The United States Congress recently asked that long-term care providers offer policy recommendations for the health care Reform Act. These policy recommendations and requests for these recommendations came on the heels of the new health care reform act ignoring any long-term care issues. Currently, Medicare does not cover long-term care unless it is a post-acute related issue. This means that issues directly following an inpatient or outpatient procedure are covered under long-term care in Medicaid. However, if it is the illness or issue was not incurred during an outpatient, inpatient, or because of outpatient inpatient procedure that Medicare does not cover long-term care. This was a major issue for several providers of long-term care insurance.
As a result, long-term care insurance providers were seeing a decrease in sales because the long-term care insurance would not, at the time, meets the gap between Medicare and the long-term care itself. In fact, in many states, women were being penalized with a higher or long-term care insurance quote then a male in their same age group with their same issues illnesses. All of these combined led to several provider recommendations.
On August 20, 2013, an 88-page document was given to Congress by the American Health Care Association and the National Center for Assisted-Living. The American Health Care Association and the National Center for Assisted Living are the United States largest providers of long-term care. This 88-page response to Congress in included all recommendations made by the major organizations. Of these recommendations, the following were included.
Eight policy changes, within the core policies, were discussed. These policy changes included the payments based on quality, skilled nursing, risk adjustments, assessments, the care tool, and payments that were included within bundled payment packages. These points were considered the most important for long-term care reform. The main critique offered by the American Health Care Association and the National Center for Assisted Living, was the all-inclusive health program put in place by the reform healthcare ask. This all-inclusive health program did not take into account long-term care, special needs, and more severe illnesses that place an individual into a bed-ridden status. It also did not include those individuals who need long-term care and do not fall under Medicare or Medicaid status. In addition, it did not cover individuals who were not part of the elderly group. In other words, a child with a long-term care illness that was not connected to a post-acute related issue, would not be covered under Medicaid or Medicare even if the child themselves was.
These reform recommendations have not been openly listed to the public. Only the points that they covered and considered to be vastly important. The 88-page document will be available online within the coming days. This document covers exactly what the recommendations are to the health care Reform Act committee and Congress. It is still unclear if Congress will be making any changes towards the health care act as it pertains to long-term care.