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SCAN Foundation Addresses Senate Special Committee on Aging About Future of Medicaid and Long-Term Care

by Published On: Apr 20, 2012
Bruce Chernof
Dr. Bruce Chernof

On April 18, Dr. Bruce Chernof, president and CEO of the SCAN Foundation, provided testimony to the U.S. Senate Special Committee on Aging during a hearing entitled, “The Future of Long Term care: Saving Money by Serving Seniors.” 

Bruce provided excellent background to the discussion by pointing out that 75% of Americans who reach the age of 65 will need at least 3 years of some form of long-term supports and services. When asked about solutions, he separated what we need to do today from where we need to go in the future. 

In focusing on the current challenges, Bruce addressed the fiscal realities states are in, particularly their struggle to maintain Medicaid funding for the current structure of services and meet the needs of the growing population of individuals relying on those services. 

He cautioned that in the haste to move to managed care, if states are seeking only to achieve cost savings the result will be the risk of creating undue harm to our most vulnerable citizens. 

Bruce mentioned that states need flexibility to create models that reflect the unique aspects of the geography and needs of families and the people they are caring for in their own communities. He described the characteristics of an “accountable and flexible system of care” as having 4 characteristics: 

  1. Quality and the ability to target specific services to those individuals who need them. 
  2. A priority of rebalancing – where the system of care recognized that most people prefer to receive their supportive care in the communities of their choice.
  3. Self-direction and choice are the essential cornerstone to how care and services are provided by the system.
  4. Any system created cannot just be “more expensive because it is better,” but must include efficiencies built in. He also reminded the Committee that we do not have to start from scratch. There are many good models already out there from which to learn.

The future of long-term care

In looking to the future, Bruce acknowledged that “we have failed as a country to develop a social policy goal for people to plan ahead for their long term care needs.” 

His testimony reflects what we all know and so many are saying: 

  • We need to get better at targeting services for people who can and want to remain in their homes and communities.
  • We need a prepared workforce that can provide the care in these settings.
  • We need to shift incentives to allow for transformation in Medicaid LTSS. 

“Medicaid is poised to take on more LTSS costs dues to the trifecta of increasing life expectancy, increasing prevalence of chronic conditions and functional limitations at older and low saving rates among baby boomers," Bruce said. "American families deserve affordable, accessible and comprehensive solutions in order to plan for their future LTSS needs without having to spend down to Medicaid. Policy opting in the public and private realms should be thoroughly explored to meet these aims.” 


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