For seniors trying to manage multiple chronic disease, moving from one care setting to another can literally be a matter of life and death. That's why it is so important that health providers--doctors, nursing homes, hospitals, assisted living facilities, and home care agencies--work together to make sure that those moves happen safely. Too often in our poorly coordinated health and long-term care systems, those [...]
It is a tough time to try to sell long-term care insurance. The private market was stunned on Nov. 11 when MetLife, one of the nation's biggest carriers with insurance on 600,000 lives, announced it would stop selling new policies. At the same time, surveys by two of the nation's most respected long-term care researchers suggest why it will continue to be very [...]
The co-chairs of President Obama's bipartisan deficit commision have proposed a far-reaching plan to reduce the nation's massive deficit. It includes big changes for both current and future seniors. Among them: higher Social Security taxes and reforms in the design of benefits, reduced payments to Medicare providers and greater cost sharing by Medicare beneficiaries, and, perhaps most dramatic, a fundamental change in federal payments for Medicaid long-term [...]
There is lots of quiet speculation in Washington about the fate of the CLASS Act in the wake of the huge Republican 2010 election day victory. Will CLASS be repealed? Will it be changed in any major way? My best guess is that CLASS--the national voluntary long-term care insurance program passed as part of the 2010 health reform law--will neither be repealed nor fundamentally [...]
After my mother-in-law died suddenly, my wife and I found ourselves caring for my father-in-law. There was so much we didn't know. One area where we were flying blind: We had no idea what financial resources he had, what banks and mutual funds he used, or how to access the funds he needed to pay for his home health aides and, later, assisted living [...]
It is an article of faith among many in the elder and disability advocacy communities that aging in place is always the best alternative for someone who needs personal care. I don't believe it, and I recently heard an important panel discussion that confirmed that view. The panel, sponsored by Washington Grantmakers, was especially interesting because the participants were all supporters of [...]
More than half of long-term care residents in skilled nursing facilities made at least one emergency room visit in 2006. A quarter had two or more. Even more troubling, 38 percent were admitted to the hospital at least once that year, and nearly half were admitted twice or more. In all, one-quarter of all hospitalizations for nursing home residents were potentially preventable. These very [...]
The other day, Josh Wiener, who is one of the nation's experts on long-term care, presented three papers on certified nursing assistants (CNAs) in nursing homes. Josh and his colleagues at the consulting firm RTI International looked at quality of care, immigration, and injuries. And some of what they found may surprise you. The papers are available here (some may require [...]
Medicaid, which funds more long-term care supports and services than any other payer--$115 billion in 2008--is about to crash. Like a head-on train wreck, we can see it coming. The question is: What are we going to do about it? The Kaiser Family Foundation, in an extensive new survey of all 50 state Medicaid programs, tells the grim story. Medicaid is [...]
In an important new study, Lynne P. Snyder and Christopher Baker show the importance of energy assistance for elders living at home. The paper, Affordable Home Energy and Health: Making the Connections, was published by AARP. It is another example of why it is not enough for states to provide Medicaid waiver programs to help people receive long-term care at home. Without additional [...]