Long term managed care systems

9781284199062_SLID_CH01.pptx

CHAPTER 1

Long-Term Care Today: Turbulent Times

Learning Objectives

Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system.

Define the term continuum of care.

Identify and define the consumers and providers of long-term care.

Define institutional and noninstitutional care and the strengths and shortcomings of each approach.

Identify the changes taking place in long-term care today.

Defining the Long-Term Care System

Long-term care: “Care of those persons requiring health care, personal care, social, and supportive services over a sustained period of time”

Factors Contributing to Development of the Long-Term Care System

Financing: Growing role of government

The impact of regulations

The results of past successes

Cost-reduction efforts

Components of the Long-Term Care System (1 of 2)

Consumers

– Elderly users of long-term care

The elderly as a political force

– Nonelderly long-term care users

The physically handicapped

The mentally ill/mentally retarded

Baby boomers: new long-term care consumers

Components of the Long-Term Care System (2 of 2)

Providers

– Nursing facilities

– Subacute care

– Assisted living/residential care

– Elderly housing

– Community-based services

Institutional vs. Noninstitutional Care

Institutional

– Nursing facilities

– Assisted living

– Subacute care

– Hospice care

Noninstitutional

– Adult day care

– Home health

Long-Term Care as Part of a Continuum

The continuum of care is:

– Client-oriented

– Comprehensive

– Integrated

Long-Term Support and Services

New terminology: LTSS

– Expands the definition for delivery and payment

– Used by federal and state governments

Strengths and Weakness in the Long-Term Care System (1 of 2)

Strengths

– Response to changing needs

– Uniquely American nature

– Dedication of caregivers

– Focus on customer service

– Innovative types of care

– Integration efforts

Strengths and Weakness in the Long-Term Care System (2 of 2)

Weaknesses

– Payment-driven

– Inequitably distributed services

– Fragmented and uncoordinated

– Mix of health and social services

– Multiple entry points

– Overshadowed by the acute system

– Poor public image

– Inadequate support for informal caregivers – but improving

– Confusing and “user-unfriendly” system

– Not prepared for boomer cohort

Summary

The long-term care system has taken years to develop, and is still evolving.

It is a critical part of the overall continuum of care, and has both strengths and weaknesses

The boomer cohort will be a challenge for providers and payers

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InformalCaregiving.docx

1. Informal Caregiving: Contrast the positive and negative aspects of care giving from the caregiver's perspective and discuss the issues that tip the balance for any given individual. Page 33 in the text discuss the problem of inadequate support for informal caregivers. Along with the video on this page, the video, "A Window into The Daily Struggles of Long-Term Care" on the Week 1 Page is useful to watch for this discussion. http://www.youtube.com/watch?v=CYZdsJqx4xc

How would support and incentives for informal caregivers support our current long-term care system?

2. Continuum of Care: Long-term care providers may be considered in a continuum of care. Summarize this concept and include the three elements of a continuum discussed in Chapter 1 in the text.

9781284199062_SLID_CH01.pptx

CHAPTER 1

Long-Term Care Today: Turbulent Times

Learning Objectives

Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system.

Define the term continuum of care.

Identify and define the consumers and providers of long-term care.

Define institutional and noninstitutional care and the strengths and shortcomings of each approach.

Identify the changes taking place in long-term care today.

Defining the Long-Term Care System

Long-term care: “Care of those persons requiring health care, personal care, social, and supportive services over a sustained period of time”

Factors Contributing to Development of the Long-Term Care System

Financing: Growing role of government

The impact of regulations

The results of past successes

Cost-reduction efforts

Components of the Long-Term Care System (1 of 2)

Consumers

– Elderly users of long-term care

The elderly as a political force

– Nonelderly long-term care users

The physically handicapped

The mentally ill/mentally retarded

Baby boomers: new long-term care consumers

Components of the Long-Term Care System (2 of 2)

Providers

– Nursing facilities

– Subacute care

– Assisted living/residential care

– Elderly housing

– Community-based services

Institutional vs. Noninstitutional Care

Institutional

– Nursing facilities

– Assisted living

– Subacute care

– Hospice care

Noninstitutional

– Adult day care

– Home health

Long-Term Care as Part of a Continuum

The continuum of care is:

