Many policymakers, health care and insurance executives, and consumer advocates argue that better integrating medical care with long-term supports and services (LTSS) can both save money and improve the well-being of frail elders and younger people with disabilities. It seems logical, and there is some tantalizing evidence that it is true. Unfortunately, health care is filled with ideas that sound [...]
A friend is about to have big surgery that will require a long recovery at home. She and her husband have no idea what to do. Another friend is the primary caregiver of a couple in their 90s—the husband has dementia and his wife had a stroke. The caregiver has no idea what to do. Another friend learns on a [...]
Medicaid long-term care is rapidly changing, and some of those trends may eventually remake the way all of us receive personal assistance as we age or become disabled. Nearly half of all states are now providing Medicaid long-term care benefits through managed care, and 13 states are requiring older adults to receive care that way. At the same time, four [...]
We all want to live at home as we age. But while we may not want to admit it, getting the support we need can be much tougher at home than in a nursing home or assisted living facility. For all their problems, nursing homes or residential care facilities can be an efficient way to deliver care to many people [...]
Federal regulations are finally catching up with a decade of seismic change in the delivery of Medicaid services. More than 650 pages of proposed new rules are aimed at overseeing managed care, which has become the standard health care delivery system for low-income adults and children, and is now being expanded to include both medical care and long-term supports and [...]
A powerful bipartisan group of U.S. senators wants to improve medical care for older Americans with chronic disease. By doing so, they are taking an important step in improving the health and quality of life of these seniors. But so far at least, they are focusing on only half the problem. While older people with chronic conditions do need improved [...]
What if they gave a managed care plan and nobody came? That seems to be the problem with California’s ambitious effort to enroll more than 400,000 low-income seniors and younger people with disabilities into a fully-integrated care program that covers both medical treatment and long-term supports and services. The idea has enormous promise, but relatively few Californians seem willing to [...]
Medicare has a huge and growing problem caring for patients after they have been discharged from the hospital. After years of talk, Congress may be about to take a modest but important first step toward cleaning up the mess, and making sure that patients get care that gives them the best chance to live a healthy and active life after a [...]
For decades, seniors and others with chronic illness have had to scale a seemingly insurmountable barrier built by the health care system, aided and abetted by Medicare and Medicaid. On one side of the wall was medical care, mostly controlled by doctors, hospitals, drug companies, and skilled nursing facilities. Medicare paid them to do as many medical procedures as possible, and [...]
For an important clue into the future of senior care in the U.S., watch Kindred Healthcare, a $5 billion company that operates in 47 states. As recently as 2010, half of Kindred’s business was generated by its skilled nursing facilities. This year, only one-fifth of its revenues will come from its nursing and rehab centers. In a major strategic shift, [...]