Nearly two months ago, Congress created a commission to recommend reforms to the current long-term care system. So what has happened since? Not much. Leaders of Congress have appointed members to serve on the panel but President Obama—who has three of 15 picks-- has not yet made his choices. The commission can’t select a chairman, find a staff, or set an agenda [...]
Seniors continue to be readmitted to the hospital too frequently. But when it comes to explaining why, patients and providers are on Mars and Venus. The patients blame doctors and nurses. Doctors and nurses blame patients. And everybody blames the hospitals. The problem, everyone seems to agree, is that hospital discharges are a mess. Patients don’t understand what they need [...]
Pope Benedict delivered an important message today: There comes a time for most of us when our bodies and minds weaken and we must change the way we live our lives. As with the Pontiff, it may mean giving up a demanding job. But for others, it may mean much more: Getting help with those activities we once took for granted. [...]
Health policymakers love the idea of hospice. Yet Medicare seems to be learning exactly the wrong lessons from the success of the program, which provides well-integrated patient-centered comfort care to people with terminal illness. Instead of trying to understand why hospice is growing in popularity, Medicare is instead making it harder to enroll. As often happens in its regulation of [...]
On New Year's Day, as part of the law that kept the nation from toppling over the fiscal cliff for two months, Congress quietly repealed the Community Living Assistance Services & Support (CLASS) Act, and created a new commission to recommend broad long-term care reforms that could affect financing, delivery and care workers. I was, and continue to be, very skeptical about the commission's ability to [...]
The New Year's budget agreement to avoid the fiscal cliff includes two key measures that could be critical to people receiving long-term supports and services and their caregivers. The first repeals the Community Living Assistance Services and Supports (CLASS) Act. The second creates a new national commission to develop a plan for better financing and delivery of long-term care services. Unfortunately, there may be [...]
Slowly but surely, more people who receive Medicaid benefits for long-term supports and services are getting their care at home rather than in nursing facilities. Still, only about 3.3 million seniors and younger people with disabilities who require long-term care get such help at home—about 1 million more than in 2000. Overall, the program now spends about $50 billion or [...]
Medicaid is in the budget bull’s eye. But many lawmakers aiming to cut the program have no idea what it does, and how important it is to frail seniors who need help with daily living. The popular image of Medicaid: health care for a poor mother and her children. The all-too-common reality: long-term supports and services for an 85-year old [...]
With the election behind him, Barack Obama's first item of business will be dealing with the fiscal cliff--that toxic combination of tax increases and automatic spending cuts that are due to kick in on Jan 2, unless Congress acts to delay or replace them with a long-term deficit reduction plan. Going over the cliff would mean deep cuts in a wide range of government programs. [...]
Last week, Medicare agreed to expand its skilled nursing care and rehabilitation therapy benefit for some people with chronic disease, including many elderly. This added care, which came in a settlement of a lawsuit brought by a Vermont woman named Glenda Jimmo, the Center for Medicare Advocacy, and others is potentially very important for some Medicare beneficiaries. But the settlement [...]