ACP calls for supporting, improving long-term care services
In a recent position paper, the College recommends universal catastrophic long-term care insurance, more support for the long-term care workforce and informal caregivers, and improvements in quality monitoring, among other reforms.
Long-term care services and supports (LTSS) in the United States must be improved to provide adequate care to an aging population, ACP said in a recent position paper.
LTSS can be delivered in nursing homes or other institutional settings as well as in patients' homes and can include assistance with everyday tasks like bathing, eating, dressing, and other activities of daily living. Such services can be costly and difficult to access and make up a substantial part of U.S. health care spending, the position paper noted. ACP believes that the LTSS sector must be strengthened to ensure that patients can maintain quality of life and retain their financial stability as they age.
Specifically, ACP recommends the following:
- A multipronged public-private sector approach to reforming LTSS financing, including a publicly funded, universal catastrophic LTSS insurance program and policies to make private long-term care insurance affordable, accessible, and viable. Access to home and community-based services should also be improved.
- Addressing shortages in the workforce for the LTSS sector through comprehensive training, pay increases, benefit packages, and opportunities for career advancement and growth. Policies designed to assist unpaid caregivers through respite care, training, and reimbursement are also needed.
- Evidence-based interventions to assure and improve the quality of LTSS across settings, including robust monitoring, enforcement of quality reporting and improvement requirements, federal minimum nurse staffing levels for nursing homes, expanded quality and safety information for consumers, research and implementation of emerging alternatives to institutional care, and models to better integrate medical care and LTSS.
- Research into the effect of ownership status on the LTSS sector, including quality of care, staff and patient safety, costs, and staffing ratios. Nursing homes and other LTSS providers should be required to disclose comprehensive ownership and cost information, including private equity investment and related data.
- Funding, assistance, and staff support for nursing homes and other LTSS organizations to develop and implement emergency preparedness plans to ensure the safety of patients and staff.
The position paper was published July 12 by Annals of Internal Medicine.