Imagine being able to receive fully integrated medical, social, and spiritual care in your own home. Nursing care is available 24/7. Home health aides provide basic personal assistance. Care is person-centered and focused on the specific needs of each patient. And for people with incurable chronic conditions, it focuses on managing symptoms, including pain, thus vastly improving their quality of [...]
Medicare has a huge and growing problem caring for patients after they have been discharged from the hospital. After years of talk, Congress may be about to take a modest but important first step toward cleaning up the mess, and making sure that patients get care that gives them the best chance to live a healthy and active life after a [...]
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 [...]
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 [...]
The most important trend in care for the frail elderly and younger people with disabilities may be what’s called managed long-term supports and services, or MLTSS. This effort to combine medical care with long-term care would replace today’s disorganized, ineffective, and even dangerous system with one that can bring together complex care that’s being delivered by many different providers. Done [...]
A new Medicare payment model would encourage health systems to provide fully-integrated medical care for people with chronic disease, according new bipartisan legislation sponsored by senators Ron Wyden (D-OR) and Johnny Isakson (R-GA), and congressmen Erik Paulsen (R-MN) and Peter Welch (D-VT). The measure would allow, but not require, participating providers to offer long-term services and supports as well as medical [...]
After Thomas J. McInerney took the helm of insurance giant Genworth Financial Inc. last January, he ordered an intensive review of the firm’s long-term care insurance business. Genworth was one of the biggest players in the market, but the industry was struggling and investors unhappy. In an exclusive interview, McInerney tells Caring for Our Parents about his decision to stay [...]
Despite the fears of consumer advocates and the predictions of many insurance companies, seniors are flocking to Medicare Advantage managed care plans. It shouldn’t be a surprise since premiums for these policies are a fraction of the cost of traditional fee-for-service Medicare. This shift may be one driver of the recent slowdown in the growth of health care costs and [...]
California has taken the idea of managed care for low-income seniors and people with disabilities to a whole new level. Under an agreement with the Obama Administration announced last week, the state will begin shifting both medical care and long-term supports and services to managed care companies in just seven months. Watch this closely. You may be looking at the [...]
America’s system for financing long-term care is failing, and the window for creating a payment system that works is rapidly closing. That was the conclusion of a morning-long expert session sponsored last week by the SCAN Foundation. While the participants differed on specific solutions, most agreed on four key issues: The existing system for funding paid long-term supports and services [...]