Monday, October 3, 2011

Long term services and the deficit

Today, I went to an alliance for health reform session on long term services and support (LTSS) (replaces the term long term care).  The panel is described:

the Alliance for Health Reform and The Commonwealth Fund are sponsoring an October 3 luncheon briefing. Panelists will be: Bob Hornyak, Administration on Aging; Cynthia Woodcock, Impaq and formerly Hilltop Institute; and Carol Raphael, Visiting Nurse Service of New York. Mary Jane Koren of Commonwealth and Ed Howard of the Alliance will co-moderate.

Very worthwhile session. While the panel did not have an asnwer to my question on what changes would they propose re LTSS and the deficit super committee, here are some of my ideas

1) Integrate the funding of medicare and medicaid.  Right now these funds are not that integrated, so that Medicare pays one set of providers or plans, and medicaid pays another set.  Somehow integrate the payment systems, either medicare funds go to medicaid plans and providers or visa versa. 

2) Pay for chronic care/LTSS through managed LTSS.  Ensure that there are bonuses, e.g., pay for performance, for better quality of care. This is especially need for dual eligibles. 

3) Do more to integrate LTSS.  Right now hospitals, nursing homes, home care, etc are not integrated very well.  We need to find ways to integrate.  Some possible ways are  to have a coordination council, or use care managers. Managed care plans could do this, but many are not setup to do so.  Integrate housing programs into the system and other delivery services, e.g, meals, transportation, etc. 

4) Provide more incentives for individuals and families to purchase long term care insurance. 

1 comment:

  1. A report issued after this posting.
    Under Medicare's Umbrella--Dual Eligibles by the urban institute. see