Continuum of Long-Term Care

The Continuum of Long-Term Health Care Lisa Lewis HCS/310 August 9, 2010 John Dean The Continuum of Long-Term Health Care Health care is a fascinating industry. So many types of care are included within the industry. Health care can be very broad or very specific. Health care is also comprised of different types of health care. One specific sector is long-term health care. Long-term care plays a huge role in the health care continuum.

This paper will define long-term care and a continuum as well as discuss the services provided and how these services fit in the continuum of care, the resources that go along with long-term care and how it contributes to overall health care resources, and how long-term care services will be impacted in the future. Long-term health care tends to many types of people. “Long-term care (LTC) typically refers to settings in which individuals reside for ongoing care.

Long-term care also refers to health care needs or supervision that an individual may require for undetermined time, or even lifelong” (Long-Term Care, para. 1). Long-term care is not specific to a certain age group, and long-term care can be given in various settings. “Long-term care can be acquired in one’s home or more typically in sheltered care or independence-supporting settings described continuing care retirement communities” (Long-Term Care, para. 1). To make sure long-term care is provided at the optimum level, it must be a part of a continuum of health care. A continuum of aging services is a comprehensive and integrated network of services that guides and tracks patients/clients over time and includes acute, transitional, long-term, and preventative care” (Clapp, 1993, General Definition, para. 1). A continuum in the long-term care field will help ensure quality care because more resources are involved to make sure the patient is being taken care of properly. “An integrated continuum requires active collaboration among local providers in two general groups.

The first includes hospitals, nursing homes, retirement communities, physicians, and home health services” (Clapp, 1993, General Definition, para. 1). According to Clapp, even though the typical “continuum” is incomplete, not all pieces have to be a part of the continuum to serve the patients and their families (Clapp, 1993, General Definition, para. 2). “What is critical to understand is that linking with other community services to provide a continuum which benefits patients, payers and providers will be the design of the future” (Clapp, 1993, General Definition, para. ). “Collaboration is what holds a successfully implemented continuum together” (Clapp, 1993, General Definition, para. 4). By connecting different aspects of the continuum through the services provided, long-term care can be beneficial to its patients. Many services are provided through long-term care. “Long-term health care includes many different types of services, not just institutional care provided in a nursing home or a hospital when a person has a mental or physical disability.

In short, it includes a variety of services to maintain healthy living and quality of life, such as shelter, transportation, housekeeping services, therapeutic services, home health nursing care, and nutritional and social support programs” (Hussain, 2009, p. 72-73). These services help patients in a number of ways. For example, the transportation aspect allows patients to get around for various activities such as going to a doctor’s appointment or going to the grocery store. The housekeeping services help the patients maintain a clean living space to instill a healthy environment. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom” (Medicare. gov, What is Long-Term Care, para. 1). All of the services provided are to help meet the medical and personal needs of the patients. To acquire the best outcome, all of the services within long-term care need to be part of a continuum. If all of the services are linked to each other in one way or another, the patient can be taken care of in the best way.

Each factor of the continuum helps transition the patient from one level of service to the next. The doctor referral for future treatment in a hospital, or the doctor overseeing treatment in an LTC facility can help the patient transition better and have a better quality of life. Each part of the continuum plays a part in the future health of the patient. Another part of the continuum is health care resources available to the patients. Long-term care does contribute to the management of these resources. Without LTC, these resources would not be in such high demand. According to Medicare. ov, there are many resources that go along with long-term care that need to be used, such as drug and health plans, doctors, hospitals, formulary finder, long-term planning, home health agencies, nursing homes, medical equipment suppliers, dialysis facilities, forms, and publications (Medicare. gov, Resource Locator). These resources will help the patients and their families find the best collaboration of services to meet their needs. Drug and health plans are major resources to long-term care. Medicare does not cover most of long-term care services, but it may pay a portion depending on selected coverage.

Medicaid may step in and help pay as well. “The Medicare Plan Finder tool provides one central point to view and compare all available drug and health plan choices, including Medigap policies in your area” (Medicare. gov, Resource Locator). The formulary finder is a resource that ties in with the drug and health plan section. “The Formulary Finder for Prescription Drug Plans tool will allow you to find plans in your state that match your required drug list” (Medicare. gov, Resource Locator). The directory for doctors is a tool that can be very helpful when deciding the next course of action in long-term care. You can use the Physician and Other Healthcare Professional Directory tool to search for basic information about physicians and many other types of healthcare professionals including nurse practitioners, physician assistants, social workers, psychologists, and physical therapists” (Medicare. gov, Resource Locator). This tool will also show with what hospital each doctor is affiliated. “On the Hospital Compare tool you will find information on how well hospitals care for patients and results from a survey of patients about the quality of care they received during a recent hospital stay” (Medicare. ov, Resource Locator). Finding a drug and health plan along with an appropriate doctor and good hospital will lead into making a long-term health care plan. “The Long-Term Care Planning tool is to help you understand: what long-term care services are available, how much you can expect to pay for long-term care, and what financing options are available to support your long-term care costs” (Medicare. gov, Resource Locator). The LTC tool is the most helpful to see which LTC facility would be most beneficial. Providing LTC at home can be difficult. The Home Health Compare tool gives detailed information about Medicare-certified home health agencies. This tool will assist you in selecting a Home Health Agency; provide Home Health Agency information; Home Health Quality Measures and how to use the quality measures to compare home health agencies” (Medicare. gov, Resource Locator). If another type of LTC facility is used, the nursing home tool is helpful. “The Nursing Home compare tool has detailed information about every Medicare and Medicaid-certified nursing home in the country.

