Adequate financing, improving the quality of care services and developing an adequate, skilled workforce are some of the urgent challenges facing long-term care in the future, said respondents to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey.
Approximately 79 percent of respondents favor or strongly favor adding a long-term care benefit to Medicare, financed by a premium.
"As our population ages, healthcare opinion leaders are sounding the alarm about the significant challenges we will face financing and improving the quality of long-term care," said Commonwealth Fund President Karen Davis. "Although healthcare leaders say long-term care is important to include in healthcare reform plans, the presidential candidates have not yet addressed this issue, which is certain to become an increasing concern for American families."
The survey found 69 percent of respondents believe it is important or very important that the health reform plans of the presidential candidates address the quality and financing of long-term care.
A majority of healthcare opinion leaders say that long-term care costs should be shared by individuals and the government (55 percent), while one-quarter (26 percent) say costs should be shared by individuals, employers and the government.
Other findings from the survey include:
-
76 percent say it's urgent or very urgent to develop a sufficient supply of home- and community-based services; 67 percent say it's urgent to create and disseminate adequate information on long-term care facilities to better educate consumers and families about available options.
-
To finance long-term care, most favored adding a long-term care benefit to Medicare financed by a premium (79 percent); fewer respondents favored providing tax incentives for individuals to purchase private long-term care insurance (64 percent) and transferring the responsibility for Medicaid long-term care from states to the federal government (63 percent).
-
74 percent say using payment incentives to promote quality would be effective in assuring and improving quality of care in home health, nursing homes and assisted living arrangements.
-
61 percent say increased public availability of quality and price information on nursing homes and home healthcare would be an effective way to improve quality, and 56 percent say having a full-time physician or nurse practitioner on site would improve quality of care.
-
When considering effective strategies for helping consumers make informed choices about long-term care, the strategies cited as effective or very effective were care coordination services (74 percent); counseling services to help people navigate service options (74 percent); having a medical home to link families and services (68 percent); and ensuring that hospital discharge planners are informed about services in their community (67 percent). Less than one-third (29 percent) say general public information campaigns to stimulate planning for the future would be effective.
-
A majority (66 percent) say they are at least somewhat familiar with the culture change movement in long-term care, which is working to make the nursing home less institutional and more home-like to preserve residents' rights to make decisions affecting their daily lives.
In 2005, only 27 percent of respondents said they were extremely familiar, very familiar or familiar with culture change in long-term care; in 2008, 38 percent of respondents said they were very familiar or familiar with the culture change movement.
The survey was conducted from June 2-30, 2008, among 1,078 opinion leaders in health policy and innovators in healthcare delivery and finance. Those surveyed included experts from four healthcare sectors: academia and research organizations; healthcare delivery; business, insurance and other health industry; and government and advocacy groups. Elected officials and media representatives were excluded. The final sample included 196 respondents for a response rate of 18 percent.