MANAGED LONG-TERM CARE
The Need Importance for Long Term Managed Care
Having a frail or chronically-ill elder at home requires doing utmost care and attention – physically, socially, and medically. A significant number of people and families, however, are not ready for such weighty obligations and if some persons will be willing to do such familial responsibilities, they are just too busy and preoccupied by work and other priorities. Today’s generation, with the advancement of modern technologies, is characterized with people who are grossly engaged with a great range of technologically-related jobs and activities. With these factors comes the importance for managed long-term care or MLTC.
Chi, Mehta and Howe (2002, p. 54-55) explained that the need for long-term care is brought by “interrelated factors in demography, prevalence of disability, and the role of informal caregivers vis-à-vis formal services.”
The demographic trend in the U.S. sees the rapid population growth of elders. The U.S. Bureau of the Census projected that the future population of the country will be composed mostly of Americans aging 65 or older. Between 2010 and 2030, the baby boomers will join the older population that will account 20% of the total population or 69.4 million. In addition, the 85+ population is seen as the most rapidly growing group, doubling in number by 2025 and increasing fivefold or reaching 18.2 million in 2050 (cited in Chi, Mehta and Howe, 2002, p. 54-55).
Expectedly, as the percentage of people in advanced age surge, the morbidity rate and the count that needs daily assistance also increase. Considering these aspects, the government itself is doing extensive efforts to render professional care to everyone who needs it as much as possible.
MANAGED LONG-TERM CARE
Once a program afforded only by people having bigger income, the managed long-term care package already include care services and options designed to cater the special needs of the needing adults, which means the family does not have to pay for a comprehensive package but according to the family members’ choosing.
The role of professional care versus non-professional ones is also an important factor. Employing informal or substandard caregiving may pose added health concerns. Without professional guidance, an ailing person would receive incorrect treatment that may result to the multiplication of one ailment to multiple others.
Over the years, the program for long-term care has undergone modifications in policies and benefits. These changes have brought high-quality and cost-effective care and services. Data showed that at least one family member needs long-term care in about 80% of American families, and the long-term care policy reforms are now helping them afford the high medical costs for sustained care for their elders.
One relevant change in the policy is the integration of long-term care into the health services with the option to choose if long-term care would be done at home or at health institutions. Home care gives families the opportunity to be with their elders while ensuring that
MANAGED LONG-TERM CARE
the best care is given to their loved ones.
As some cases involve special services like care transitions, some policies, like the Affordable Care Act, offers extension of transitional care services through a number of programs. According to the New York State Nurses Association (2011, p. 2), transitions of care are vulnerable periods that contribute to unnecessarily high rates of health service use and healthcare spending; transitions of care expose chronically ill people to lapses in quality and safety, have been associated with increased rates of potentially avoidable hospitalizations. NYSNA (2011, p. 2) also pointed out that the knowledge and skills of the registered professional nurse must be ideally suited to the effective management of care transitions.
With diverse services already available, the family can select aptly what services their elders specifically need – inpatient or outpatient care, primary or specialty care, or home health care for acute medical services; nursing home care, respite, adult day care, or home care services for long-term care services; and counseling or housing services, among others, for social services.
Managed long-term care program ensures that there is continuity of care for the elder and that they receive professional medical care and proper counseling. Government efforts to improve the quality of care in nursing and other care institutions also give families significant comfort.
Another factor that sees the need of long-term care is the reality that those days when both poor and wealthier Americans could get affordable health care – the not-so-poor having fee-for-service insurance and the poor having Medicaid – were gone. But as developments came in including medical technology, the health budget has to be reduced and health care cost has to be
MANAGED LONG-TERM CARE
increased. Consequently, family funds are getting tight because of medical expenses. And as long-term care is foreseen as one big concern for all, the wiser way to spend for medical needs is to integrate it in one’s health care. The program is especially important for the elderly as they need medical assistance four times that of the youths and eight times that of children.
The growth of number of elders needing long-term care also means an “increasing number of families who will also face the daunting challenge of providing long-term care for their frail older relatives alongside other familial and job-related responsibilities” (Chi, Mehta, Howe, 2002, p. 55). It is in this reality that managed long-term care is of great importance.
MANAGED LONG-TERM CARE
References
Chi, I., Mehta, K., & Howe, A.L. (2002). Long-term Care in the 21st Century: Perspectives from
Around the Asia-Pacific Rim. New York, NY: Routledge
New York State Nurses Association (2011, September 19). Comments to the Managed Long
Term Care Implementation and Waiver Redesign Work Group public hearing on behalf of the New York State Nurses Association. Retrieved from http://www.nysna.org/images/pdfs/advocacy/medicaid/longTermCareComments.pdf
