Howard Gleckman

The COVID-19 pandemic has “amplified and exposed an already deeply flawed system” for long-term care in the United States, according to an analysis Wednesday in Forbes.

Senior Contributor Howard Gleckman, senior fellow at The Urban Institute, noted that the current payment system is severely underfunded, leaving operators unable to provide adequate care for frail older adults and younger people with disabilities.

Gleckman called for a new model of care that allows seniors and those with disabilities, along with support from family and a case manager, to choose a care setting and supports that allows recipients to live the best life possible. Those services should be well integrated with medical treatment, with no regulatory or payment barriers, and should be based on a financial model that creates incentives for strong chronic care management. 

Medicaid or a similar public program could still support this care for those with very low incomes. But the default setting for care would be people’s own homes, not nursing homes, Gleckman said. He also called for training and perhaps compensation for family caregivers, while paying direct care workers better.

As for where the additional funding for this model of care might come from, Gleckman suggested a public long-term care insurance program, perhaps similar to one Washington state already has adopted and several other states are exploring. 

“We may not get all the way to the ideal system, but many intermediate solutions already are on the table,” he noted. “With the political will, we can change a failed system that is needlessly killing our seniors before their time.”

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