managed care

How To Redesign Long-Term Care For Older Adults After COVID-19

The way we care for older adults in the US is, self-evidently, not working.  In just the past three months, at least  44,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19. Hundreds of thousands have been sickened. And millions have been isolated from family and friends for months. Yet, this crisis did not [...]

By |2020-06-09T10:11:34-04:00June 9th, 2020|long term care reform|10 Comments

Urging Doctors and Health Systems To Recognize The Importance Of Social Supports To Patients 

The influential National Academies of Sciences, Engineering and Medicine (NAS) has called for a major initiative to better integrate heath care and social supports. The group, formerly known as the Institute of Medicine, has published a white paper on the subject that should encourage both policymakers and medical practitioners to pay more attention to the importance of social supports to [...]

By |2019-10-02T10:56:00-04:00October 2nd, 2019|social determinants of health|0 Comments

Can Managed Care Plans Reduce Health Care Costs By Providing Social Supports? Maybe.

Many policymakers, health care and insurance executives, and consumer advocates argue that better integrating medical care with long-term supports and services (LTSS) can both save money and improve the well-being of frail elders and younger people with disabilities. It seems logical, and there is some tantalizing evidence that it is true. Unfortunately, health care is filled with ideas that sound [...]

By |2019-05-01T10:31:56-04:00May 1st, 2019|Care Coordination|1 Comment

Where Do Older Americans Die?

Increasingly, older Americans are likely to die at home, and not in a hospital. And more seniors are using hospice care as they near end of life. However, stubbornly large numbers of Medicare beneficiaries still land in intensive care units or find themselves shuttled from home to hospital and back again in their last months of life. A fascinating and [...]

By |2018-07-01T09:02:56-04:00July 1st, 2018|End of life|0 Comments

Are Medicare Managed Care Plans Steering Members To Low-Quality Nursing Facilities?

Last year, a friend with complex medical needs had multiple stays at a skilled nursing facility (SNF). He was a member of a Medicare Advantage managed care plan and, as a result, could choose among only a handful of in-network facilities within a reasonable distance of his home. The care he received at the available facility was poor and since [...]

By |2018-02-14T12:43:53-05:00January 23rd, 2018|Medicare|1 Comment

Medicare Spends Far More On Older Adults Who Need Personal Assistance

Want to know if an older adult is likely to use lots of medical care? Just ask if she needs help with living activities such as bathing, dressing, or getting out of bed. In a new study with important implications for both caregivers and policymakers, researchers at the Long-Term Quality Alliance (LTQA) found that Medicare spends an average of three [...]

By |2018-02-14T12:43:53-05:00October 30th, 2017|Medicare|2 Comments

A Bipartisan Group Proposes A Package of Modest, But Important Long-Term Care Financing Reforms

The Bipartisan Policy Center, a Washington (DC) based group that develops consensus policy solutions,  has proposed a series of reforms aimed at helping families finance long-term care for themselves and their loved ones. The proposal aims to encourage more people to buy private long-term care insurance, including through Medicare,  and would provide a new Medicare respite benefit for family caregivers. [...]

By |2017-07-12T16:38:29-04:00July 12th, 2017|long-term care financing|0 Comments

Fix The Affordable Care Act By Letting People 55-64 Buy Into Medicare

Congressional Republicans seem once again stymied in their efforts to “repeal and replace Obamacare.” So here is a partial solution that can be a winner for both political parties, the insurance industry, and consumers: Allow people 55-64 to buy into Medicare. And enhance the deal by letting Medicare Advantage plans offer some long-term supports and services, such as personal care, [...]

By |2017-04-28T14:55:11-04:00April 28th, 2017|long term care reform, Medicare|0 Comments

Long-Term Care Is Increasingly Becoming Managed Care At Home

Medicaid long-term care is rapidly changing, and some of those trends may eventually remake the way all of us receive personal assistance as we age or become disabled. Nearly half of all states are now providing Medicaid long-term care benefits through managed care, and 13 states are requiring older adults to receive care that way. At the same time, four [...]

By |2016-10-21T14:00:28-04:00October 21st, 2016|aging in place, Care Coordination, Medicaid|5 Comments