Why the country needs a 'Medicare Help at Home' policy

A "Medicare Help at Home" policy would go a long way toward providing financial protection and improving health outcomes for the one-fifth of Medicare beneficiaries who require long-term services and supports, according to a recent Health Affairs Blog post.

The current system fails to integrate medical care and LTSS and leaves gaps in Medicare coverage, which exposes beneficiaries to high out-of-pocket costs and erodes their ability to live independently, argue Karen Davis and Amber Willink, of the Johns Hopkins School of Public Health, and Cathy Schoen, The Commonwealth Fund Council of Economic Advisors' executive director.

Instead, they propose a policy that would create:

  • A Medicare home and community-based benefit for certain qualifying beneficiaries that would cover 20 hours per week of personal service worker care or equivalently valued LTSS
  • Integrated care organizations that act as extensions of accountable care organizations by coordinating medical care and LTSS that meet quality standards, honor beneficiaries' preferences and support caregivers
  • Healthcare delivery models that apply a team approach to home care, building on other promising delivery model innovations that have made gains in preventing avoidable hospitalizations, reducing emergency department visits and reducing long-term institutional care

Eligible beneficiaries would include those who have serious physical and/or cognitive limitations, severe cognitive impairment or Alzheimer's diagnoses, the authors say, and their benefit level and care plan would be based on the degree of their limitations.

They note that while their proposal isn't a comprehensive long-term care financial policy, "it is a policy proposal worthy of serious consideration as the nation grapples with Medicare redesign to meet the needs of an aging population."

To learn more:
- read the post

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