The cost of Informal Elder Care

Many adults spend significant time caring for sick, elderly parents.  What is the cost of providing this informal care?  Would it be better to have family members outsource the care to formal caregivers? A paper by Chari, Engberg, Ray and Mehrotra (2014) attempt to answer this question.  They use data from the  American Time Use Survey…

Long-Term Care in 5 European Countries

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…

Long Term Care in the 13th Century

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…

CLASS Act Repealed

In 2011, 13 percent of Americans were over 65 years old.  In the coming years, this number will only increase.  Unsurprisingly, the demand for long-term care will also increase. Currently, spending on long-term care in Medicaid only was over $50 billion in 2009. One option for increasing the affordability of the long-term care market is…

Long-term care hospitals (LTCHs)

Today I review how Medicare pays for long-term care hospitals (LTCHs) based on information from MedPAC’s 2011 Report to Congress. LTCHs furnish care to patients with clinically complex problems—such as multiple acute and chronic conditions—who need hospital-level care for relatively extended periods. These facilities can be freestanding or colocated with other hospitals as hospitals within…

Incentives for Long-term Care Facilities to Hospitalize Patients

Why are hospitalization rates so high for Medicare beneficiaries living in long-term care facilities (i.e., skilled nursing facilities, nursing facilities, and assisted living facilities)?  The first reason is obvious: they are sick.  If they weren’t, they wouldn’t need to be living in these facilities in the first place.  Hospitalizing sick patients is often necessary.  Unnecessary…