Steps on the Path to Public/Private Long-Term Care Financing

Yesterday, the CEO of the nation’s largest long-term care insurance company, Genworth, acknowledged the US needs a new model of LTC insurance that includes some government role.  Tom  McInerney estimated that between half and two-thirds of Americans simply cannot afford to buy insurance in the traditional private market.  A 50-something can expect to pay an average of $2,500-$3,000-a-year for a typical policy ($150-a-day for three years, with inflation protection).

And that’s not the only problem. It is impossible to buy private insurance to protect against truly catastrophic long-term care risk of more than 10 years and difficult to buy coverage for more than five years. And perhaps as many as one-quarter of those who would like to buy can’t: They cannot pass the medical underwriting necessary to qualify for insurance.

A New Way For Family Caregivers To Get Lawmakers’ Attention

Here is a political mystery: At least 44 million Americans are caring for aging parents or other relatives and friends. That’s more than one of every six adults in the US—an enormous voting block. Yet, their interests are largely ignored both in Washington and in state capitals.

Now, the Altarum Institute, a non-partisan, Washington-based research organization, has come up with a new way to get caregiver issues on the political radar. The initiative, called the Family Caregiver Platform Project , is aimed at getting families who help their loved ones with personal care involved in writing the policy platforms of the political parties.

Big Strides in Cancer Treatment Will Increase Long-Term Care Needs

Cancer researchers are closer than ever to achieving their long-held dream of turning the disease from a death sentence to a chronic illness. This would be a remarkable scientific achievement. But while people may soon routinely live decades with their cancer in remission or even cured, they will not become immortal. Most will eventually suffer from some other debilitating condition and require a period of long-term supports and services.

A New Snapshot of America’s 44 Million Family Caregivers: Who They Are and What They Do

A landmark new study paints a dramatic picture of family caregivers: Nearly 44 million adults in the US are providing personal assistance for family members with disabilities or other care needs. That’s more than one out of every six adults. More than 34 million care for frail elders and nearly 4 million help children with disabilities. About 6.5 million care for both.

The typical family caregiver is a 49-year-old woman who is assisting a parent or in-law and working at a paid job. She reports spending an average of about 24 hours-a-week providing personal assistance such as bathing or dressing or helping with activities such as shopping or rides. Almost six in 10 say they perform nursing or other complex care tasks, such as giving oral medicines or injections, wound care, or operating medical equipment.

What New Managed Care Regulations Will Mean For Frail Elders

Federal regulations are finally catching up with a decade of seismic change in the delivery of Medicaid services. More than 650 pages of proposed new rules are aimed at overseeing managed care, which has become the standard health care delivery system for low-income adults and children, and is now being expanded to include both medical care and long-term supports and services for older adults and younger people with disabilities.

Many of the new regulations are aimed at boosting consumer protections for those enrolled in these managed care plans, including frail elders.

What Medicare and Medicaid’s Ratings Say About Nursing Homes

For all of its flaws, Medicare and Medicaid’s Nursing Home Compare five-star rating system gives consumers a head-start when searching for a facility. Now, the Kaiser Family Foundation has taken a closer look at the ratings, and reached some interesting conclusions:

  • In a system that rates facilities from 1-5 stars, about one-third have low 1 or 2 star ratings, while about 45 percent received 4 or 5 stars.
  • Non-profits, which represent only about one-quarter of nursing facilities, generally get higher ratings than for-profits.
  • Smaller facilities score higher than larger ones.

Senators Want To Improve Medicare For Seniors With Chronic Diseases, But Are Ignoring Half The Problem

A powerful bipartisan group of U.S. senators wants to improve medical care for older Americans with chronic disease. By doing so, they are taking an important step in improving the health and quality of life of these seniors.

But so far at least, they are focusing on only half the problem. While older people with chronic conditions do need improved medical care, they also need better social supports, personal assistance,  access to services such as transportation, and safe and affordable housing.  Improving delivery of medical care without including social supports is like pumping air in a flat tire without first fixing the puncture.

Why Old People Get Such Bad Medical Care

In a recent essay in The Washington Post, geriatrician and author Jerald Winakur described the recent hospital experience of his 91-year-old mother. You won’t be surprised to learn it was a nightmare: Poor pain management, overworked staff, insufficient training, little communication among physicians and no communication between his mom and the waves of medical professionals who treated her each day.

She survived her two-month hospital stay but, Winakur suggests, only because he and his brother were constantly at her side.

Hill Republicans Won’t Try To Restructure Medicare—Yet

Congressional Republicans agreed to a non-binding budget framework yesterday that would slow projected growth of Medicare, but not completely restructure the program as the House GOP wanted.

House Republicans tried to use the budget process to fundamentally rewrite Medicare, turning it from an open-ended entitlement program to a model known as premium support. But the move was blocked by Senate Republicans, who feared a political firestorm.

In the premium support model, the federal government would provide a fixed subsidy (or a voucher) to help seniors buy insurance on the open market. Participants would gradually pay a much greater share of the program cost than they do today.

AARP’s New Evidence That Medicare’s Hospital Observation Rules Are a Mess

Of all the complex rules that plague fee-for-service Medicare, few are harder to understand and potentially more important for seniors than observation status. By now, many older adults have heard the phrase. But they are still not clear what it means.

A new study by AARP sheds some light on the consequences for seniors of hospital observation stays. But they turn out to be a muddle, in part because Medicare pays for hundreds of millions of dollars of skilled nursing facility care that probably should be billed to patients.