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Aging and caregiving experts are engaging in a year-long national dialogue to explore the future of long-term care, including innovative ways to expand the direct care workforce, increase home- and community-based services, and reform payment models. 

The Convergence Dialogue on Reimagining Care for Older Adults will explore different care models and potential reforms to regulations and payments systems to innovate care in different settings. The group, led by the Convergence Center for Policy Research, also will examine the coordination of health, social services, transportation, housing and other nonmedical factors that influence health and happiness.

“The reality is that a lot of older adults are in nursing homes because they can’t access care assistance any other way,” said Stuart Butler, a senior fellow at The Brookings Institution and chief investigator for the Dialogue. “It’s time to reimagine what aging care could look like in the future to give older adults more choices in where they live and how they receive care and thrive late in life.”

The Dialogue builds on a series of brainstorming sessions by 50 long-term care experts — including American Health Care Association / National Center for Assisted Living, LeadingAge, the National Investment Center for Seniors Housing & Care, ATI Advisory, PHI, the AARP and the Urban Institute — that resulted in a report, short papers on administrative actions to improve care, and an issue-framing paper released in September.

Successful aging requires a range of support services and housing options, the group noted. But Butler said the system is rigged toward nursing homes, with many older adults spending their later years in these institutions because regulations, payment systems and outdated models of care make options difficult to provide, it said. 

The previous reports recommended creating a continuum of care model that offers a variety of assisted living communities and other settings. The group also recommended revamping compensation and training for the direct care workforce to change the way senior living is presented to the public.

The focus of the national dialogue will be on home- and community-based care, residential facilities, access issues, workforce training and career pathways, and payment options. The goal is to consolidate all of the group’s previous work into an implementation and dissemination plan of recommendations to reimagine long-term care for older adults — no matter where they call home.

The Convergence Dialogue on Reimagining Care for Older Adults is co-funded by The John A. Hartford Foundation and The SCAN Foundation.