There are many proposed solutions in discussion to help care for the aging population. We should begin by reforming our incident-based system of care. Health care today is reactive: if we get sick, we make an appointment to see a physician; if we become seriously ill or injured, we go to an emergency department or clinic. One proposed solution, pay-for-performance programs, would tie higher reimbursement to quality of care—thus reducing funds to lower-performing facilities.
But these facilities most need investment and incentives to improve resident care and quality of life. What’s more, current performance measures provide only a “snapshot” of care. Such point-in-time measures cannot gauge how well providers manage the multiple chronic conditions common among elderly patients. To build a viable elder health care system, we need to do the following: Provide five years of stable reimbursement for elder care so that professionals, legislators, and regulators can work together to focus on financial and intellectual strategies.
Turn the system for evaluating nursing homes from one based on penalties to one based on partnership, building on the positive results from work done by the Centers for Medicare and Medicaid Services’ quality improvement organizations. Provide financial incentives to upgrade elder care facilities and invest in health information technology. Establish financial models for reimbursement based on evidence-based clinical research.
Provide government and private financial programs that enable the consumer to obtain the care they expect, and possibly deserve, based on individual responsibility of their own wellness. Finally, Curb unnecessary lawsuits, which siphon funds from direct care. If we take these steps, we can create a health system in which older patients take responsibility for their own health and reap the benefits of high-quality care. References J. Derr, Financing Health Care for an Aging Population, The Commonwealth Fund, December 2005
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