The most important trend in care for the frail elderly and younger people with disabilities may be what’s called managed long-term supports and services, or MLTSS. This effort to combine medical care with long-term care would replace today’s disorganized, ineffective, and even dangerous system with one that can bring together complex care that’s being delivered by many different providers. Done [...]
A new Medicare payment model would encourage health systems to provide fully-integrated medical care for people with chronic disease, according new bipartisan legislation sponsored by senators Ron Wyden (D-OR) and Johnny Isakson (R-GA), and congressmen Erik Paulsen (R-MN) and Peter Welch (D-VT). The measure would allow, but not require, participating providers to offer long-term services and supports as well as medical [...]
The Washington Post published an extensive investigative story on hospice the other day. The take away: Hospices (mostly for-profits) are making big bucks by manipulating their case loads to maximize Medicare payments. In short, they are taking on many patients who are frail but not dying and thus staying on hospice care for a very long time. But the Post [...]
Despite the fears of consumer advocates and the predictions of many insurance companies, seniors are flocking to Medicare Advantage managed care plans. It shouldn’t be a surprise since premiums for these policies are a fraction of the cost of traditional fee-for-service Medicare. This shift may be one driver of the recent slowdown in the growth of health care costs and [...]
In the past few weeks, no fewer than three highly respected groups have proposed major health care reforms. They all promise greater use of patient-centered integrated care, but none include supports and services for frail elders or younger people with disabilities. It took four decades to incorporate a drug benefit into Medicare. Now we seem to be in the same place [...]
California has taken the idea of managed care for low-income seniors and people with disabilities to a whole new level. Under an agreement with the Obama Administration announced last week, the state will begin shifting both medical care and long-term supports and services to managed care companies in just seven months. Watch this closely. You may be looking at the [...]
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, [...]
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 [...]
Patient-centered care (as it is described by doctors) or person-centered care (the phrase-more frequently used in non-medical settings) is one of those concepts everyone supports--except when it comes to the details. On Nov. 8-9, I'll be participating in a two-day symposium sponsored by the Samueli Institute aimed at breaking down the barriers between the medical and non-medical world and seeking evidence [...]
Everybody wants to do a better job coordinating care for the frail elderly and younger adults with disabilities who have extensive medical and personal care needs. But just how to do it is becoming increasingly controversial—especially on Capitol Hill. The current flashpoint is an aggressive new Obama Administration initiative aimed at improving care and cutting costs for those who are [...]