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 [...]
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, [...]
For the first time in years, there is hope that the U.S. can create a new model to help families finance long-term supports and services. The solution isn’t yet visible, and lawmakers won’t address the issue any time soon. But a wide range of private interests including long-term care providers, consumer groups, the insurance industry, and policy analysts seems to [...]
The loud debate over how many people have gotten health insurance under the Affordable Care Act misses the point. Yes, reducing the number of uninsured was one goal of the ACA. But only one. The law’s most enduring legacy will come from its historical—but largely unnoticed—changes in the way health care is delivered. Unlike the insurance expansion, which largely excludes Medicare, many [...]
On Monday, I participated in a PBS NewsHour panel on how to improve services and supports for an aging America. PBS brought together a diverse group of long-term care experts to discuss some interesting international models for delivering supports and services to the frail elderly in a way that allows them to preserve their dignity and independence. The models ranged from [...]
On Monday, Nov. 4, I’ll be on a panel with a group of some highly respected long-term care policy experts to discuss some international creative models for delivering supports and services. The program, which will be held in Washington, is sponsored by the PBS Newshour and funded by the SCAN Foundation. We’ll be discussing a broad range of ideas—from the [...]
Why is there no catastrophic long-term care insurance? It could benefit millions of middle-income people who are able to pay for a few years of services and supports on their own but need to protect themselves against the risk of a very long period of need that would impoverish all but a handful of us. Even though catastrophic coverage is a [...]
A divided congressional long-term care commission has adopted a package of recommendations aimed at improving the nation’s long-term supports and services. However, while a majority of the panel agreed on some modest delivery and workforce reforms, it could not reach a consensus on all-important financing solutions. In effect, the commission will recommend changes that would effectively retain the current framework of financing [...]
It is a cruel paradox: As the cost of long-term care rises and the number of people needing it grows, traditional options for paying for these supports and services are narrowing. Traditional private long-term care insurance is largely disappearing from the marketplace. Reverse mortgages, already something of a niche product, are likely to become harder to get-- especially for those [...]