- Have any questions?
- +1(689) 256-5483
- info@myessaythinkers.com
Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system.
Research the Long Term Care System by reading the assignments this week and finding a scholarly resource that relates to the discussion. Then discuss three strengths and three weakness in the long term care system.
- The initial discussion post must be at least 250-350 words of content, referencing the reading of the week, and including at least one scholarly source.
- All initial posts need a reference. Your initial post should never be all opinion. You need to refer to the reading and required resources and prove your information with valid data
Chapter 1
Long-Term Care Today:
Turbulent Times
Learning Objectives
Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system.
Define the term continuum of care.
Identify and define the consumers and providers of long-term care.
Learning Objectives (continued)
4. Define institutional and non-institutional care and the strengths and shortcomings
of each approach.
5. Identify the changes taking place in long-term care today.
Defining the Long-Term Care System
Long-Term Care:
Care of “those persons requiring healthcare, personal care, social, and supportive services over a sustained period of time” (Continuing Care Council, 1992, p.1)
Factors Contributing to Development
of the Long-Term Care System
Financing: Growing role of government
The impact of regulations
The results of past successes
Cost-reduction efforts
Components of the
Long-Term Care System
Consumers:
Elderly users of long-term care
- The elderly as a political force
Nonelderly long-term care users
- Physically handicapped
- Mentally ill & intellectually disabled
Baby boomers: new long-term care consumers
Components of the
Long-Term Care System
Providers:
Nursing facilities
Subacute care
Assisted living / residential care
Elderly housing
Community-based services
Institutional vs. Noninstitutional Care
Institutional: Noninstitutional:
- Nursing facilities • Adult day care
- Assisted living • Home care
- Subacute care • Hospice care
Long-Term Care as
Part of a Continuum
The Continuum of care is:
Client oriented
Comprehensive
Integrated
Strengths and Weakness in the
Long-Term Care System
Strengths:
Response to changing needs
Uniquely American nature
Dedication of caregivers
Focus on customer service
Innovative types of care
Integration efforts
Strengths and Weakness in the
Long-Term Care System
Weaknesses:
Reimbursement-driven system
Inequitably distributed services
Fragmented and uncoordinated
Mix of health and social services
Multiple entry points
Strengths and Weakness in the
Long-Term Care System
Weaknesses (continued):
Overshadowed by the acute system
Poor public image
Inadequate support for informal caregivers
Confusing and “user-unfriendly” system
Summary
The long-term care system has taken years to develop and is still evolving. It is a critical part of the overall continuum of care and has both strengths and weaknesses.
Chapter 2
The Affordable Care Act
Learning Objectives
Discuss how the Affordable Care Act came to be and the factors leading to
its passage.
Discuss the content of the Affordable Care Act of 2010.
Learning Objectives (continued)
Identify and discuss the impact of the Affordable Care Act on long-term care providers and consumers.
4. Identify and discuss the issues still remaining in the Affordable Care Act.
Introduction
The stated aim of the ACA was to:
“Increase the quality, affordability, and rate of health insurance coverage for Americans.”
“Reduce the costs of health care for individuals and the government.”
Key Components of the ACA
Requires individuals to have insurance coverage and businesses to provide coverage or pay fines.
Creates health insurance exchanges to provide a marketplace where individuals and small businesses can buy insurance.
Requires insurance companies to cover all applicants within new minimum standards regardless of pre-existing conditions.
History/Passage of the Law
Passed without a single Republican vote, and 34 Democrats also voted against it.
Attempts to filibuster the bill were defeated by Senate President Harry Reid (D-NV) who used a budgetary process called “reconciliation” to pass the bill with only 51 votes.
Various public polls at the time (and since) showed that more than 60% of Americans did not approve of the law.
Constitutionality of the Law
The constitutionality of the act was challenged, specifically targeting one provision of the act known as the “individual mandate.”
On June 28, 2012, the United States Supreme Court upheld the constitutionality of the Affordable Care Act.
Implementation
Designed to be implemented over several years.
Began with some of the more popular portions.
More controversial regulations (increased taxes, expansion of Medicaid, etc.) were designed to be spread out over later years.
Regulations
The ACA has spawned from 10,000 to 30,000 pages of new regulations.
Only a portion apply to long-term care.
Funding of the ACA
Funded by a combination of taxes and cost offsets (reductions).
Major Medicare taxes include:
A much-broadened tax on mid-level and high-level incomes.
An annual fee on insurance providers.
A 40% excise tax on “Cadillac” insurance policies.
Funding of the ACA (continued)
Cuts in Medicare to finance part of the new spending include reductions in:
Funding for Medicare Advantage policies.
Medicare home healthcare payments.
Certain Medicare hospital payments.
Impact on Long-Term Care
Majority of provisions in the act, including many of the more controversial, are tangential to long-term care.
Originally, it was thought that long-term care would be a potential cost saver because this type of coverage would not be needed immediately.
Impact on Long-Term Care (continued)
Health insurance exchanges
Shifting focus away from institutional care
CLASS Act
Community First Choice Option
Balancing Incentives Payment Program
Money Follows the Person program
Impact on Long-Term Care
(continued)
Spousal impoverishment protections
No Wrong Door system
Aging and disability resource centers
Health homes
Dual-Eligible Initiative
Other Provisions Impacting
Long-Term Care
Improving nursing home quality
Pay-for-performance
Bundling
Accountable care organizations (ACOs)
Medicaid expansion
Other Provisions Impacting
Long-Term Care (continued)
Asset recovery
Readmissions reduction
Medicare Advantage Plans
Medical device tax
Employer mandate
Projected staff shortages
In Summary
The Affordable Care Act (ACA) of 2010 is the most significant health-related piece of legislation since passage of the Medicare and Medicaid amendments of 1965. While many of its provisions do not impact long-term care, others do.
