Q: You and co-author Edward Alan Miller recently released the long-awaited report to the National Commission for Quality Long-Term Care. What were your major findings?A: It’s pretty important we get financing right, and the big question is how people feel about socializing payment for long-term care. The next issue is the quality side, which has a lot of components, including workforce issues. Then there’s this whole area of how you measure quality and how you use quality and public reporting as a stimulus to all providers to get better.

Q: So the system needs fixing.

A: It’s not as if these problems are unique to long-term care. In fact, hospitals contribute to the problem by discharging their patients without adequate follow-up care.

Q: What kind of impact do you expect this report will have?

A: I think there’s some level of receptivity on the industry side, but it’s important to bring state policy and perhaps the federal side on board, too. It’s important to think about the provisions included in the Deficit Reduction Act for the payment to follow the patient and the movement to test pay-for-performance in long-term care, not just as staccato pieces but as the beginning of a policy initiative.

Q: Are you hopeful about the future of long-term care?

A: I’m hopeful it will get better. I’m not hopeful it will be perfect.