Kudos to President Obama for making a "recess appointment" of Don Berwick to run the Centers for Medicare and Medicaid Services (CMS). Berwick may be the ideal choice for the job. He is the right candidate at exactly the right time. The new health law makes possible broad reforms in the way we deliver health and long-term care. But it by no [...]
Medicaid long-term care is well on its way to destroying state budgets, according to a new study by the international consulting firm Deloitte LLC. By 2030, according to estimates by the firm's Center for Health Solutions, Medicaid long-term care benefits for both home and nursing facility care will absorb a staggering 18 percent of total state budgets if current trends continue. Overall state [...]
For the first time since President Bush's ill-fated effort to privatize Social Security five years ago, the future of the nation's flagship retirement program is back on the policy agenda. For example, Social Security will almost certainly be an issue for President Obama's deficit reduction commission. Unfortunately, we may be headed for the same non-productive shouting match we had over the Bush [...]
The health reform bill passed by Congress last night includes big changes in the way we pay for long-term care, both at home and in nursing facilities. The reforms will give the elderly and disabled far more flexibility in the way they get care and, at the same time, begin turning long-term care from largely a welfare program to an insurance system. The biggest change [...]
Connie Garner, the top Senate staffer on long-term care issues, said today that she is certain the CLASS Act, which would create a new national long-term care insurance program, will be included in the final health bill being considered by Congress. "I don't have any question CLASS will survive," Garner told a long-term care conference sponsored by the journal Health Affairs. [...]
I spent today with the New Hampshire legislature's long-term care caucus and a group of stakeholders as they wrestled with the challenges of expanding the state's Medicaid home and community based care program for the elderly and adults with disabilities. Thanks to a kind invitation from State Representative Kate Miller, who chairs the caucus, AARP executive vp John Rother and I were able [...]
In a bit of surprising news, Senate Finance Committee Chair Max Baucus (D-Mont) added some key long-term care amendments to his health reform bill. The provisions, first proposed by senators John Kerry (D-Mass), Maria Cantwell (D-WA), and Chuck Schumer (D-N.Y.) would all make home and community based care more accessible under Medicaid. Currently, Medicaid is only required to provide long-term [...]
For those interested in long-term care, the House Democrats' consensus health reform bill is pretty disappointing. Unlike the Senate Health, Education, Labor, and Pensions Committee version, it includes no proposal for national long-term care insurance. And it largely ignores efforts to expand access to home care for those on Medicaid, who now often can only get care in nursing facilities, or to better coordinate care [...]
The Democrats on the Senate Health, Education, Labor, and Pensions Committee have, as I expected, included three key long-term care services proposals in their massive 615-page health reform bill. The measure would require states to offer the same access to home and community care as they currently provide for skilled nursing facilities under Medicaid. It would provide new incentives for training both paid [...]
If you are impoverished and unable to care for yourself, Medicaid is required by law to provide long-term services--in a nursing home. Although the frail elderly and younger people with disabilities overwhelmingly prefer to stay at home, states are under no obligation to offer care in the community. So here is an idea: Why doesn't Medicaid make home care the default option for assistance? [...]