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 […]
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 […]
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 […]
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 […]
The Nursing Home Culture-Change Movement: Recent Past, Present, and Future Directions for Research
Published: | 7:33 pm | Posted in: Nursing Home Care
This article uses a retrospective approach to critique the research base underlying the nursing home culture-change movement—an effort to radically transform the nation’s nursing homes by delivering resident-directed care and empowering staff. The article traces the development of the movement from its inception 10 years ago to 2005, when the Centers for Medicare and Medicaid […]
The Aging Network and Managed Long-Term Care
Published: | 8:11 pm | Posted in: The Aging Network
Since the early 1980s, service providers and area agencies on aging, that is, the aging network, have developed a number of strengths as they built a community-based long-term-care system in most states. Many area agencies and providers now have the capacity to assess the needs of older persons, identify appropriate services, and administer cost-effective community […]
Georgetown Report on Florida’s Long Term Care Medicaid Waiver
Published: | 2:12 pm | Posted in: MLTC
Florida’s 2011 Managed Care Legislation, HB 7107, established “Medicaid Managed Care,” a new statewide managed care program for all covered services. The program is expected to control Medicaid program costs by using a capitated rather than fee-for-service payment model. Two separate components are anticipated for the new program: the Florida Long-Term Care Managed Care program, slated […]
Integrated Payment And Delivery Models Offer Opportunities And Challenges For Residential Care Facilities
Published: | 8:46 pm | Posted in: Assisted Living
Under health care reform, new financing and delivery models are being piloted to integrate health and long-term care services for older adults. Programs using these models generally have not included residential care facilities. Instead, most of them have focused on long-term care recipients in the community or the nursing home. Our analyses indicate that individuals […]