No easy solution ahead for LTC funding dilemma

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James M. Berklan, Editor
James M. Berklan, Editor
The year-end scramble for Medicare and Medicaid dollars ended with a bang — and the usual whimpers from various provider interests. There were winners on one side, losers on the other. And then there were those who won some but weren't totally satisfied — in a big group in the middle.
And with a new year starting, the funding game begins again. 

The long-term care funding puzzle is beyond Rubik's cube stage, despite the best efforts of lawmakers and august bodies such as the short-lived National Commission for Quality Long-Term Care.

Significant barriers still exist to figuring out how to stretch dollars far enough in the overly complex Medicaid program.

A recent Kaiser report tapped into a large pool of disenchantment with Medicaid, long-term care's No. 1 funding source. Many commonly recommended funding alternatives to current schemes don't take into account that low-income beneficiaries simply can't afford to take part, report authors noted.
“Greater coverage of private long-term care insurance and use of home equity programs, such as reverse mortgages, are not applicable to many low-income elderly and disabled people served by the [Medicaid] program,” wrote authors from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.

Then, there are the more well off and those who do have some home equity to play with. That's where Steve Moses and his tireless campaign to get bogus Medicaid beneficiaries out of the mix come into play.

Moses, the well-traveled, eloquent leader of the Center for Long-Term Care Reform, has embarked on a yearlong, nationwide journey to stump for better long-term care funding options. Odds are he and his “Silver Bullet” trailer will be coming to an area near you in 2008.

Moses says he wants to reach out to long-term care providers and get them more involved. He reasons that operators can only benefit if more private long-term care insurance is brought into the mix and fewer people use estate planning to drain Medicaid funding.

He'll spend the first couple of months in the Southeast and strategically shoot the Bullet to other regions as the seasons change. On Jan. 27, in fact, he'll be in Greensboro, NC, addressing an audience at the North Carolina Health Care Facilities Association.

Whether he'll be able to get enough policy makers to pay attention and act on his message in 2008 remains to be seen. But if history has taught us anything,  it's that Moses will be going the extra mile to try.ꆱ