Most of long-term care’s problems — including impaired access and quality, institutional bias, interminable home-care waits, paid caregiver shortages, and excessive dependence on unpaid family and friends — are the direct result of too much reliance (61% of $400 billion in 2022 LTC spending) on Medicaid’s parsimonious reimbursements (70% of private-pay rates) and the Centers for Medicare & Medicaid Services’ overbearing regulation (such as uncompensated staffing mandates).
This LTC market status quo has persisted for decades. But America is experiencing a political inflection point. A rare opportunity looms to move away from central planning toward freer markets, from government dependency toward individual responsibility, and from heavy-handed regulation toward unfettered competition. What would a LTC marketplace reflecting the full implementation of those changes look like?
Everyone, including Medicaid, would pay market rates for LTC in all care venues. That extra revenue flowing through the service delivery system would improve access and quality, eliminate caregiver shortages through increased compensation, and rebalance care venues toward the home care most people prefer, and which they would demand if paying with their own money.
The full article can be found in McKnight’s Long-Term Care News.