This tool enables you to compare the quality of the nursing homes you’re considering using Five-Star Quality Ratings, health inspection results, nursing home staff data, quality measures, and fire safety inspection results” (Medicare. gov, Resource Locator). Other than the facilities needed to provide LTC, there are other services that may be needed. Other services may include medical supplies or even dialysis. “The Medical Equipment Suppliers tool provides names, addresses, and contact information for suppliers that provide services or products under the Medicare program.

This tool lists suppliers of the following services and products; Durable Medical Equipment, Prostheses & Prosthetic Devices, Orthotics and Supplies” (Medicare. gov, Resource Locator). “You can use Dialysis Facility Compare to find addresses and phone numbers for each facility and compare information about the services and quality of care provided at dialysis facilities in any state” (Medicare. gov, Resource Locator). All of these services are easily accessible through the Internet. Forms and publications are accessible online that can be used to help facilitate the process.

If managed properly, these resources can help patients find the right collaboration of care. With so many changes in health care, strategic management is needed more than ever. “Health care organizations cannot be all things to all people. Organizations have to develop a ‘stop doing’ list to include those services that are least profitable and must be eliminated. Doing away with any service is very hard in health care because no one wants to eliminate a service that is helping people even if it is very expensive” (Swayne, et al. , 2005, p. 8).

Some resources for LTC may be of higher cost, but the resources are needed to maintain an effective health care continuum. The fact still remains that the increase in health care costs may reduce the number of resources that will be available. The current trends in health care will impact the future of LTC. “The key factors that will substantially increase the need for long-term care services and financing in the future are reduction of informal care, increased demands of institutional care, high turnover rates of health care workers, and advances in technology” (Hussain, 2009, p. 3). The future of financing LTC is largely dependent on the future economy of the health care industry. As costs continue to rise, patients will not be able to afford LTC. “Population statistics suggest that as the present ‘baby boomer’ generation ages, health care services must cover the entire spectrum-from wellness programs, to meet the needs of healthier individuals, to skilled nursing and rehabilitative care for individuals with chronic illness and functional limitations.

Currently, 5% of the elderly population live in LTC facilities; however, an increase of this population by even a few percentage points could strain resources both in terms of available facilities and available funding” (Long-Term Care, para. 8). According to Dicken (2005), national spending on LTC totaled $183 billion in 2003, and nearly half of that was paid for by the Medicaid program, and private insurance paid a small amount of long-term care expenditures-about $16 billion or 9% in 2003 (p. 1). The average cost for a private room in a nursing home is $74,208 a year, or $203 a day, according to Genworth Financial’s 2009 cost-of-care survey. If these figures continue to rise at the current rate (more than 4% per year), a year in a nursing home could cost more than $270,000 in 30 years” (Galloway, et al. , 2009, para. 1). Home health care is not going to be the alternative as far as cost is concerned. “The Genworth survey found that the average state-licensed home health aide charges $18. 50 per hour, which tops $220 per day if you need 12 hours or more of daily care” (Galloway, et al. 2009, para. 1). Something needs to be done to control costs now so there will be LTC available. Policymakers want to reduce spending on LTC. “With the aging of the baby boomer generation, long-term care expenditures are anticipated to increase sharply in coming decades. The projected spending on long-term care presents a looming fiscal challenge for federal and state governments. As a result, some policymakers are looking for ways to reduce the proportion of long-term spending financed by Medicaid and promote private insurance as a larger funding source” (Dicken, 2005, p. ). A program is in place for four states called the Long-Term Care Partnership Program. Policymakers are hoping that the results from this program will lead to a nation-wide enrollment program. “The Long-Term Care Partnership Program is a public-private partnership designed to encourage persons with moderate income to purchase long-term care insurance to fund their long-term care needs rather than relying on Medicaid” (Dicken, 2005, p. 8). According to Dicken (2005), the goal of this program is to reduce or eliminate the need for Medicaid to finance long-term care (p. ). No matter what the situation is, the current trend of high costs will ultimately lead to a reduction in services. With a rise in the population and the aging baby boomers, there is more of a need for long-term care than there has ever been. With costs rising the way they have, the people in need of long-term care will not have access. Purchasing long-term care insurance seems to be the best way to cover future costs. The more private insurance covers, the more likely that the current resources will remain in place.

The continuum of long-term care needs to have all the pieces work together to ensure that long-term care will be accessible to more people. References Clapp, R. (1993). Health Care Continuum. (cover story). Nursing Homes: Long-Term Care Management, 42(9), 6. Retrieved August 6, 2010, from MasterFILE Premier database. Dicken, J. (2005). Overview of the Long-Term Care Partnership: GAO-05-1021. GAO Reports, 1. Retrieved August 9, 2010, from MasterFILE Premier database. Galloway, D. , Ambalam, T. , M. , L. , & S. , L. , (2009). Long-Term-Care Scare. Kiplinger’s Personal Finance, 63(7), 65.

Retrieved August 9, 2010, from MasterFILE Premier database. Hussain, A. , & Rivers, P. (2009) Confronting the challenged of long-term health care crisis in the United States. Journal of Health Care Finance, 36(2), 71-82. Retrieved August 6, 2010, from MEDLINE with Full Text database. (n. d). Long-Term Care. Retrieved August 9, 2010, from XRefer XML database. Medicare. gov. (n. d). Long-term care. Retrieved August 9, 2010, from www. medicare. gov Swayne, L. , Duncan, W. , & Ginter, P. (2006). Strategic management of health care organizations. Malden, MA: Blackwell Publishing.