LTC Bullet: Public Policy Principles for Long-Term Care

Friday, December 13, 2024

Seattle—

LTC Comment: What matters most for long-term care and how to achieve it, after the ***news.***

*** ILTCI ’25 PHILLY is just around the corner (March 9-12). Register here now to lock in early-bird attendee discounts. Organizers report you can find “the working titles for all sessions currently proposed for ILTCI 2025” here. They’ll release the final schedule soon and the mobile app for attendees in late January. ***

LTC BULLET: PUBLIC POLICY PRINCIPLES FOR LONG-TERM CARE

LTC Comment: Your Center for Long-Term Care Reform closes 2024 with a new report. The paper’s Abstract follows. Find the full text here and the entire reports archive here.

Thank you for supporting the Center for nearly 27 years. We invite you to redouble your support for our work in 2025 as the challenges and opportunities are greater than ever before. Real public policy change for the better is more realistically possible right now than it has been for two decades. Seize the moment.

“Long-Term Care: Principles, Policies, Proposals, and Petitions”

Abstract: The challenge to provide and fund long-term care (LTC) for a rapidly aging population confounds scholars and policymakers. America’s current LTC system is expensive, dominated by public financing, and heavily regulated, but it fails to deliver the kinds and quality of care consumers prefer. Unintended consequences of well-intentioned public policies account for this poor outcome. In 1965, Medicaid funded LTC for everyone “whose income and resources are insufficient to meet the costs of necessary medical services … .” This open-ended LTC funding source caused excessive utilization of Medicaid LTC benefits, unleashed explosive public spending, obviated the need for people to plan for LTC risk and cost, led to cost control measures that caused access and quality problems, resulted in low provider reimbursements that created caregiver shortages, and impeded the development of the home and community-based services options consumers prefer. To reverse these negative outcomes and deliver an affordable LTC system that provides the care people want in the venues they prefer, Medicaid must (1) pay LTC providers market rates, (2) limit eligibility to the needy who have actually spent down private income and resources for medical or LTC expenses, (3) cover the full range of LTC services and venues, (4) ensure access and quality across the care continuum, (5) regulate minimally relying primarily on market competition to ensure quality, and (6) focus LTC spending back onto the aging and disabled instead of the young and able. Reconfiguring Medicaid around these public policy objectives will achieve the positive results described and explained below.