Last Thursday, I attended a conference in Washington, D.C. that focused on health reform in long term care. The conference was hosted by Health Affairs and the SCAN Foundation, drawing speakers with expertise in all areas of long term care—Robyn Stone from the Institute for the Future of Aging Services, Susan Reinhard from AARP, and Dr. Connie Garner, Policy Director to Sen. Edward Kennedy, to name a few. As I listened to the impassioned speakers, each with broad ranging ideas for health reform, they all seemed to have one goal in common: to ensure long term care is given the attention it deserves and is not pushed aside amid the larger debate about health reform.
In light of the recent recovery act legislation and the Obama administration’s push for health care reform, this conference further drove home the need to include long term care in national discussions. In fact, many of the high-level problems in health care that the recovery act seeks to address—cost of care, workforce development, quality improvement, continuity of care—are even more marked in long term care.
For example, one of the ways the recovery act aims to improve health care is through encouraging the use of health IT by providers. Many experts believe that when health IT is used meaningfully, it can be a vehicle for reducing health care costs and improving quality of care. The recovery act allocates money to increase Medicare and Medicaid reimbursement rates for providers using electronic health records as well as for the development of a skilled workforce competent in health IT. Issues of cost and workforce are especially pertinent in long term care. For example, approximately 32% of Medicaid dollars are spent on long term care. Additionally, of the 78,500 nurse practitioners that make up the nation’s workforce, only 2,000 are affiliated with nursing homes. Despite these facts, the recovery act does not include long term care facilities as being eligible for Medicare and Medicaid incentives. Additionally, money set aside for workforce development does not specifically address the growing need for a specialized geriatric workforce. While the HHS Secretary is charged with performing studies to evaluate how long term care may benefit from similar incentive structures, more attention clearly needs to be paid to the needs of our aging population.
As the baby boomer generation ages, the elderly comprise one of the fastest growing sectors of the population. Additionally, aging patients are more vulnerable, have more chronic conditions, and often have multiple morbidities. As demonstrated by the passionate speakers at this conference, all efforts to improve health care and encourage the use of health IT must keep a focus on long term care and recognize the great potential it holds for reform.