Broad-based, integrated, community-wide initiatives can help keep seniors out of the hospital, says an important new study from the Journal of the American Medical Association. The study, done by a team led by Dr. Joanne Lynn of the Altarum Institute’s Center on Elder Care and Advanced Illness is new evidence that by working together, hospitals, physicians, social workers, nursing homes, [...]
Health policymakers love the idea of hospice. Yet Medicare seems to be learning exactly the wrong lessons from the success of the program, which provides well-integrated patient-centered comfort care to people with terminal illness. Instead of trying to understand why hospice is growing in popularity, Medicare is instead making it harder to enroll. As often happens in its regulation of [...]
On New Year's Day, as part of the law that kept the nation from toppling over the fiscal cliff for two months, Congress quietly repealed the Community Living Assistance Services & Support (CLASS) Act, and created a new commission to recommend broad long-term care reforms that could affect financing, delivery and care workers. I was, and continue to be, very skeptical about the commission's ability to [...]
The New Year's budget agreement to avoid the fiscal cliff includes two key measures that could be critical to people receiving long-term supports and services and their caregivers. The first repeals the Community Living Assistance Services and Supports (CLASS) Act. The second creates a new national commission to develop a plan for better financing and delivery of long-term care services. Unfortunately, there may be [...]
In 2012, about 13 million seniors participated in Medicare Advantage (MA) managed care plans—about 27 percent of the Medicare population and twice as many as were enrolled just seven years ago. This rapid shift to managed care by seniors may be just a first step towards a fundamental change in the way Medicare is delivered and financed. And it has the [...]
A new insurance company survey of financial advisers reports that four-in-ten have clients who ask about giving away their assets so they can become eligible for Medicaid long-term care. Oddly, though not surprisingly, the same advisers report their clients say that a key goal of their long-term care planning is “maintaining control.” The online survey, by Nationwide Financial, questioned a [...]
Slowly but surely, more people who receive Medicaid benefits for long-term supports and services are getting their care at home rather than in nursing facilities. Still, only about 3.3 million seniors and younger people with disabilities who require long-term care get such help at home—about 1 million more than in 2000. Overall, the program now spends about $50 billion or [...]
Too often, we stash our elders away in institutional residential care facilities. And, sadly, even many active seniors choose to separate themselves from the broader world, opting for what they see as the safety and security of gated communities. This week, I spent a couple of days in Rochester, N.Y., where the St John’s Living Community has developed two [...]
Medicaid is in the budget bull’s eye. But many lawmakers aiming to cut the program have no idea what it does, and how important it is to frail seniors who need help with daily living. The popular image of Medicaid: health care for a poor mother and her children. The all-too-common reality: long-term supports and services for an 85-year old [...]
With the election behind him, Barack Obama's first item of business will be dealing with the fiscal cliff--that toxic combination of tax increases and automatic spending cuts that are due to kick in on Jan 2, unless Congress acts to delay or replace them with a long-term deficit reduction plan. Going over the cliff would mean deep cuts in a wide range of government programs. [...]