I recently had the pleasure of speaking to NICHE, (Nurses Improving Care for Healthsystem Elders) a joint venture of the Hartford Institute and the New York University School of Nursing dedicated to improving the quality of geriatric nursing. NICHE understands that caring for elders is not like caring for younger patients, and it has developed new techniques to both assess [...]
As if we needed it, this week has provided yet more evidence that the world of both medical and long-term care services for seniors is changing in profound ways. It is complicated and hard to follow, but the bottom line is this: There will be increasingly less government support for the services frail seniors and their families need. And senior services [...]
The House Republican Budget proposal released today calls for the biggest changes in health and long-term care services for the elderly in a half-century. While there is no chance that these proposals will be enacted as proposed, they reflect a profound sea change in the way many in Washington look at assistance for seniors, and especially for the frail elderly. [...]
Hospital readmissions are bad for patients—especially seniors who may already be weakened by multiple chronic disease. They cost tens of billions of dollars. They are not even good for hospitals (at least not top-quality facilities that regularly fill their beds). About one in five Medicare patients are readmitted within 30 days, and one-third within 90 days, according to a New [...]
On Thursday, I'll be participating in an Urban Institute panel on the future of the Community Living Assistance Services and Supports (CLASS) Act, the new national voluntary long-term care insurance program in the 2010 health reform law. It should be an interesting discussion, with other participants including Marty Ford, cochair of the Long Term Services and Supports Task Force, Consortium for Citizens with Disabilities; Rhonda Richards of [...]
Home equity can be a valuable tool for cash-strapped seniors who need to fund their long-term care needs. But one method, reverse mortgages, is running into a raft of new problems, including higher interest costs and a lawsuit by AARP that promises to be a public relations nightmare for the industry. Unlike traditional mortgage loans, RMs are a way for those 62 and [...]
Money Follows the Person is a cornerstone of the federal government's effort to move Medicaid beneficiaries from nursing homes into the community. But a new study commissioned by Medicaid itself shows how difficult those transitions can be. In the 30 states that have been testing the program over the past three years, only 8,500 people have used MFP to return to their communities. That's [...]
Powerful Republicans are pushing the twin ideas of capping the federal contribution to Medicaid and eliminating federal regulation of the program. These changes would do profound damage to the Medicaid benefit for long-term care, whether it is provided at home or in nursing facilites. This plan would turn Medicaid from a federal entitlement into a block grant. Over time, states would be responsible [...]
As Medicaid budget pressures grow, more states are turning long-term care over to private managed care companies. USA Today reports that six states now require both frail elderly and younger adults with disabilities to enroll in insurance-run Medicaid managed care plans. Another 10 states are planning to either create or expand these programs, according to the story. The reason, of course: money. States pay the [...]
President Obama's 2012 budget is the latest indication of the growing pressures government-provided aging services will face in coming years. And as tight as his budget is, spending on assistance for poor and frail seniors is likely to end up much lower than Obama proposed. With congressional Republicans vowing to cut $100 billion from domestic spending over the remaining seven [...]