Home- and community-based care advocates seek a total rebalance of care. They want the care dollars to be shifted to home- and community-based care, which has been historically short-shifted. However, shifting one group of care against another does not achieve a balance. Home-based caregivers still must be able to rely on good nursing home care.
Initially many thought that the Medicare Catastrophic Coverage Act will be a popular piece of legislation. However, while provisions were popular with providers and some seniors, many were not especially among seniors who had coverage, those who will pay more (so-called wealthy seniors), and the insurance lobby. So what has changed and what will lead us to believe that ACA will last?
Leadership, governance, talent (people) services and safety programs supports efforts in performance improvement and outcome assessment. The purpose of the outcome assessment system is to increase value to constituents served through feedback and improvement.
Outcome assessment should be seen as a tool for change management and will likely become the new standard for assessing resident care under the Affordable Care Act.