Tips
for Choosing Assisted Living as an Alternative
Alzheimer’s Study Group Reveals Strategic Plan
Guest Columnist: Lessons Learned From the Great Depression
National Service Target of New Bill
Retirement Confidence Plummets During Recession
Senior Health: Alexander Technique Can Improve Your Quality of Life
Along The Boomer Trail: America’s Royal Couple Visits the Windsors
Ken's Corner: It’s the ‘Thingamajig’ Making Those Mysterious Noises
Health Reforms Must Include Long-Term Care Plan
By
Stephen Baetge
Staff Writer
Leaders
from the nation’s top long-term care advocacy organizations
have presented a reform proposal to the president and Congress that
they claim will enhance senior care choices and save $35 billion
over 10 years but cautioned that any broad-based reform of the nation’s
health care system in the months ahead will be incomplete without
including long-term and post-acute care as part of the fix.
The proposal was developed by the American Health Care Association (AHCA), the
National Center for Assisted Living (NCAL) and the Alliance for Quality Nursing
Home Care (QNHC).
Assessment of the proposal was provided by health care strategy analysis firm,
Avalere Health, using a new proprietary model to assess the federal costs of
change in long-term care policy using methods and assumptions similar to those
employed by the Congressional Budget Office.
According to Avalere, reforming the Medicare post-acute payment system would
generate $81 billion in savings over 10 years of operation. Those savings would
offset the costs of launching a new federal long-term care program estimated
to cost $46 billion over the 10 years it would take to come to fruition.
The total 10-year program savings is $35 billion. A full set of assumptions and
methods is published in the report entitled, “Post-Acute and Long-Term
Care Reform/ Estimating the Federal Budgetary Effects of the AHCA/NCAL/Alliance
Proposal.”
“The health reform goals debated today — achieving greater efficiency
and value for the healthcare dollar, adding discipline to Medicare spending and
better use of evidence to improve patient experience — are inextricably
tied to improving long-term and post-acute care in the U.S,” explained
Anne Tumlinson, a vice president at Avalere Health and lead author of the firm’s
analysis. “Any meaningful reform effort will involve a careful analysis
of choices, policy options and trade-offs.”
Key components of the AHCA/NCAL/Alliance plan include a voluntary federal long-term
care benefit and greater choice of care settings and services for consumers with
expanded access to assisted living and other home- and community-based services
in addition to nursing facility care.
The plan also includes qualification guidelines for indigent participants who
would be exempt from payment of plan participation fees ranging from $50,000
to $180,000 based on income and assets. Care costs above those paid by participants
would be paid by the government.
The plan increases the effectiveness of health care coordination as part of the
overall benefits package and also includes development of a new “prospective
payment system” for Medicare post-acute care services that would base payments
on patient need instead of the setting in which services are delivered.
Supporters of the proposal cautioned that decisive action is necessary to ensure
the plan is effective.
“The health care reform goals articulated by President Obama and our congressional
leaders — expanding access, improving quality, enhancing choice, boosting
efficiency and controlling costs — can now be achieved in a realistic,
comprehensive manner by adopting our proposal,” stated Bruce Yarwood, president
and CEO of AHCA.
“There exists a narrow window of time to achieve the global reforms that
will guide the U.S. health system for decades to come, and we must not allow
this enormous opportunity to escape our collective grasp,” he concluded.
Others emphasized the need for long-term care reform as part of an overall plan
to deal with the American health care system.
“Addressing post-acute and long-term care in the manner we advocate — which
has now been validated by highly credible health policy experts — is not
only consistent with the overarching national goal of health care reform, it
is central to achieving it,” opined Alan G. Rosenbloom, president of the
Alliance. “This plan provides a substantive roadmap to accomplish many
of the key reform policy objectives that will benefit every American.”
There was also a call to action directed at long-term care professionals as well
as to elected officials.
“Now that there is a strong, credible plan to bring about positive change
that benefits every senior in need of care, it is incumbent on our elected leaders
as well as our profession to help move this proposal from the drawing board to
the health care marketplace,” David Kyllo, executive director of NCAL declared.
AHCA/NCAL/Alliance leaders said the current patchwork approach to reform is unsustainable
in its present form and will eventually collapse.
They also said that accessing the long-term care they need to live productive,
dignified lives requires many older Americans to exhaust their personal resources
and declare bankruptcy — which in itself is an admission the system is
morally wrong.
Advocates stressed that the demand for eldercare services like those under discussion
is expected to double by 2040 and that America has an obligation to reform the
nation’s healthcare system in a manner that optimizes quality, choice and
efficiency throughout the health care system.
This page and its contents ©2009
Metropolitan News Company, Inc.
