Long-Term Care Financing Solutions: AARP

Date

Jun 20th, 2008 10:28am

Author

Eric Schubert

Category

Earlier we blogged here about the long-term care financing forum at the University of Minnesota. One of the solutions put forward came from AARP. Here are highlights from Enid Kassner, director, Independent Living/Long-Term Care Public Policy Institute. Next we’ll share an approach from the American Association of Homes and Services for the Aging. AARP’s Goal: Create an affordable, consumer and caregiver-focused system providing coverage for, and access to, high quality long-term services and supports for independent living. 1. Promote - nationally and in the states - reform of delivery and financing for long-term services and supports. 2. REFOCUS reform debate on providing: long-term services and supports for independent living … rather than on "long-term care" or "Medicaid Reform." 3. Include ALL opulations, people with: developmental disabilities and physical disabilities . . . while improving services for seniors. 4. Defin "long-term services and support system" as FOUR separate, but related components: 1. Caregivers 2. Housing 3. Health Care 4. Long-Term and Community-Based Supportive Services … . plus mechanisms to finance each component. FIRST: Revamp Medicaid - Revamp Medicaid as one vehicle for both: System financing ---- structural reform. - See that proposed reforms: promote increased home and community-based services and cover additional services, populations - Eligibility: move from "categorical" to "financial means plus functional need." Oppose restrictive changes to eligibility and services - Oppose mandatory, risk-based managed care, but recognize managed care can be vehicle for reform. SECOND - Delivery Reform - Support for family caregivers: respite services, financial help, single point-of-entry, navigation assistance - Workforce development and quality: recruitment, retention; enhancing image of workers; promote workforce training by U.S. schools, esp. community colleges - Consumer-directed programs for obtaining needed services - Quality measures and incentives - Regulations and standards - Support Innovative Models for long-term services and supports: - Endorse, help expand and fund effective, existing, new or demonstration models and promising state models for financing and care delivery. - Use states' efforts as means for galvanizing a national FOCUS ON REFORM - Encourage personal planning for and family conversations about long-term care - Motivate consumers to demand more options for long-term services and funding - Promote products and services that help consumers with decision making, navigation THIRD - System Reform - Federal disablity-based insurance system that protects ALL Americans. - Expanded chronic care coverage and management under all insurance programs - Navigation help - and financial help - for informal caregivers LONG-TERM CARE REFORMED 1. Rebalanced Medicaid to emphasize home and community-based care 2. Single point of entry and navigation help 3. Supports for informal caregivers 4. Chronic care management under Medicare 5. Quality improvement throughout 6. Consumer-driven options 7. Workforce development 8. Insurance against disability for all FINANCING THIS APPROACH 1. Medicaid Rebalancing - Older Americans Act and state funding 2. Delivery System Reforms - Medicare with chronic care funding - Tax credits for caregivers - Home equity options - Private insurnance 3. Federal Insurance Value added tax dedicated to health care and long-term care