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 [...]
Yesterday morning, a veteran of the decades-long effort to improve the way we deliver and pay for long-term supports and services asked me a question. Why, he wondered, should he believe that recent attempts to reform long-term care could succeed when so many previous initiatives have failed. Last evening, I may have found an answer. My wife and I went to see [...]
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 [...]
With the presidential election in less than two weeks, consumers, advocates, and providers should pay attention to what Barack Obama and Mitt Romney would do about long-term supports and services for the frail elderly and younger people with disabilities. It is hard to know for sure, because neither man has said much. Yet, between the lines, there are important messages. [...]
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 [...]
Insurance giant Wellpoint is the latest carrier making a big bet on managing care for those seniors and adults with disabilities who are eligible for both Medicare and Medicaid. About 9 million people, called “dual eligibles” receive benefits from both programs. They are both very poor and very sick and often have significant needs for personal assistance. Medicaid alone spends $145 [...]
People often say that the patients most at risk in the U.S. health system are the elderly who suffer from multiple chronic diseases. But it may be that a subset of these seniors—those with chronic disease who also need personal assistance with routine activities—are in the most jeopardy. An important 2011 research paper finds they are the most costly to care [...]
By upholding the constitutionality of the Affordable Care Act, the Supreme Court has preserved—at least for now—major changes in the way long-term care supports and services are delivered and financed. Here are some provisions of the law that directly affect the frail elderly and younger adults with disabilities. Medicaid: The law is filled with important changes to this state/federal program [...]
WBUR radio and Kaiser Health News report that the Massachusetts Senate has quietly approved a measure requiring doctors and nurses to discuss end of life options with patients who have a terminal illness. The Palliative Care Awareness bill was included as part of a sweeping health reform measure and, remarkably, was not controversial. It was supported by both Republicans and Democrats and [...]
The fate of many important health reforms aimed directly at seniors is in the hands of the Supreme Court. While the public has focused most of its attention on whether the High Court will strike down the individual mandate in the 2010 health reform law, the justices today are hearing arguments about another critical issue: What should happen to the rest of the Affordable Care [...]