Building Bridges: Making a Difference in Long-Term Care
2006 Colloquium
Sponsored by The Commonwealth Fund
Conducted by AcademyHealth
TABLE DISCUSSION FRAMEWORK: TRANSITIONS IN LONG-TERM CARE SETTINGS
The goal is to maximize colloquium participants’ opportunity to engage in discussion around the issues raised, as
well as to identify the most important take-aways – lessons learned, research needed, policy change needed, etc. –
regarding transitions in long-term care settings. The following questions are to serve as a framework for a rich
discussion, bringing to light the many different perspectives – providers, policymakers, consumers, and researchers
– represented at the colloquium. While a one-day conference does not allow full discussion of ALL the topics of
interest that will be raised at the tables, the notes from each table discussion will inform the meeting summary that
will be disseminated broadly following the colloquium.
Instructions for Table Discussions:
A facilitator will moderate a 30-45 minute discussion among participants at each table. Please try to spend at least
some time on each question. EVERY TABLE SHOULD RESERVE AT LEAST FIVE MINUTES FOR THE LAST
QUESTION! Please ask the youngest person at your table to serve as the Recorder/Reporter, taking notes reflecting
your discussion. At the end, the Reporter at each table will be asked to share one (and only one) of the issues or
questions identified in the last question with the entire group. Note: Try to identify 3-4 priority issues/questions to
share with the entire colloquium in case another table raises your issue first.
1. Does the paper’s description of the fragmentation of the LTC system (and its interaction with the acute care
system) and its impacts on quality, satisfaction, and costs reflect your experiences interacting with LTC
providers, recipients, and payers on a day-to-day basis? In particular, what issues do consumers and providers
face, as a result of this fragmentation?
2. Do some or all of the innovations described present realistic options for improving quality and financing of LTC
services for the elderly? How might you incorporate key components of these models or lessons learned into
your work? Are there additional innovations, not already presented, that exist or might be tried? How might you
redesign any of the innovations described to better address transition issues for the elderly?
3. What information or evidence might additional research contribute to dealing with transition issues that affect
LTC service delivery and financing for the elderly? What outcomes of transition innovations should be evaluated?
4. What incentives are necessary to encourage additional development of performance measures and testing of
payment system changes that encourage providers and systems to work together to meet beneficiary needs?
What is the role for public policy in creating less fragmentation? Are there ways that reimbursement could
provide incentives for more continuous care, both within LTC settings and between LTC and acute settings?
What can consumers and their relatives do to make the system work better for themselves? What resources are
available to them for working through difficult transitions? What can providers and other professionals (both
long-term care and acute) do to reduce the costs and stress of transitions in care?
5. Please identify 3-4 questions or issues for further plenary discussion. You will be asked to share one with the
entire colloquium, either directed toward the presenter and discussants, or toward other experts participating in
the colloquium.