Image by Richard White via flickr.
Americans today are more supportive of a government-administered long-term insurance program, similar to Medicare, and think a number of measures would be helpful for improving the quality of ongoing living assistance, than they were just a year ago, according to a new survey from The Associated Press-NORC Center for Public Affairs Research. However, the survey also found that most people believe they lack enough information about long-term care assistance and planning – and intend to rely on family members for the majority of care, or already do.
The study follows up on results from the AP-NORC Center’s 2013 long-term care survey to obtain additional data on how much advance planning is being done and what role families play in the process, according to Trevor Tompson, director of the AP-NORC Center. Compared with the 2013 survey, nearly six in 10 Americans aged 40 and older (58 percent) now favor a government administered long-term care insurance program similar to Medicare, a seven-point increase from prior year’s results. Continue reading
The first in-depth look at long term care services in the United States was released last week by the National Center for Health Statistics.
“Long-Term Care Services in the United States: 2013 Overview” (PDF) analyzes supply, organizational characteristics, staffing and services offered by providers of long-term care services provided to some 8 million people in 2012. These findings establish a baseline for monitoring trends and effects of policy changes within and across the major sectors of long-term care services as policy makers, providers, researchers and advocates look to meet the needs of an aging population.
Key findings include : Continue reading
Most policymakers and experts agree the U.S. needs to do a better job of addressing the rising demand for long-term care services and supports for our senior population. But how? That was one of the key questions at the annual Gerontological Society of America Conference, last month in New Orleans.
As our aging population increases and health care shifts towards an aging-in-place approach, long term care issues become increasingly important. According to USA Today, some 70 percent of seniors will need help with care at some point. How much and when depends on many related factors – chronic disease management, socioeconomics, access to care, housing, age-friendly neighborhoods, caregiving, prevention, transportation, cognitive function, frailty, quality of life, provider reimbursement and of course, cost of care. There are dozens of angles for journalists to pursue.
Should we leave it up to private insurers? Create a new entitlement? Form some type of hybrid? How should it be regulated, if at all?
While The CLASS Act would have addressed many of these questions, it was sacrificed in the final version of the Affordable Care Act. So, what now? Wally Roberts, who attended the GSA conference, developed this tip sheet that highlights why some private insurance consultants don’t see long-term care insurance as a viable option and what happens after the bipartisan Federal Commission on Long Term Care – whose mandate was to come up with a replacement plan – couldn’t come to consensus on how to pay for it.
On Thursday, the federal Commission on Long-Term Care completed a package of recommendations for inclusion in its final report on long-term services and supports to be published by the end of September. A majority of commissioners appointed by Democratic and Republican leaders voted in favor of these recommendations to be submitted to Congress. The commission’s goal is to address the issues and challenges that millions of Americans and their families face on how to best to deliver and finance needed long-term services and supports.
“This is an issue that has been brewing for decades,” said Dr. Bruce Chernof, the commission’s chair, in a press release. “I am pleased that a majority of the Commission has agreed on a number of thoughtful recommendations that serve as a launching pad for future action by Congress and the Administration. I hope both the bipartisan nature of this report and the suite of ideas garnering broad agreement dispels the myth that our nation’s long-term care crisis is just too hard a problem to tackle. We must work to improve our approach to serving Americans with functional and cognitive limitations and their families, realizing that the time to act is now.”
Key recommendations include: Continue reading
September is Healthy Aging Month, and perhaps appropriately, it is also when the federal Commission on Long-Term Care must wrap up hearings and develop final recommendations on how the United States cares for its aging population. The Commission has heard from state Medicaid directors, who urged the panel to support a shift in federal funding from institutional to home and community-based services.
In a letter to the commission, the National Association of Medicaid Directors encouraged the Commission to:
- Permanently reauthorize the Money Follows the Person program with further modifications based on state input and program evaluations data. Progress and evaluation reports about this program are available from from policy think tank Mathematica, which is working with CMS to assess results.
- Align payment with key measures of performance, including the member’s experience of care through value-based purchasing, which ties hospital payments to performance.
- Give states authority to prioritize Medicaid Home and Community Based Services programs to make sure they have flexibility and support in implementing and managing their long-term service and support programs “in a manner that ensures resources are better allocated in accordance with needs and which allows them to stretch limited resources across more of the people who need care.”
- Develop and implement more robust quality and outcome measures, which factor in the various settings and and payment approaches of a particular state. This will allow beneficiaries to act on data, reward quality providers, and reduce waste and fraud in the system.
- Enact policy changes to ensure that Federal Benefit dual-eligible beneficiaries receiving long-term support services enroll in integrated programs of care that coordinate care across the continuum.
State Medicaid directors struggle with a complicated and patchwork system of federal oversight and regulation. As they work to rebalance their Medicaid long-term care programs, the impact of the Affordable Care Act is not yet clear. However, there seems to be consensus on some of the best practices and technical assistance needed to ensure continued service delivery for current and future enrollees.
Image by Enrique Bosquet via flickr.
Providing care and support for older adults is expensive, drains time and energy of family caregivers, and can make family lives chaotic. The repeal of the CLASS Act leaves the United States with no national long term care services and support plan for the millions of older adults who need it now, and the millions more who will need it in the next 20 to 30 years.
As part of last year’s “fiscal cliff” bill, Congress established a Commission on Long-Term Care to investigate options and make recommendations on how our nation can address this growing challenge. The 15-member panel is working under tight deadlines to propose solutions that offer cost-effective health and social services to seniors, and support their caregivers, who are frequently caught between raising their own families, work and caring for aging relatives.
Lynn Feinberg, senior strategic policy adviser for AARP’s Public Policy Institute, testified before the commission on the urgent need for family caregiver supports. “What I was struck with the most at this most recent hearing, was virtually everyone who testified spoke about the importance of family support in long term services and support,” she said. “Everyone was recognizing this was not just an aging issue, or not just a woman’s issue, but it’s a family issue that really touches everyone and increasingly affects more people and will affect most everyone in the future.” Continue reading