AARP Promotes Long-Term Care System Reform
By: Source: AARP.org Date Posted: 2005-10-18 13:51:59
Governor Jeb Bush and the Florida Legislature are right to raise the issue of reforming long-term care. While AARP has strong concerns about the proposals to force people into Health Maintenance Organizations (HMOs) in order to access long-term care through Medicaid, AARP agrees that the current system needs improvement. It is fragmented between many different programs, each with its own confusing bureaucracies, so people get lost in the system. Too much emphasis is placed on expensive nursing homes instead of less costly and more desirable home- and community-based care. Not enough emphasis is placed on quality all settings.
AARP is advocating for improving the system by giving the consumer the power to choose what services they need, in the setting they need and want. A voluntary model where managed care is one option, but not the only option, gives consumers real choice to get the right care, in the right setting, at the right price.
Real Choice
Giving people choice over what care they get and in what setting sounds costly, but it's not. Studies show that people don't over-consume long-term care; if anything, they under-consume. That is, if you give people the power to choose, they will want only the least amount of help necessary to get by. Older people do not like others interfering in their lives.
Right Care
Controlling cost and promoting efficiency is important, but it can't be an excuse for rationing care or providing shoddy care. Efficient care must include quality care in all settings.
No system can accurately determine what care someone needs without a consistent tool for evaluating what each person needs.
A person's needs change over time. Case management has to include regular needs assessments and care evaluations.
Right Setting
Individuals almost always prefer to remain independent in their home and their community. This avenue is almost always less expensive as well.
The key to making this happen is to get rid of the "turf battles" between different programs and agencies and collapse all long-term funding into a single, global budget.
This would allow people who need long-term care to get it in the appropriate setting rather than in whatever setting had funding.
Right Price
The real savings in long-term care is in shifting the caseload from institutional care (people in nursing homes) to less expensive home-based or community-based services. This shift is called rebalancing.
In a privatized system, HMOs reap the savings of forcing rebalancing.The state should do it itself so the state keeps the savings.
Related Articles
- Changes to Florida ' s Health Care System, Could They Affect You?
Other Resources
- AARP Policy and Research — Topics in Long-Term Care
- AARP Public Policy Institute- Profiles of Long-term Care 2004
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