Senior Woman With Crutch Get Support
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Long-term services and supports are critical to frail older adults and must be improved to ensure access and quality of life as demand grows, according to an association representing primary care physicians who specialize in caring for adults.

In a position paper published this week in the journal Annals of Internal Medicine, the American College of Physicians provided several recommendations for reforming and improving LTSS to help ensure quality, accessible, equitable and affordable care for the 73 million older adults who will need it by 2030.

ACP President Ryan D. Mire, M.D., and colleagues wrote that long-term care providers are challenged by resident and staff member safety needs, especially during the pandemic, as well as a workforce shortage, quality issues and fragmented coverage options. They offered policy recommendations to address LTSS coverage, financing, workforce issues, safety matters, and quality and emergency preparedness for policymakers and other stakeholders.

“Similar to many other aspects of healthcare, the COVID-19 pandemic highlighted some of the challenges facing LTSS in our country,” Mire said. “We need to ensure that the U.S. has a high-functioning LTSS system that is ready to meet increased demand and deal with potential future pandemics or other events that threaten the patients who depend on these services.”

Specifically, the ACP recommended a multi-pronged, public-private sector approach to reforming LTSS financing. That approach, the group said, would include a publicly funded, universal LTSS insurance program as well as policies to make private long-term care insurance more affordable and home- and community-based services more accessible.

The organization also called for workforce investments, including better wages and benefits, as well as career advancement opportunities. Funding, assistance and staff support to develop emergency preparedness plans also were recommended.

The ACP also advocated for robust monitoring, enforcement of quality reporting and improvement requirements, and models to better integrate medical care and LTSS, as well as research into emerging alternatives to institutional care and how ownership status potentially affects quality of care, staffing and resident/patient safety.

“The population over age 65 is projected to increase by over 15 million between 2020 and 2030, and these individuals will need a system of LTSS they can rely on,” Mire concluded. “We need to make improvements to the system so that it is able to meet the challenges it faces today and provide older adults with the additional services and support that will be needed in the future.”

Previous recommendations for LTSS financing have been released by the Bipartisan Policy Center, the Long-Term Care Financing Collaborative and LeadingAge, among other groups. Additionally, a 2016 BPC report cited four areas in which the financing of LTSS could be improved.