New Federal Budget Freezes Most Spending for Senior Services—Again

Congress has again frozen funding for most senior services programs, from Meals on Wheels and other nutrition programs to falls prevention and state health insurance assistance programs (SHIPs). This has been the trend throughout most of the Obama Administration. But it may be about to come to an end, as we near a time when federal funding for senior programs is not frozen, but cut—hard.

Why are So Few Low-Income Seniors Enrolling in Managed Care Plans?

What if they gave a managed care plan and nobody came?

That seems to be the problem with California’s ambitious effort to enroll more than 400,000 low-income seniors and younger people with disabilities into a fully-integrated care program that covers both medical treatment and long-term supports and services.  The idea has enormous promise, but relatively few Californians seem willing to participate. And many who have been automatically enrolled are dropping out.

The California program, called Cal MediConnect, is a demonstration program aimed at the so-called dual eligibles–people who receive benefits from both Medicaid and Medicare. The goal is to improve health outcomes and save money by managing care for those who are high-risk and high-cost patients.

Are Tax-Free ABLE Accounts The Right Financial Solution For People With Disabilities?

For the first time since 2010, Congress may be about to acknowledge that people with disabilities cannot have a decent quality of life with limited financial resources and modest government support. It is on the verge of approving the Achieving a Better Life Experience (ABLE) Act, which would create tax-free savings accounts to assist some people with disabilities while not jeopardize their eligibility for Medicaid or Supplemental Security Income (SSI).

The New World of Assisted Living

Assisted living facilities (ALFs) may be going the way of cable TV.  Still around, but with a limited future.

Their residents are changing. Even as their needs become more complicated, they are demanding less institutional-like care.  At the same time, assisted living will have to find its place in a world where medical and social care are becoming better coordinated and providers will be expected to organize themselves in very different ways than today.

Assisted living was once a creative alternative to nursing homes. Soon, something new will replace ALFs. The details remain uncertain, but we can begin to see what this new model of residential care will look like.

What Does Genworth’s Bad News Mean for the Future of Long-Term Care Insurance?

Last week, Genworth Financial, the dominant player in the traditional long-term care insurance market, acknowledged it is continuing to struggle to keep the product afloat. The firm announced it increased its reserves against future insurance claims by $531 million and said it is reviewing outstanding policies to determine whether it will have to take an additional charge before the end of the year. Its stock price plummeted by more than one-third (though it has rebounded a bit since) and the firm is facing enormous pressure from Wall Street to stop selling LTC policies.

What the GOP’s Congressional Victory Means for Senior Services

Republican control of Congress means that senior service programs—most of which have been frozen for years—will face growing budget pressures. At the same time, the GOP also may try to give states more flexibility in the way they provide Medicaid and other benefits to the elderly and disabled. And while the GOP leadership will be under pressure from Tea Party conservatives to trim Social Security and Medicare benefits, it is less likely a Republican Congress will try to do so without bipartisan support.

How Medicare Advantage Plans Can Improve Care and Save Money

Medicare Advantage plans, the managed care programs that currently insure nearly one-third of all Americans over 65, are supposed to achieve two goals: Improving health outcomes by organizing care of older Americans and reducing costs. Those two goals can sometimes conflict, but a new study provides something of a roadmap for how plans can do both.

Nursing Homes Use Too Many Antibiotics, and Residents Are Dying

Infections are all-too-common in nursing homes. And all-too-often facilities treat these conditions with large doses of antibiotics. Now the Obama Administration has announced a major initiative aimed at dramatically reducing the use of these drugs. And the effort has the potential to fundamentally change the way nursing homes operate—and the way residents receive care.

Today, antibiotic use is routine in nursing facilities. The Centers for Disease Control estimates that two-thirds of all residents will be given at least one course of antibiotics this year, and that 25 percent to 75 percent of those prescriptions will be inappropriate. But as a result of the heavy use of antibiotics, 27,000 nursing home residents will suffer from a drug-resistant infection. And many will die.

Don’t Panic About Ebola: Get a Flu Shot and Wash Your Hands

If you are 65 or older and living in America, your chances of getting Ebola are vanishingly small. You are far more likely to contract—and die from—everyday infectious diseases such as flu, a variety of stomach viruses, or common bacteria such as C. difficile (c. dif.) and methicillin-resistant Staphylococcus aureus (MRSA).

These common infectious diseases are responsible for one-third of all deaths among older adults in the U.S. while Ebola has been responsible for none.

Nearly Half of All Seniors Need Help With Daily Activities, Far More Than We Thought

Nearly 18 million older adults, or nearly half of everyone 65 and older, report that they need some assistance with routine daily activities. That’s significantly more than generally believed and suggests that the burden on families and the overall care system may be much greater than previously thought.

According to a new study by Vicki Freedman of the University of Michigan and my Urban Institute colleague Brenda Spillman, about 11 million of those 18 million seniors were getting help in some form—usually from a family member or friend and less frequently from a paid aide. Their study was published in the September, 2014 issue of the Milbank Quarterly (behind a pay wall).