Unbiased Analysis of Today's Healthcare Issues
What are Long-Term Care Hospitals (LTCH)? These facilities are different from nursing homes. The New York Times explains the type of care they provide: These are no ordinary hospitals: Critically ill patients, sometimes unresponsive or in comas, may live here for months, even years, sustained by respirators and feeding tubes. Some, especially those recovering from accidents,…
Trends in long-term care spending and use has been rising over time. The graphs below, from Nadash et al. (2012) demonstrate this trend between 2000 and 2008. Annual Expenditures Long-Term Care Expenditures Annual Enrollment in Long-Term Care Programs Today, I review the long-term care systems in five European countries: Austria, England, France, Germany, and…
In the past, I have written about how Medicare pays for Skilled Nursing Facilities (SNF). Medicare uses a case-mix adjusted per diem rate. This approach, however, isn’t the only manner payers can use to reimburse nursing facilities. Consider how Australia pays for nursing care under their Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP):…
Aging adults with additional functional need typically are either cared for in one of two settings: i) the home, or ii) a nursing home. Singapore’s policy greatly favors the former. In contrast with the United Kingdom and the United States, Singapore has sought to minimize LTC costs by adopting an LTC policy that promotes “the…
In order for Medicare to reimburse post-acute care in a skilled nursing facility (SNF), Medicare beneficiaries must have a 3-day hospital stay. Some hospital stays, however, are not counted as hospital stays; rather, they may be defined as “observation status” care that do not merit an inpatient admission. Patients may stay overnight at the hospital…
There have been a number of recent efforts to finance long-term care for the elderly. The health reform law, as amended by the Health Care and Education Reconciliation Act of 2010, created a national, voluntary insurance program for purchasing community living services and supports known as the Community Living Assistance Services and Supports program (CLASS…
The Office of the Inspector General found substandard care at a number of skilled nursing facilities. Their investigation found the following: For 37 percent of stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. For 31 percent of stays, SNFs did not meet discharge…
Over 10 million Americans need long-term services and supports to assist them in life’s daily activities. Of these, 1.6 million reside in a nursing home. Nursing home care, however, is expensive ($74,800 per year) and and quality is highly variable. To improve the quality of care, many states have begun adopting pay-for-performance (P4P) programs for nursing homes. Between…
Although many people believe that the U.S. healthcare system is a free-market, that is far from the case. Consider nursing homes. Two-thirds of patient spending on nursing home care comes from public sources. Not only do public funds pay for the variable cost of running nursing homes, but the federal government also provides low-interest…
Typically, Nursing Home quality is measured using metrics from Nursing Home Compare. These metrics are calculated based on survey and certification processes and resident assessments from from the Minimum Data Set (MDS). These, however, are not the only quality metrics one can use. For instance, one can use consumer complaints as a measure of quality…