The coronavirus pandemic has been brutal for the long-term care system in the United States, but the pandemic can serve as a learning opportunity to rethink the care system and how it’s funded, according to a leading expert.
“In short, long-term care in the U.S. needs more money and a new model for delivering care,” Forbes columnist Howard Gleckman explained Tuesday.
“Our system never will provide adequate care for frail older adults and younger people with disabilities as long as it remains so severely underfunded. And those with chronic disease and physical or cognitive limitations should have services well-coordinated and tailored to their individual needs, not driven by an outdated and dysfunctional payment system,” he added.
That type of system would allow people to choose their own long-term care setting that best serves them and wouldn’t be restricted by legacy regulatory and payment systems, Gleckman explained.
A revamped system also should place an emphasis on more home-based care and would mean states would have to “better align” its Medicaid LTSS with other public services, which would “fundamentally redesign the delivery of long-term care.”
Gleckman also suggested that a public long-term care insurance program, along with Medicaid, could help pay for that type of system.
“Start with where older adults get their supports and services. Today, 85 percent to 90 percent — or about 12 million — of those with long-term care needs get care at home. About 700,000-800,000 live out their days in nursing homes, and another 700,000 live in assisted living or other congregant care,” he explained.
“Roughly 80 percent [of] those long-stay residents of nursing homes receive Medicaid. The vast majority have no clinical reason to live in such a facility. They are there because Medicaid puts them there,” he added.
