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 [...]
On Thursday, I'll be participating in an Urban Institute panel on the future of the Community Living Assistance Services and Supports (CLASS) Act, the new national voluntary long-term care insurance program in the 2010 health reform law. It should be an interesting discussion, with other participants including Marty Ford, cochair of the Long Term Services and Supports Task Force, Consortium for Citizens with Disabilities; Rhonda Richards of [...]
I'm just back from a two day conference sponsored by the Catholic Health Association on ways we can do a better job integrating both medical and personal care for chronically-ill seniors. There may be no more important issue for the delivery of care to this population. If you don't believe me, ask Don Berwick, who runs the Medicare and Medicaid programs for the federal [...]
Medicaid, which funds more long-term care supports and services than any other payer--$115 billion in 2008--is about to crash. Like a head-on train wreck, we can see it coming. The question is: What are we going to do about it? The Kaiser Family Foundation, in an extensive new survey of all 50 state Medicaid programs, tells the grim story. Medicaid is [...]
What do family caregivers want? What do they need? Education and training. Respite care. And, most important, peer support. Those are the conclusions of the HSC Foundation, which, along with several partners, organized a series of 2009 listening session to hear what caregivers had to say. They were not necessarily caregivers of parents or other frail elderly family members, Some were caring for wounded vets, others [...]
I was fascinated by both Dale Russakoff's recent New York Times blog post on dementia care and the reader comments her article generated. Dale's piece was a list of tips on how to care for a person with Alzheimer's and similar diseases. Many were sensible enough, but they didn't begin to describe how difficult it can be to care for a dementia patient. The real lesson is a simple, but painful, [...]
For months, physicians have been refusing to take new Medicare patients, and some are now even dropping long-time patients. The problem: Congress's inability to resolve a now 13-year-long argument over how much Medicare should pay docs. The whole mess started in 1997, when the government concluded that Medicare was overpaying many doctors. The reality was that some physicians probably were being paid too much while others were [...]
By now, long-term care providers and consumers may know something about MRSA, the antibiotic-resistant infection. But chances are they don't know nearly enough. If you want to learn more--and believe me, you need to learn more--pick up a copy of Maryn McKenna's new book Superbug. (Free Press 2010). Part detective story, part expose, part careful explanation of the science of bacteria, Superbug is a frightening [...]
The compromise health reform plan proposed today by President Obama includes many of the key long-term care provisions that were included in the earlier House and Senate bills. The CLASS Act--the national long-term care insurance program--along with federal incentives to encourage states to expand their home and community based care programs under Medicaid, and improved care coordination for those receiving both Medicare and Medicaid [...]
Pity the supporters of the CLASS Act, the proposal to create a national long-term care insurance system. They are on to an important idea, but they are caught between the proverbial rock and a hard place. Here's the problem: much of the congressional support for the CLASS Act is based on the Congressional Budget Office estimate that it will generate [...]