Older men are living longer and enjoying more active lives than ever before. In fact, in a dramatic change from three decades ago, these men can now expect their last decades of life to look very much like that of women. Even as men live longer, they are less likely to suffer physical limitations than in past years, and when [...]
You’ve probably heard somebody say, “assisted living is the new nursing home.” A new study suggests that, in important ways, it is true. People living in residential care communities, including assisted living, care homes, or adult group homes, look a lot like those who once lived in nursing homes. They suffer from serious chronic conditions, need assistance with daily activities [...]
Imagine you are 75 and suffer a stroke. You have some financial assets but, suddenly facing a lifetime of unexpected personal care needs, you are worried about outliving your money. You never bought long-term care insurance and could never pass underwriting that would allow you to buy now. What do you do? You could tap your home equity with a [...]
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 [...]