John O’Connor

When it comes to improving long-term care, two threadbare options always seem to be first in line.

Throw more money at the problem, one camp insists. Hold providers more accountable, claims the other. While each option would certainly help, neither will get the job done on its merits alone. Far from it.

That’s one reason why a recent deep-dive assessment by David Grabowski, Ph.D., is so welcome. Yes, it calls for better funding and accountability. But it doesn’t stop there. 

So what has the good doctor ordered? Well, his remedy has 10 components in all. It starts with the obvious: Give front line employees better wages. Then there’s a call for meaningful regulatory reform.

Also needed is a greater presence of advanced practice clinicians in skilled nursing facilities, along with realigned Medicare and Medicaid rates.

Rounding out the list: increase financial and ownership transparency; bolster alternate models of nursing care; increase the use of home- and community-based services while ensuring the future viability of skilled nursing care; and improve funding mechanisms.

Easier said than done, right?

When my colleague Kim Marselas talked to Grabowski last week, he sounded cautiously optimistic.

“Not everything has to be done tomorrow, but I do think that all of these things really have to be done,” he said.

You can read the full report in the Annals of the American Academy of Political and Social Science.

Grabowski’s prescription may not change the way you think about improving this field. But it will surely expand it.

John O’Connor is Editorial Director for McKnight’s.