At first glance, it looks like Medicaid and other key government programs for the frail elderly and others with disabilities avoided a major hit in the debt limit agreement reached by Congress today. But in truth all of these programs remain in severe jeopardy. The complex deal calls for several stages of deficit reduction. The first is a cut of $25 billion [...]
We all know the sad story: Despite extensive rehab, a patient in a skilled nursing facility is failing. Instead of improving, she is finds herself returning to the local hospital with trouble breathing, heart failure, or unmanaged pain. Eventually, she may die in the hospital hooked up to a ventilator and feeding tube that she never wanted. A team at [...]
Next week, I'll be speaking to faculty and others at the University of Massachusetts School of Medicine on the importance of fully integrating long-term care services and supports with medical care. On May 23, I'll be delivering the same message to a large non-profit health system that includes more than two dozen hospitals. Physicians and health system adminstrators are beginning to get it: [...]
In recent weeks, I've written about what the House Republican plan to cap federal Medicaid contributions would mean to the frail elderly and younger adults with disabilities who are receiving care at home. Today, I'll take a look at what it would mean for skilled nursing facilites and their nearly 900,000 residents whose care is paid for by the joint federal/state program. The picture is [...]
As if we needed it, this week has provided yet more evidence that the world of both medical and long-term care services for seniors is changing in profound ways. It is complicated and hard to follow, but the bottom line is this: There will be increasingly less government support for the services frail seniors and their families need. And senior services [...]
The House Republican Budget proposal released today calls for the biggest changes in health and long-term care services for the elderly in a half-century. While there is no chance that these proposals will be enacted as proposed, they reflect a profound sea change in the way many in Washington look at assistance for seniors, and especially for the frail elderly. [...]
Hospital readmissions are bad for patients—especially seniors who may already be weakened by multiple chronic disease. They cost tens of billions of dollars. They are not even good for hospitals (at least not top-quality facilities that regularly fill their beds). About one in five Medicare patients are readmitted within 30 days, and one-third within 90 days, according to a New [...]
As Medicaid budget pressures grow, more states are turning long-term care over to private managed care companies. USA Today reports that six states now require both frail elderly and younger adults with disabilities to enroll in insurance-run Medicaid managed care plans. Another 10 states are planning to either create or expand these programs, according to the story. The reason, of course: money. States pay the [...]
In the decade between 1999 and 2008, almost 3,000 nursing homes closed while the number of skilled nursing facility beds shrunk by nearly 100,000, or about 5 percent, according to a new study in the Archives of Internal Medicine. In a nation with more nursing homes than McDonald's, and at a time when long-term care can be provided in other settings, that may not be [...]
The co-chairs of President Obama's bipartisan deficit commision have proposed a far-reaching plan to reduce the nation's massive deficit. It includes big changes for both current and future seniors. Among them: higher Social Security taxes and reforms in the design of benefits, reduced payments to Medicare providers and greater cost sharing by Medicare beneficiaries, and, perhaps most dramatic, a fundamental change in federal payments for Medicaid long-term [...]