Ailing seniors could be living in more comfortable settings while saving money for taxpayers
June 7, 2015 12:00 AM
By Ron Barth
If government could provide better services for less money, wouldn’t it make sense to do it? That is exactly the opportunity Pennsylvania has in how it funds necessary services for low-income older adults.
For years LeadingAge PA has been advocating rebalancing the way the state pays for services for older adults.
Skilled-nursing facilities are essential, but they have evolved into shorter-term, post-acute care. However, many people need something less than post-acute care that still provides 24/7 assistance and supervision.
Home- and community-based services, such as home care, adult day services and senior centers, are important and effective for many people not needing 24/7 care or assistance. Those people able to pay for their own services often find this in personal-care and assisted-living facilities. Unfortunately, those unable to pay between $3,000 and $4,000 per month find there is little to no assistance to obtain this type of service.
Yet if the state reimbursed providers for services in personal care or assisted living at even half the rate it pays for Medicaid recipients in nursing facilities, our studies show that many residents in nursing facilities who really don’t need that level of service could live in more comfortable and appropriate settings while saving the commonwealth and federal government at least $80 million to $100 million per year.
To his credit, Gov. Tom Wolf, in his March budget address, set the stage for Medicaid-managed long term services and supports. If done right, Medicaid managed care could rebalance the system and allow consumers to get the right care in the right setting at the right time.
Experiences in other states show that this must be done with the involvement of consumers, providers and managed-care organizations. It will take time to listen to all these groups, consider their concerns and develop a system that is right for Pennsylvania. Experience also shows that this should not be implemented statewide without first testing the program in a more limited area.
Medicaid managed care of this sort is likely to take at least five years to be fully implemented. In the meantime, Pennsylvania could save tens of millions of dollars annually from its Medicaid budget if the Department of Human Services would adequately pay for services in personal-care and assisted-living facilities instead of forcing low-income older adults into nursing homes.
The current system of funding services for low-income older adults is completely unsustainable. It is no secret that Pennsylvania is one of the “grayest” states demographically. Our population of people age 85 and over is growing at 10 times the rate of the rest of the population. The baby boom generation is just now entering its 70s and, without significant changes in the way we provide and fund services for older adults, the system will collapse.
The crisis of an aging population doesn’t stop there. It’s not just about how we will be able to afford services. We also have an aging workforce in the senior-care sector. How will we attract enough qualified workers? How will we be able to use technology to help address the coming crisis? It’s a conversation we need to start now.
Mr. Wolf has begun the process of fundamentally changing the way we supply these services. But we urge the administration to consider what it can change now instead of waiting another five years or more to do anything.
Here is an opportunity for government to provide better services and save money at the same time. It just makes sense.
Ron Barth is president of LeadingAge PA, a trade association representing nonprofit providers of senior housing, health care and community services, which include skilled nursing, assisted living and personal care (leadingagepa.org).
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