plans at the end of August.

The move comes after the Trump administration changed a Biden-era definition of "lawfully present" to revoke health care eligibility for thousands of immigrants.

Christine Smith, policy and legislative advocate for the nonprofit Health Access California, said people only have a few weeks to get medical appointments in before their coverage ends.

"If you're enrolled in Covered California and you're a DACA recipient, the Trump administration just ended your coverage," Smith emphasized. "People should use as much of your health care as you can before the August 31st deadline."

The Centers for Medicare and Medicaid Services defended the move, saying it will save taxpayers money. CoveredCA estimated the change affects about 2,400 DACA recipients in the state who make too much to qualify for Medi-Cal and have jobs not providing health insurance. They can still buy private insurance but it is much more expensive. People who prepaid for their coverage can seek a refund.

Smith predicted it will be a blow not just to those who lose coverage but to the state's health care system as a whole.

"The lines in the ERs are going to be longer because people are not going to be able to get affordable preventive care," Smith projected. "They're just going to get sicker and then end up in the ERs. People will overall incur more medical debt. Hospitals will have more uncompensated care."

The change is nationwide. As of mid-July, about 538,000 people in the DACA program across the U.S. are ineligible to enroll in any state-based insurance marketplace and are unable to access premium subsidies or cost-sharing assistance.

Artificial intelligence is appearing more prominently in many aspects of life and research suggests older populations are curious, yet remain wary of using the technology in their everyday lives.

According to Stats Indiana, there are more than 1.5 million Hoosiers aged 65 and older, or 18% of the state's population. Experts said it is likely the demographic will use AI in some form in the next few years, either by choice or necessity.

Dr. Shaun Grannis, vice president of data and analytics for the Regenstrief Institute on Aging, said AI offers real benefits.

"It can reduce loneliness through conversation, provide reminders for medications and appointments," Grannis outlined. "It can support cognitive stimulation via games, storytelling, news updates."

The technology can also offer a low-pressure way to access information on public services, he added, which is valuable for those with mobility issues or those who feel intimidated by technology.

Grannis cautioned any tool which can be used for good can also lead to problems. He noted AI can create a false sense of companionship and mask social isolation. Overdependence is a legitimate concern, he argued, if the technology becomes a "crutch" for all forms of interaction.

"All cognitive activities or decision-making, it can actually lead to and create a negative feedback loop, lead to a decline in engagement and even basic self-management skills," Grannis explained. "This is risky."

Grannis believes one solution is designing AI systems to complement, not replace, human interaction. He stressed it can be done though building broader support ecosystems including family, friends, caregivers and community services. Grannis emphasized it would encourage real-world activity, prompting the user to go for a walk, call a grandchild or attend a local senior event.

If you have an extra five minutes, you can save a life because you can learn cardiopulmonary resuscitation at no cost from a new mobile, hands-only CPR kiosk.

The new kiosk is in the lobby of Saint John's Health Center in Santa Monica. The machine's touch screen gives a brief overview of hands-only CPR and you can practice right there, on a mannequin.

Dr. Rigved Tadwalkar, cardiologist at St. John's, said it is an easy way for people to get more comfortable giving chest compressions in an emergency.

"It's a lot like a video game but of course, a lot more important than a video game," Tadwalkar pointed out. "It gives real-time feedback about the depth and rate of compressions, proper hand placement, which are all factors that influence the effectiveness of CPR."

The American Heart Association operates the St. John's mobile kiosk and a stationary model at L-A-X with support from the hospital. Santiago Canyon College in Orange County also has a mobile hands-only C-P-R kiosk now through September, sponsored by Edwards Lifesciences.

Steven Munatones, an Orange County business owner, said he survived what's known as a "widowmaker" heart attack which led to cardiac arrest nine years ago, thanks to his 17-year-old son, who gave him immediate CPR with instructions from a 911 operator.

"You don't have to put your mouth to anybody's mouth," Munatones explained. "You just put your hand on their chest and pump. He saved me, and others can do the same, anywhere. So, it's absolutely a lifesaving, heroic act that anybody can do."

Statistics show 350,000 Americans suffer from cardiac arrest outside a hospital each year and about 90% die, in part because they do not receive CPR. About 70% of those cardiac arrests happen at home, so people often depend on family or friends to give CPR before an ambulance arrives.