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Critical Analysis of Long-term care service
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Critical Analysis of Long-term care service
Introduction
Changes are inevitable in any business that aspires to reach its full status as an industry.
Long-term care has taken a bit longer to adjust to new changes, which has led to organizational
turbulence. Therefore, leaders in long-term care are analyzing several factors of improving the
profession and solving the challenges. It has led to the establishment of new levels of care, and
for the existing type of care such as sub-acute care or assisted living, new rules and names are
constantly established. As long-term care providers integrate with other healthcare system
providers, they should also acknowledge competition from the same partners. The collective and
individual changes impacting the long-term care services should be considered redefinition
factors that shape the organization to a better course.
Components contributing to the development and need of long-term care services
The evolution of the long-term care system has taken a long time compared to other
services such as acute care systems. Several forces have played an important part in its
development. The first force is the government growing role in financing long-term care. Pratt
(2015) outlines that the US government in the first two decades of the 20th century was
minimally involved in long-term care services support. This might have led to the great
depression as the population increased; it could not care for itself. The care of the society needs
would be made from 1995 through the passage of the Social Security Act that acted as a mother
for the industry of nursing homes. It is through the nursing home that other long-term care
services have sprouted. The financing of healthcare, especially for the elderly (above 60yrs)
through the 1965 Act, contributed to the development of long-term care. Medicare and Medicaid
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programs have also reduced the cost does developing long-term care. Government regulations
such as the Omnibus Budget Reconciliation Act (OBRA) of 1987 have developed long-term care
by imposing new strict rules (Pratt, 2015). Sometimes the regulation impacts are felt by care
consumers; for instance, when the available revenue is low compared to the cost needed for longterm services, the providers may cease the service. But through these regulations, providers can
balance the quality, revenue, and cost. However, the impact of regulations such as the Affordable
Care Act of 2010 is not yet understood.
Social and demographic changes, for example, many people being employed leaving the
elderly alone, have contributed to the need for long-term care. This can be related to past success
developing the service; past medical care improvements have made people live longer thus,
needing a longer care service for many years. Also, the rising cost in acute care facilities has led
to a practice known as quicker and sicker (Pratt, 2015), where patients whose length of stay in
acute care facilities are transferred to long-term care facilities. It has made the long-term care
facilities adjust to changes because of the increasing number of patients meaning new services.
Affordable Care Act impacting long-term care providers
According to Pratt (2015), the Affordable Care Act is a work in progress because some of
its sections are yet to be implemented, some need changes, some are delayed, and some are
repealed. The impact of the act is felt by America's aging population. Pratt may have published
the book when ACA's effects were not fully realized, but his concepts are still implying a change
to the long-term care service, especially on the Medicare program. Its major effect is ensuring
that the elderly and their families are provided with increased healthcare and greater savings. By
doing so, ACA will help the elderly and reduce costs through the provision of coordinating care
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and community support, leading to preventing seniors from costly and unimportant hospital
return trips. Although most of the criticisms on ACA are speculative, they should be explored to
curb any effect that may occur to the elderly and long-term care. Current researches have shown
that in long-term care facilities, Medicaid payments have been increased by the implementation
of ACA, which has improved care by decreasing falls, ulcers, and readmissions (Walker et al.,
2020).
Accessibility components to long-term care services
There should be easy accessibility in the long-term care system. Components that
determine this accessibility are the services availability, degree of complexity of needs of
consumer, physical logistics such style and location, and financial coverage. For those
individuals that are using the services, they should be provided with maximum accessibility with
limited hassle through the long-term system’s collective or individual attention. All the
components are aiming towards the customer's need. Therefore, the system should be user
friendly in order to achieve client convenience, either it is through financial approval that is
simplified or setting a sing-site location for all long-term care services, or provision of care in a
minimum restricted environment, the main goal should be aimed at making long-term services
easily accessible to consumers (Pratt, 2015). A consumer-driven long-term system will lead to an
ideal system. Currently, the service is attaining the ideal system in incremental steps by utilizing
ADL as an eligibility criterion or nature of the underlying condition of the consumer. Therefore,
if functional needs are emphasized more and made uniform or equal, the ideal system will be
realized soon.
Trends likely to affect assisted living in future
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The combination of healthcare, support services, and housing is known as assisted living.
It provides services to individuals that need medical, bathing, meals, or dressing. There are
trends that will exert impacts in the future on assisted living. For example, the movement
towards standards through agencies such as AHCA/NCAL that have initiated quality programs
for recognition will contribute to best practices for assisted living (Pratt, 2015). Also, new
policies to regulate the service uniformly will be formulated. The political climate will determine
if the policies will be effective. Another trend is integration with other healthcare providers, and
this will increase better services and financial prosperity.
The benefit of integration for long-term care consumers
Competition forces may force long-term care providers to join integrated systems. Their
financial situations and competitiveness power might be improved, but also consumers will gain
benefits. In a fragmented continuum, consumers will not have access to all needed services;
therefore, the integration will overcome the challenge (Pratt, 2015). The range of services offered
is increased, and providers are able to coordinate referrals through a centralized information
system. It enables the consumers to obtain effective and efficient services and avoid missed
treatment. Also, the problem of consumers coordinating their own insurance coverage will be
prevented by financial information that is centralized as a result of integration. Therefore,
seamless care to consumers is inevitable through integration.
Meaning of long-term care being reimbursement drive
When long-term care service is delivered to consumers depending on the way it is
financed, it is referred to as reimbursement driven. The type and amount of reimbursement will
determine the care access, specific service availability, and the quality of care provided (Pratt,
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2015). The US long-term care system is reimbursement-driven and not consumer-driven,
resembling other healthcare systems in the US. It has resulted in gaps in the services because the
services do not primarily focus on individual consumer needs but on the availability of payment.
Therefore, the inconsistency in the application and development of standards of care is
contributed by reimbursement.
Conclusion
The long-term care system is experiencing changes from internal and external forces. It
should be proactive in anticipating the needs of consumers and accommodate creativity and
innovation to meet the needs of a growing population that has identified its priorities. Leaders in
the sector should genuinely provide the services to meet the consumer needs even when they are
exposed to regulations and rules that are incomprehensible.
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References
Pratt, J. R. (2015). Long-term care: Managing across the continuum (4th Ed.). Jones & Bartlett
Publishers.
Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2020). The effect of the
Affordable Care Act on Medicaid payments in long-term care facilities. International
Journal of Healthcare Management, 1-8.