Current Issues

What are the hot issues in long-term care?

Financing (short-term) - state budgets are in serious trouble, and that puts serious pressure on Medicaid.

Financing (long-term) - what will health care reform do to long-term care?

Post-acute bundling of payment - see previous post.

Nursing - good news, the lousy economy may be pushing more nurses back into the workforce. Bad news, are these the quality nurses we want?

Transparency - should ownership of facilities be more transparent to the public?

Home and community based services for the disabled

The Hospital Discharge and Re-Admit Cycle

The federal government has major issues with the cost of health care programs, at the same time the reform movement is trying to expand insurance coverage.

One of the targets is the discharge / re-admit issue with Medicare patients.

Hospitals have incentives to discharge elderly patients to home or an ltcf, but re-admissions are quite common, driving up cost.

Physician judgments and family wishes play into this, and these factors may be difficult to change.

One proposal is "payment bundling," the hospital would get a single payment and then must reimburse the ltcf. This could be difficult for ltcfs, but could also provide incentives for better cooperation and coordination of services.

Briefing Paper: Email and electronic communications

The first in a series of briefing papers on administrative topics:

http://www.scribd.com/doc/16018098/Email-Briefing-Paper-Health-Care

Selling Health Care Reform

President Obama is selling health care reform with the argument that we need to fix health care in order to fix the overall economy.

Economic advisor Christina Romer distributed an op-ed piece today explaining how health care reform would 1) improve family incomes, 2) enhanced GDP, 3) lower budget deficits, 4) lower unemployment, 5) provide greater health care coverage (of course) and a 6) better labor market.

Wow, this is quite a claim.

http://www.whitehouse.gov/assets/documents/CEA_Health_Care_report.pdf