Sometimes, you just have to say what is crashingly obvious. And when it comes to older adults aging at home, here it is: If seniors are going to avoid a nursing home, they need a safe, affordable alternative. Without one, they may die prematurely. And even if they live, they will almost surely need institutional care, which may be a [...]
Public opinion surveys show that most Americans incorrectly think Medicare pays for long-term supports and services (LTSS). It does not. But should it? Should Congress add a long-term care benefit to the program’s current package of insurance for hospital care, doctor visits, and drugs? Three highly respected health researchers, Karen Davis, Amber Willink, and Cathy Schoen, think it should. In [...]
We all want to live at home as we age. But while we may not want to admit it, getting the support we need can be much tougher at home than in a nursing home or assisted living facility. For all their problems, nursing homes or residential care facilities can be an efficient way to deliver care to many people [...]
A new Medicare pilot program will make it easier for patients to access some hospice benefits without giving up standard medical treatment for a terminal disease. It is an important step towards building a health system that fully integrates social, spiritual, and palliative care such as pain management with health care. But it doesn’t get all the way there. Today, [...]
Today, America’s vision of long-term care is limited and grim. Supports and services for frail elders or younger people with disabilities are delivered in a fragmented, disorganized way that puts recipients of care at risk for serious harm or even death and likely wastes billions of dollars. Indeed, if the goal of supports and services is to provide the best [...]
The number of people needing long-term supports and services is likely to double by mid-century, and there is broad agreement across the political spectrum that our system for delivering and financing that care is, frankly, terrible. But for years, these problems seemed intractable. How could we break the political gridlock that has infected this issue, along with so many others? [...]
Federal regulations are finally catching up with a decade of seismic change in the delivery of Medicaid services. More than 650 pages of proposed new rules are aimed at overseeing managed care, which has become the standard health care delivery system for low-income adults and children, and is now being expanded to include both medical care and long-term supports and [...]
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 [...]
What if they gave a managed care plan and nobody came? That seems to be the problem with California’s ambitious effort to enroll more than 400,000 low-income seniors and younger people with disabilities into a fully-integrated care program that covers both medical treatment and long-term supports and services. The idea has enormous promise, but relatively few Californians seem willing to [...]
Medicare, which will celebrate its 50th anniversary next year, needs to be fixed. But if backers of reform frame that change primarily as a way to reduce federal spending, they are doomed to fail. The other day, former Republican senator Judd Gregg wrote a guest column in The Hill newspaper about a gathering of policy wonks at Dartmouth College aimed at reforming [...]