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Differences In Life Expectancy Due To Race And Educational Differences Are Widening, And Many May Not Catch Up

Published: | 4:45 pm | Posted in: Welfare, Inequality, and Poverty

It has long been known that despite well-documented improvements in longevity for most Americans, alarming disparities persist among racial groups and between the well-educated and those with less education. In this article we update estimates of the impact of race and education on past and present life expectancy, examine trends in disparities from 1990 through 2008, and place observed disparities […]

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 […]

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

Published: | 8:55 pm | Posted in: Medicare

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and […]

Health Affairs Article: At Least Half of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11

Published: | 8:53 pm | Posted in: Medicare

In an article in Health Affairs, Gretchen A. Jacobson and Patricia Neuman of the Kaiser Family Foundation and independent consultant Anthony Damico examined whether the 2006-2011 growth in private Medicare Advantage plans was due primarily to new beneficiaries choosing Medicare Advantage from the onset of their eligibility, or because beneficiaries enrolled in traditional Medicare were making […]

Among The Elderly, Many Mental Illnesses Go Undiagnosed

Published: | 8:52 pm | Posted in: Mental Health

Few health care providers have the training to address depression, anxiety, and other conditions in their older patients. By now, warnings about the impact of an aging population on the nation’s health care system have become familiar: rising numbers of seniors with diabetes, heart disease, and other chronic illnesses; increased costs; and a strained geriatric […]

Lessons From Medicaid’s Divergent Paths On Mental Health And Addiction Services

Published: | 8:48 pm | Posted in: Mental Health

Over the past fifty years Medicaid has taken divergent paths in financing mental health and addiction treatment. In mental health, Medicaid became the dominant source of funding and had a profound impact on the organization and delivery of services. But it played a much more modest role in addiction treatment. This is poised to change, […]

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare

Published: | 8:47 pm | Posted in: Medicare

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the […]

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 […]

The Disproportionate Impact Of Dementia On Family And Unpaid Caregiving To Older Adults

Published: | 8:45 pm | Posted in: Alzheimer's Disease: Cure & Care

The number of US adults ages sixty-five and older who are living with dementia is substantial and expected to grow, raising concerns about the demands that will be placed on family members and other unpaid caregivers. We used data from the 2011 National Health and Aging Trends Study and its companion study, the National Study […]

US Prevalence And Predictors Of Informal Caregiving For Dementia

Published: | 8:44 pm | Posted in: Alzheimer's Disease: Cure & Care

In 2010, 5.5 million US adults ages seventy and older received informal care, including 3.6 million with cognitive impairment or probable dementia. Adults with probable dementia received 171 hours of monthly informal care, versus 89 hours for cognitively impaired adults without dementia and 66 hours for cognitively normal adults Dementia, defined as a cognitive decline severe enough […]

Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS

Published: | 8:40 pm | Posted in: MLTC

Using authority in the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) has launcheddemonstrations that seek to improve care and control costs for people who are dually eligible for Medicare andMedicaid. Nearly 355,000 beneficiaries in nine states are enrolled in these demonstrations as of June, 2015. Implemented beginning in July 2013, the […]

MACRA: New Opportunities For Medicare Providers Through Innovative Payment Systems

Published: | 8:09 pm | Posted in: Medicare

Today, almost 60 million Americans are covered by Medicare — and 10,000 become eligible for Medicare every day. For many years, Medicare was primarily a pure fee-for-service (FFS) payment system that paid health care providers based on the volume of services they delivered, not the value of those services. Over time, this contributed to increased […]

Rebalancing Medicaid Long-Term Services And Supports

Published: | 7:36 pm | Posted in: Long-Term Care

Twenty-five years after the passage of the Americans with Disabilities Act(ADA), the Medicaid program is also marking an important milestone in system transformation in 2015. The national profile of Medicaid long-term services and supports (LTSS) expenditures has shifted away from primary dependence on caregiving facilities. In 2013 the majority of Medicaid LTSS spending was for […]

The Fragile Patchwork of Care for New York’s Oldest Old

Published: | 5:28 pm | Posted in: Long-Term Care

John Sorensen stood in the entryway of his Upper West Side apartment with a fresh bruise spreading over his upper arm and a blood-smeared bandage around one shin. Mr. Sorensen, 91, had fallen in his kitchen — he said he did not recall how — and was still unsteady on his feet. “It’s been a […]

The Impact Of Social Security Income On Cognitive Function At Older Ages

Published: | 7:05 am | Posted in: Alzheimer's Disease: Cure & Care, Social Security

Prior literature has documented a positive association between income and cognitive function at older ages, however, the extent to which this association represents causal effects is unknown. In this study, we use an exogenous change in Social Security income due to amendments to the Social Security Act in the 1970s to identify the causal impact […]

Long-Term Services and Supports for Older Americans: Risks and Financing

Published: | 6:25 pm | Posted in: Long-Term Care

Long-term care services and supports (LTSS) includes a range of services and supports individuals may need to meet their health or personal needs over a long period of time.1 Most LTSS is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called “Activities of Daily Living” (or ADLs) which […]

Clearing a Path for State-based Retirement Plans

Published: | 6:11 pm | Posted in: Private Pensions

What’s the number one way that workers save for retirement? Job-based 401(k) plans, which provide a vehicle for workers to put aside pre-tax dollars that are often matched by their employers. About one-third of American workers lack access to a retirement plan at work. While workers without access to a workplace plan can save on […]

Shouldn’t Home Care Workers Earn a Living Wage?

Published: | 2:30 pm | Posted in: LTC Workforce Issues

Healthcare workers in Massachusetts got good news twice this past week.First, the Supreme Court upheld the Affordable Care Act and its insurance exchange rules—a system expected to add some 360,000 Massachusetts residents to the healthcare rolls. On Friday, about 35,000 workers who areproviding disability and senior care through state programs got a major pay raise. […]

Medical Spending of the U.S. Elderly

Published: | 2:10 pm | Posted in: Medicare

We use data from the Medicare Current Beneficiary Survey (MCBS) to document the medical spending of Americans aged 65 and older. We find that medical expenses more than double between ages 70 and 90 and that they are very concentrated: the top 10% of all spenders are responsible for 52% of medical spending in a […]