For three years, I’ve been working with a diverse group of policy experts to create a consensus framework for financing long-term supports and services (LTSS). This morning, the Long-Term Care Financing Collaborative, released its recommendations. And they are built around two major reforms: a new universal catastrophic long-term care insurance program and major improvements to Medicaid’s LTSS benefit. Our insurance [...]
We’ve all seen those best- places-to-retire lists. Inevitably, they are based on low taxes, good weather, or lots of activities. But how about this metric: Where will you get the best care if you are old and frail? Hint: Oregon is good. Rural Louisiana is not. The Dartmouth Institute for Health Policy and Clinical Practice, which has access to an [...]
In his newly-unveiled 2017 budget, President Obama has proposed little or no increase in federal funding for key senior services programs, higher consumer out-of-pocket costs for brand-name drugs and home health services under Medicare, higher Medicare premiums for upper-income seniors, and reductions in federal subsidies to Medicare Advantage managed care plans. The budget also includes many other changes in the [...]
Four former top government officials—two Democrats and two Republicans—have proposed a new plan aimed at improving the nation’s system for financing long-term care. Their package of ideas is detailed but relatively modest. However, by agreeing to a consensus plan, the officials have taken a major step in raising the profile of the critical issue of long-term care financing. The group [...]
Prodded by Congress, Medicare will tie more of its compensation for doctors and hospitals to the quality of their care. And who, you might ask, could be against such pay for performance--besides incompetent providers trying to preserve their reimbursements? Doesn’t it make sense to pay docs and hospitals for improving the health of their patients rather than for the volume [...]
Dying is trendy. I got an email the other morning about “celebrity deaths.” After the recent demise of David Bowie, Glenn Frey, and “Grizzly Adams,” it seems that everyone is doing it—dying, that is. Apparently, people have been live tweeting the deaths of loved ones at least since 2013. Rock star docs such as Atul Gawande have created their own [...]
The state of Hawaii is about to have a fascinating debate over whether to create a first-in-the-nation universal long-term care insurance program. The benefit would be modest—about $70-per-day for a year-- but it would be available to all long-term residents of the state and be funded through a broad-based tax. The measure will be introduced by Senate Commerce, Consumer [...]
Discharge planning is often a broken link in the chain of care for hospital patients. Older adults and others with complex care needs nearly always need follow-up after they are discharged. They’ll almost certainly have to take new medications. They may need bandages changed after surgery, or physical therapy after a stroke. Unfortunately, they and their families rarely get the [...]
Just before leaving town for the year, Congress passed a budget that increased funding for Alzheimer’s research by 60 percent, but, as usual, provided little new money for programs that help those who have the disease, other frail elders, or their caregivers. Over the past six years, funding for most of these much-needed programs has not even kept up with [...]
I recently received a letter from a caregiver in California, expressing her frustration at the lack of support for family members who sacrifice so much to help loved ones. This is a lightly edited version of what she wrote: I read your story on the difficulties of caring for a family member with dementia and think you really have the [...]