Future of Long-Term Care and the Expanding Role of Medicaid Managed Care.


America faces a complex policy challenge that lies at the intersection of social welfare and health care: the 12 million people who cope with one or more chronic disabling conditions requiring them to use long-term services and supports (LTSS) (also called long-term care) must negotiate a patchwork of services to find assistance. Most of the care is provided by some 40 million unpaid family members or friends, 60% of whom hold jobs while also giving care, according to recent survey research.1 Of that number, about 11% (2.6 million workers) reported leaving their jobs by resigning, retiring, or taking a leave of absence because they could not afford paid care for their care recipient. This report is an overview of the major issues that surround LTSS, a complex sphere with an array of stakeholders from federal and state governments to private employers, nursing home administrators, a host of different health and social welfare providers, an increasing number of managed-care plans, and people who need LTSS and their family caregivers. Adding further complexities to this disparate mix are different cultures and financing systems. I will also cover the political divide over the financing of LTSS that roiled the bipartisan Commission on LongTerm Care that Congress created after the Community Living Assistance Services and Supports (CLASS) Act was repealed and the accelerating efforts of federal and state government to enroll people who need LTSS in Medicaid managedcare plans. At least 26 states, “including California, Florida, Illinois and New York, are rolling out mandatory [enrollment] programs that put billions of public dollars into privately managed long-term care plans.”2 Limitations of Cover age

DOI: 10.1056/NEJMhpr1510026

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Cite this paper

@article{Iglehart2016FutureOL, title={Future of Long-Term Care and the Expanding Role of Medicaid Managed Care.}, author={John K . Iglehart}, journal={The New England journal of medicine}, year={2016}, volume={374 2}, pages={182-7} }