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Engaging 2008 Debate, Key Long Term Care Advocacy Groups Offer New Plan
To Strengthen Nation’s Long Term and Post-Acute Care Delivery System

Private Sector Investment, Patient-Centered Reform Cornerstone of
Effort to Create Greater Access to Elder Care

Washington, DC – The nation’s leading long term care organizations gathered today at the National Press Club to warn consumers and policymakers about the severe long term care crisis and to challenge policy makers -- especially the presidential candidates -- to embrace restructuring long term and post-acute care as essential to effective health care reform.   The centerpiece of the press briefing, hosted by the three advocacy organizations -- the American Health Care Association (AHCA), the Alliance for Quality Nursing Home Care (the Alliance) and the National Center for Assisted Living (NCAL) -- was the unveiling of a comprehensive plan designed to create a consumer oriented system bringing greater private resources into the system.  The plan offers a cogent approach to a looming if little appreciated crisis, and seeks to stimulate important discussion at a crucial political and fiscal juncture.

“In releasing this comprehensive new plan to reform our long term and post-acute care systems in the interest of America’s seniors, we are offering solutions that provide more comprehensive coverage, broader consumer options and responsible use of government resources,” stated Bruce Yarwood, President and CEO of AHCA. “In addition, we also seek to generate far more debate in the 2008 election about how we can affect immediate health policy changes that can help improve seniors’ care quality today and in the years ahead. The next President will be required to work with Congress to take bold, decisive action to ensure seniors will have ready access to quality long term and post-acute care, because the crisis is now upon us.”

Alan Rosenbloom, President of the Alliance, said, “Overall, this incisive plan addresses concerns about the accessibility of care for seniors today and tomorrow. Our plan creates a sustainable, patient-centered long term and post-acute care system that allows Americans to have more control over their individual health care futures.” The proposal in its totality, he said, would help replace the current patchwork financing structure, increase the viability of private long term care financing, and streamline the post-acute care and long term care delivery systems. Implementation of our proposed plan would help a more reliable long term and post-acute care financing system so Americans can rest assured their future post-acute and long term health care needs are secured without jeopardizing their retirement security.

David Kyllo, Executive Director of NCAL, stated, “The growing diversity of long term care settings is a welcome and necessary trend that better serves the needs and choices of aging Americans.  It is incumbent on our elected leaders as well as our profession to help drive policy that ensures care quality is optimal across the full spectrum of care. In regard to both quality and financing, we must view the growing multiplicity of care settings as complementary to one another, not mutually exclusive.  This plan reflects our desire to ensure Americans’ retirement years should be something to look forward to, not to fear.”

The three groups worked closely with Avalere Health, a leading advisory company providing strategic guidance, objective analytic research, and quality educational programs focused on the full range of healthcare issues facing our nation. Dan Mendelson, President of Avalere Health, described the details of the proposal during the event.  His remarks underscored the imperative of addressing our nation’s long term care financing challenge, described the current pressures facing consumers and emphasized the urgent need for long term and post-acute care reform. 

The proposal -- which emphasizes better coordination of both care and financing, greater private sector involvement and appropriate personal responsibility -- will allow consumers to better plan for their long term care needs, which will afford them better and broader choices.  In addition, the plan will allow both federal and state lawmakers to seize control of eldercare financing issues. The plan also offers clear solutions to the nation’s Governors by dramatically restructuring the Medicaid program, which currently finances the lion’s share of long term care in America. Medicaid, established in 1965, remains a literal lifeline for the nation’s less fortunate elderly, and must be reformed in a way that ensures consistent care and services, as well as their financing, and that relieves the pressures on state government to devote ever greater resources to pay for care.  The alternative -- the inevitable collapse of the system under the growing weight of its outdated financing structure -- simply is unacceptable.  This plan will reorganize the Medicaid long term care and Medicare post-acute care systems by centralizing and streamlining government services and making more private resources available to pay for care, which will benefit the consumer, provider and taxpayer alike.

Highlights of the proposal, available in more detail at www.ahca.org and www.aqnhc.org, are as follows:

A Streamlined Long Term Care System Enhancing Consumer Choice
The proposal will infuse private resources into the entire spectrum of long term care services, ensure a viable care system for the future that covers care provided at home and in a full array of care settings, optimize choice in the type and site of care received, and federalize the system to minimize state-by-state and regional differences in the long term care benefit available to all Americans. The plan will also establish new financial products -- including improved reverse mortgages, federally-endorsed long term care (LTC) insurance products, and new LTC savings accounts -- which individuals are incentivized to purchase in order to cover future LTC costs.

New Medicare Post-Acute Payment System Featuring Updated Patient Assessment Tools
The Centers for Medicare and Medicaid Services (CMS) will implement a new Medicare post-acute payment system based on the condition, needs and characteristics of the patient, regardless of the site where care is delivered, thus further encouraging and enhancing consumer choice. A post-acute patient assessment tool will replace the existing site-specific model and will assist in determining patient placement, care plan development, continued stay and discharge decision-making, development of quality indicators, and payment calculation.  The new Medicare payment model and patient assessment will replace the current system for which each site of care has its own reimbursement system determined by varying types of patient classifications. The three long term care leaders noted and praised the fact CMS has already initiated a multi-state pilot program evaluating the care Medicare beneficiaries receive after being discharged from a hospital, and how the federal government pays for that care. Currently, they noted, Medicare pays for beneficiaries’ care based on where the beneficiary receives health care services, not the nature of the care itself.  

Yarwood, Rosenbloom and Kyllo also praised the work and recommendations of the recently-concluded National Commission for Quality Long Term Care (NCQLTC) headed by former U.S. Senator Bob Kerrey (D-NE) and former House Speaker Newt Gingrich (R-GA), and noted one of its key findings provides a strong rationale for the consumer education component of the plan released today.

An NCQLTC survey found 34% of Americans believe most long term care is paid for by Medicare, 20% believe most long term care is paid for by Medicaid (in fact the largest source of funding, accounting for 49% of long term care spending in 2004), and 22% believe individuals and their families pay for most long term care. 13% said they do not know how long term care is financed under the current system. 

“The results of the poll from the Kerrey-Gingrich panel are all the more reason the 2008 presidential aspirants of both parties owe it to the nation to discuss these issues, and to raise public awareness of the fact individuals must become far more involved in how they will help finance and take control of their own long term care needs,” Yarwood concluded.   

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The American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) represents nearly 11,000 non-profit and proprietary facilities dedicated to continuous improvement in the delivery of professional and compassionate care provided daily by millions of caring employees to 1.5 million of our nation’s frail, elderly and disabled citizens who live in nursing facilities, assisted living residences, subacute centers and homes for persons with mental retardation and developmental disabilities.  For more information, please visit www.ahca.org.

The Alliance for Quality Nursing Home Care (“The Alliance”) is a coalition of 16 national long term care provider organizations that care for approximately 300,000 elderly and disabled patients each year in nearly 1,800 facilities across America. The Alliance is dedicated to improving the quality of nursing home care in the United States through measured results and outcomes and to assuring the government resources necessary to provide high quality care and services.