– Client-oriented

– Comprehensive

– Integrated

Long-Term Support and Services

New terminology: LTSS

– Expands the definition for delivery and payment

– Used by federal and state governments

Strengths and Weakness in the Long-Term Care System (1 of 2)

Strengths

– Response to changing needs

– Uniquely American nature

– Dedication of caregivers

– Focus on customer service

– Innovative types of care

– Integration efforts

Strengths and Weakness in the Long-Term Care System (2 of 2)

Weaknesses

– Payment-driven

– Inequitably distributed services

– Fragmented and uncoordinated

– Mix of health and social services

– Multiple entry points

– Overshadowed by the acute system

– Poor public image

– Inadequate support for informal caregivers – but improving

– Confusing and “user-unfriendly” system

– Not prepared for boomer cohort

Summary

The long-term care system has taken years to develop, and is still evolving.

It is a critical part of the overall continuum of care, and has both strengths and weaknesses

The boomer cohort will be a challenge for providers and payers

image2.png

InformalCaregiving.docx

1. Informal Caregiving: Contrast the positive and negative aspects of care giving from the caregiver's perspective and discuss the issues that tip the balance for any given individual. Page 33 in the text discuss the problem of inadequate support for informal caregivers. Along with the video on this page, the video, "A Window into The Daily Struggles of Long-Term Care" on the Week 1 Page is useful to watch for this discussion. http://www.youtube.com/watch?v=CYZdsJqx4xc

How would support and incentives for informal caregivers support our current long-term care system?

2. Continuum of Care: Long-term care providers may be considered in a continuum of care. Summarize this concept and include the three elements of a continuum discussed in Chapter 1 in the text.

9781284199062_SLID_CH01.pptx

CHAPTER 1

Long-Term Care Today: Turbulent Times

Learning Objectives

Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system.

Define the term continuum of care.

Identify and define the consumers and providers of long-term care.

Define institutional and noninstitutional care and the strengths and shortcomings of each approach.

Identify the changes taking place in long-term care today.

Defining the Long-Term Care System

Long-term care: “Care of those persons requiring health care, personal care, social, and supportive services over a sustained period of time”

Factors Contributing to Development of the Long-Term Care System

Financing: Growing role of government

The impact of regulations

The results of past successes

Cost-reduction efforts

Components of the Long-Term Care System (1 of 2)

Consumers

– Elderly users of long-term care

The elderly as a political force

– Nonelderly long-term care users

The physically handicapped

The mentally ill/mentally retarded

Baby boomers: new long-term care consumers

Components of the Long-Term Care System (2 of 2)

Providers

– Nursing facilities

– Subacute care

– Assisted living/residential care

– Elderly housing

– Community-based services

Institutional vs. Noninstitutional Care

Institutional

– Nursing facilities

– Assisted living

– Subacute care

– Hospice care

Noninstitutional

– Adult day care

– Home health

Long-Term Care as Part of a Continuum

The continuum of care is:

– Client-oriented

– Comprehensive

– Integrated

Long-Term Support and Services

New terminology: LTSS

– Expands the definition for delivery and payment

– Used by federal and state governments

Strengths and Weakness in the Long-Term Care System (1 of 2)

Strengths

– Response to changing needs

– Uniquely American nature

– Dedication of caregivers

– Focus on customer service

– Innovative types of care

– Integration efforts

Strengths and Weakness in the Long-Term Care System (2 of 2)

Weaknesses

– Payment-driven

– Inequitably distributed services

– Fragmented and uncoordinated

– Mix of health and social services

– Multiple entry points

– Overshadowed by the acute system

– Poor public image

– Inadequate support for informal caregivers – but improving

– Confusing and “user-unfriendly” system

– Not prepared for boomer cohort

Summary

The long-term care system has taken years to develop, and is still evolving.

It is a critical part of the overall continuum of care, and has both strengths and weaknesses

The boomer cohort will be a challenge for providers and payers

InformalCaregiving.docx

9781284199062_SLID_CH01.pptx

InformalCaregiving.docx

9781284199062_SLID_CH01.pptx

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image2.png

InformalCaregiving.docx

image2.png

image2.png