Bundling Payment for Episodes of Hospital Care: Issues and Recommendations for the New Pilot Program in Medicare

Outlines the 2010 healthcare reform's provision to launch a pilot project for bundling Medicare payments around hospitalization episodes of care, the rationale for hospital episode bundling, and guidance on designing an effective pilot program

Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

Examines key issues seniors face in ensuring economic and health security and the role that Medicare, Medicaid, and Social Security play in ensuring seniors' financial security, including concerns about medical debt and disparities by race/ethnicity

Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

The leading edge of the baby boom generation is nearing retirement and facing uncertainty about its need for long-term care (LTC). Using a microsimulation model, this analysis projected that people currently turning age 65 will need LTC for three years on average. An important share of needed care will be covered by public programs and some private insurance, but much of the care will be an uninsured private responsibility of individuals and their families—a responsibility that will be distributed unequally. While over a third of those now turning 65 are projected to never receive family care, three out of 10 will rely on family care for more than two years. Similarly, half of people turning 65 will have no private out-of-pocket expenditures for LTC, while more than one in 20 are projected to spend $100,000 or more of their own money (in present discounted value). Policy debate that focuses only on income security and acute care—and the corresponding Social Security and Medicare programs—misses the third, largely private, risk that retirees face: that of needing LTC

Unmet Long-Term Care Needs: An Analysis of Medicare-Medicaid Dual Eligibles

People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly “dual eligibles,” this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference