Who will be the leaders that create the future of long term care?
The aging of America is one of the greatest health challenges of the 21st century. It is estimated that nearly 27 million people in the country will require some form of long term care services by 2050.
The majority of baby boomers will reach retirement without guaranteed pension funds or, based on average life expectancies, sufficient savings. As a result, a significant number of the boomers will require some type of publicly supported assistance in paying for long term care services.
While these concepts seem daunting, consider that this is also an unprecedented time that demands transformational change. States and stakeholders will be coming together as never before to create solutions to provide aging boomers with long-term care services in ways that allow them to live satisfying and happy lives reflective of individual choice.
The challenge will come in creating these solutions without significant impact to Medicaid budgets.
We work with states, providers and other stakeholders to design effective Medicaid and healthcare programs that contain costs, improve healthcare quality, leverage all available funding and reduce the number of the uninsured.
Our areas of expertise in creating positive solutions for long-term care include:
Research and Policy
- Provide an analysis of a State's long term care programs
- Sellers Dorsey can provide information on a state's long term care programs and outcomes, as well as making recommendations to improve the program.
- Review legislation and its potential impact
- Sellers Dorsey can review legislation and identify areas of concerns and potential benefits.
- Draft language changes to legislation
- Sellers Dorsey can suggest legislative language that will support and promote a stakeholder's position.
Program Development and/or Support
- Design nursing facility right sizing strategies
- Sellers Dorsey can help educate nursing homes on the need to restructure nursing home capacity to meet market demands. This includes developing financial tools to help nursing homes convert beds to other uses such as independent living, assisted living and adult day care.
- Develop PACE like programs for special populations including Veterans and Children
- The Program for All Inclusive Care for the Elderly (PACE) is an integrated care model that combines funding and services for Medicare and Medicaid enrollees. PACE seeks greater care coordination of primary, acute, and long term care in an effort to avoid nursing home and hospital admissions. PACE programs are for individuals age 55 and over.
- PACE's funding and service integration model would benefit other special populations such as Veterans, medically fragile children, and individuals with autism. Through this integration the programs can obtain better outcomes while also making better use of funds. Sellers Dorsey can help develop, obtain approval and implement these programs.
- Provide 1115 and 1915 waiver development
- Sellers Dorsey can assist with the development of Medicaid waivers, which allow states to provide programs such as home and community based waivers or demonstration programs.
- Build partnerships to create integrated long term care models
- Programs that integrate primary, acute and long term care require many varied skills. The best program may require use of partners who can bring unique skills and resources to obtain a better outcome. Sellers Dorsey can assist in identifying and building partnerships.
- Assist nursing facilities to expand their continuum of care
- Nursing homes have a long history in serving long term care consumers and a large workforce. As the market changes and evolves, Sellers Dorsey can help strategically guide nursing homes in revising their product offering to better meet the changing market demands.
- Originate and implement comprehensive rebalancing strategies
- Rebalancing long term care is a multi facet effort. Sellers Dorsey can help to develop, obtain necessary support, and implement long term care rebalancing strategies.
- Compile and analyze budget neutrality calculations
- Waivers require complex calculations to demonstrate the program meets budget neutrality requirements. Sellers Dorsey can help develop and support these calculations.
- Support long term care reimbursement strategies
- Sellers Dorsey can help to develop, obtain support, and receive approval for nursing home and non-institutional reimbursement methodologies.
- Analyze private pay and long term care insurance options
- The baby boomer market will offer a vast market potential including non-publicly funded options. Sellers Dorsey can help providers review these potential markets.
Relationship Support
- Create a political strategy to support change
- The success of implementing change includes identifying potential barriers and developing a strategy to address the barriers. Sellers Dorsey can help develop and execute these strategies.
- Work to promote nursing facility acceptance to change business model
- Successful rebalancing includes engaging nursing homes in changing their service offerings. Sellers Dorsey can help educate and work with nursing homes in making these changes happen.
- Work to obtain CMS approval of 1915 and 1115 waivers
- Obtaining CMS approval on waivers often requires lengthy discussions with CMS. Sellers Dorsey can assist with these discussions and help obtain successful outcomes.
To discuss your leadership ideas and needs further, contact Pat Brady, Director of Long Term Care.