Long-term care can be defined as a broad set of paid and unpaid services for people who are mentally or physically disabled, or whose chronic illness places them in need of medical or personal assistance for long periods of time. “It is estimated that there are more than twelve million Americans of all ages whose mix of serious disability and chronic illness places them at the high risk for functional decline, hospitalization, or nursing home placement.” (Benjamin) Several different populations require long-term care services, and the needs of these populations vary. In addition to the elderly, many of the long-term care users are younger persons with physical disabilities; persons with developmental disabilities; and persons with chronic diseases such as diabetes, emphysema, and AIDS.
The increasing need for these services is creating significant budget concerns for Federal and State Governments, as well as straining family finances. Combined Medicare and Medicaid outlays have been growing dramatically. About 40 percent of long-term care costs’ are paid by the Federal/State Medicaid program. (Feder, Komisar, and Niefeld) Although the Medicare program accounts for only a small share of total expenditures, its share has been growing. Despite rising Government expenditures, out-of-pocket payments continue to be a large source of financing for long-term care. As a result, for many individuals who have chronic care needs, long-term care remains a catastrophic cost.
Contemporarily, long-term care has become a topic of focus in the U.S. for several reasons. The clearest reason for its emergence is that people live longer than they used to. The population swell after the World Wars, the “baby-boom era,” along with a higher average li...
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...n is expanded social insurance. This is seen as an alternative to public support for private insurance. Medicare could be expanded to include long-term care, entitling all, regardless of income to some insurance protection should they become impaired. This may sound good, but is not feasible. Despite the nation’s prosperity and underlying wealth, our willingness to redistribute resources to reflect the aging of the population seems to be highly unlikely.
In conclusion, better support for the economically disadvantaged has to be a priority in future policy. Private long-term care insurance must be available to all, whether tax subsidized or federally backed; long-term care coverage must be equitably distributed. We now expect people to impoverish themselves completely before providing them assistance with long-term care, and that system seems excessively harsh.
After reviewing the current state of the long-term care policy from the United States, it
Miller, E. A. (2012). Journal of Aging and Social Policy . The Affordable Care ACT and Long Term Care .
Long Term Acute Care Hospital With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care for acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys. For patients requiring longer acute care than what is generally given at an inpatient acute care hospital, the Long Term Acute Care Hospital is an option. To be admitted to an LTACH, patients are required to have “medically complex situations with a mean length of stay > 25 days” (Munoz-Price, 2009, p. 438 ).
Medicare is a social policy many of our seniors look to for their stability when they reach 65
Today, the future of Social Security is in the news again. The reason Social Security is of such concern is that the extremely large group of citizens born in the post-World War II period—the much-discussed baby-boom generation—is retiring. The generation that will take its place in the workforce is far smaller in proportion to the number of retirees, raising fears about the sustainability of Social Security. In the past, proposed solutions to the various problems facing Social Security aroused great debate. Each time, however, the arguments were stilled, repairs were made, and the system continued to fulfill its mandate. That uncertainty about the future has resulted in suggestions for change that range from minor adjustments to complete privatization of the ...
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
By the year 2020, there is expected to be over 54 million senior citizens age 65 years or older. Despite medical technology and advanced medications, seniors older than age 65 have four times the number of hospitalizations days as compared to younger age groups (Curtain, 2007). Health care demands are increasing due to the aging United States population, and the present-day Medicare system is not capable of funding this. Health insurance emphasis is now on efficiency, profits, customer satisfaction, ability to pay, and competition (Curtin, 2007). Social and political aspects are major influencers of our health care. The shift of focus from patient care to a business model has caused hospitals to maintain a tight budget, often affecting nursing staff ratios. Lean staffing ratios is associated with an increase in malpractice suits due to adverse events (Curtin, 2007).
In the United States of America, there are millions of individuals that live with chronic medical problems. In which these conditions require some sort of medical attention at least once a month for revaluation, and possible treatment. Thankfully, for the majority of those individuals with their health insurance covers those costs that essentially would cripple their bank accounts. On the contrary, there are millions of people living in the United States, who are uninsured. Even with the implementation of the Affordable Care Act or as it is known by the public Obama Care, there are still individuals who cannot afford the basic needs of healthcare. Health care should not be looked at as a privilege but a right for everyone regardless of their
African American senior citizens face a health care crisis too. They have worked all of their lives to secure retirement, but their retirement has been threatened because of the rising cost of long-term medical care. Insurance companies have failed to provide affordable long-term care, protection that most senior citizens need. This lack of long term care and affordability has been a serious problem for the health care system. In some cities, the shortage of hospital beds is so serious that it is common for patients to stay in emergency rooms before they can be admitted to an inpatient room (Drake 109). More than one thousand hospital beds are occupied by people who could be better care for in nursing homes or through home health care (Drake 110). Of the disabled elderly 1.3 million reside in nursing homes (Drake 10). These patients are unable to perform two or more of the basic activities of daily living without assistance.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
In conclusion there needs to be an increase in government funding for long term care facilities to convey maximum ability to provide quality of care to elders and equal accessibility too homes and care. Ways that can produce this outcome are increases in staff funding for training and recruitment, as well as for equipment to help increase care. Government funding should also help elders decrease the cost of living in nursing homes and allow equal accessibility to homes and care in homes.
The public agencies such as CMS have periodically made drastic changes to their reimbursement policies. In 2003, the CMS began the hospital quality initiative and Home Health quality Initiatives ( Denisco & Barker, 2013). The hospital quality initiative mainly focused on Acute Myocardial Infarction (AMI), heart failure ( HF), and pneumonia( PNE). The home health quality initiatives also focused on quality measures for individuals receiving home care services ( DeNisco & Barker, 2013). In 2001 about 3.5 million disabled and elderly Americans received care from 7,000 Medicare certified home health agencies and about 3 Million elderly and disabled Americans received care from 17,000 Medicare and Medicaid certified Nursing Homes ( DeNisco & Barker, 2013). In 2004, CMS Nursing home Quality Initiative started 14 quality measures in the areas of delirium, pain( acute and chronic), incontinence, decline in activities of daily living, physical restraints, worsening of anxiety and depression, pressure sores, indwelling catheters, mobility decline, bedfast, weight loss and urinary tract infections( DeNisco & Barker, 2013). The National...
The future of healthcare will largely be affected by the changing demographics in the United States. Halaweish & Alam (2015), suggest by 2050 1 in 5 Americans will be 65 years or older, an increase from the current 1 in 9 Americans. In addition to the increase in aging adults, the oldest Americans, those 85 and older will also demonstrate a significant
One in six Americans and mostly all of the population 65 years and older, are covered by Medicare. In 2012, Medicare provided for 50.7 million people, 42.1 million aged and 8.5 million disabled, with a total cost of $574 billion. This is about 21% of national health spending and 3.6% of Gross Domestic Product (Davis, 2013). Medicare, being a social insurance program, is required to pay for covered services provided to enrollees so long as the specific criteria is met. On av...
Kick, Ella. "Overview: Health Care and the Aging Population: What Are Today's Challenges?" The Online Journal of Issues in Nursing. N.p., n.d. Web.