Spousal Caregivers Are Caregiving Alone In The Last Years Of Life
Published: | 11:17 pm | Posted in: Caregiving
Caregiving in the last years of life is associated with increased depression and negative health outcomes for surviving spouses, many of whom are themselves in poor health. Yet it is unclear how often spouses are caregiving alone, how they differ from supported spouses, and whether lack of support affects postbereavement outcomes. We hypothesized that spouses […]
U.S. Nursing Home Violations of International and Domestic Human Rights Standards
Published: | 10:08 pm | Posted in: Nursing Home Care
We present a review of the international covenants and conventions and U.S. domestic laws and regulations that are designed to protect nursing home residents in the United States. Based on a review of research studies, government reports, and news reports, we found extensive evidence of widespread and systematic abuse and neglect of nursing home residents […]
Long-term Care Providers and Services Users in the United States, 2015–2016
Published: | 7:46 pm | Posted in: Assisted Living
This report presents the most current national results from the National Study of Long-Term Care Providers (NSLTCP) conducted by the National Center for Health Statistics (NCHS) to describe providers and services users in five major sectors of paid, regulated long-term care services in the United States. This report provides information on the supply, organizational characteristics, […]
Effects of long‐term care setting on spousal health outcomes
Published: | 8:55 pm | Posted in: Home & Community Based Services (In Home Care)
Over the past three decades, there has been a large expansion in noninstitutional long‐term care (LTC) use, and public financing of long‐term care services has been shifting away from nursing homes toward home and community‐based services (HCBS). Medicaid, the primary payer for LTC for elderly people, spent 46% of its total LTC dollars on HCBS […]
A National Examination Of Long-Term Care Setting, Outcomes, And Disparities Among Elderly Dual Eligibles
Published: | 5:27 pm | Posted in: LTC Workforce Issues
The benefits of expanding funding for Medicaid long-term care home and community-based services (HCBS) relative to institutional care are often taken as self-evident. However, little is known about the outcomes of these services, especially for racial and ethnic minority groups, whose members tend to use the services more than whites do, and for people with […]
The Financial Burden Of Paid Home Care On Older Adults: Oldest And Sickest Are Least Likely To Have Enough Income
Published: | 9:32 pm | Posted in: Long-Term Care
Paid home care can significantly improve the lives of older adults with disabilities and their families, but recipients often incur substantial out-of-pocket spending. We simulated the financial burden of paid home care for a nationally representative sample of non-Medicaid community-dwelling adults ages sixty-five and older. We found that 74 percent could fund at least two years […]
Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending
Published: | 4:09 pm | Posted in: Long-Term Care
About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high […]
Care and its constraints: Will care work pass through Pettit’s gate?
Published: | 4:13 pm | Posted in: Caregiving
Welfare states are in a care crisis both in the sense of a practical care gap (abundant needs but not enough caregivers) and in the new movement to limit care to mere rehabilitation. Few political theorists pay attention to these developments, and those who do say little about the potential limits to care. This article […]
Medicaid blues: Hospitals, insurers wage political battle over managed-care dollars
Published: | 7:53 pm | Posted in: MLTC
“That’s all I have to say about that—I have to go bury the dead,” undertaker Stephen Holland said after listing his grievances with his state’s Medicaid politics early one Friday morning in June. Holland is one of a handful of white Democrats left in Mississippi’s House of Representatives, and he helped shape the past 20 […]
Managed Medicaid Long-Term Services and Supports is the Answer, But What is the Question?
Published: | 5:08 pm | Posted in: MLTC
A Presentation for the Annual Meeting of the Gerontological Society of America, November 2018: Medicaid expenditures (25%) continue to dominate state policy HCBS Waivers Have Grown Dramatically over the past two decades The expansion means that HCBS and Nursing Homes need to be managed States have been trying to shift risk– financial and management to […]
Modernizing Social Security: Caregiver Credits
Published: | 6:48 pm | Posted in: Caregiving, Social Security
Women still tend to work fewer years and earn less than men, which leads to less income in retirement. One reason is that women are often still the main family caregiver. Traditionally, Social Security has recognized this role by providing spousal and widow benefits for married women. Today, however, many women are not eligible for […]
Medical Marijuana Laws May Be Associated With A Decline In The Number Of Prescriptions For Medicaid Enrollees
Published: | 6:38 pm | Posted in: Pain Management
In the past twenty years, twenty-eight states and the District of Columbia have passed some form of medical marijuana law. Using quarterly data on all fee-for-service Medicaid prescriptions in the period 2007–14, we tested the association between those laws and the average number of prescriptions filled by Medicaid beneficiaries. We found that the use of […]
How Growing Inequality Is Altering The Long-Term Care Policy Battlefield, While Tightening The Financing Knot
Published: | 7:29 pm | Posted in: MLTC
For many years, long-term care (LTC) policy makers have tended to fall into two warring camps: those favoring expanded social insurance, and those wanting tighter Medicaid eligibility criteria to incentivize people to plan for and buy LTC insurance. Both sides have warned of looming financial catastrophe as the Baby Boomers move into retirement and more […]
Rhetoric and Reform in Waiver States
Published: | 5:06 pm | Posted in: MLTC
Abstract Seven states have used Section 1115 waivers to expand Medicaid as part of the Affordable Care Act (ACA). While each state pursued a unique plan, there are similarities in the types of changes each state desired to make. Equally important to how a state modified their Medicaid programs is how a state talked about […]
Minnesota Managed Care Longitudinal Data Analysis
Published: | 7:28 pm | Posted in: MLTC
EXECUTIVE SUMMARY This study tests the hypothesis that delivery of Medicare-funded and Medicaidfunded services to dually eligible beneficiaries aged 65 and older via fully integrated managed care plans is associated with stronger community-based service utilization patterns compared to service delivery when Medicare- and Medicaid-funded services are delivered independently. The hope is that integrated Medicare-Medicaid managed […]
Neoliberalism and health care: the case of the Irish nursing home sector
Published: | 5:14 pm | Posted in: Health Care Policy and Reform, Nursing Home Care
Abstract The usefulness of neoliberalism as a theoretical concept in health research has been debated. This paper argues that when the concept of neoliberalism is used precisely and concretely, it provides an important and valid framework to analyse how health systems have been transformed over the last several decades. This claim is illustrated through the […]
What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study
Published: | 6:17 pm | Posted in: Nursing Home Care
Abstract We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued […]
The German Long-Term Care Insurance Program: Evolution and Recent Developments
Published: | 8:07 pm | Posted in: Long-Term Care
Abstract Background and Objectives: Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing […]
Toward a Model Long-Term Services and Supports System: State Policy Elements
Published: | 4:20 pm | Posted in: MLTC
In response to a new Federal initiative to improve the U.S. long-term services and supports (LTSS) system, this commentary discusses an array of policies and practices that could potentially improve LTSS provision by shifting from institutional to community-based services, increasing equity across populations, offering consumers more choice and control, improving conditions for workers and caregivers, […]
Twenty-First Century Medicaid: The Final Managed Care Rule
Published: | 1:00 am | Posted in: MLTC
With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid […]