Healthcare Chapter 35 Flashcards

Study Notes

Long-Term Care Needs

Individuals aged 85 and older have the highest demand for long-term care, with 50% requiring services.
This age group is the fastest-growing segment of the elderly population.

Nursing Home Statistics

As of 2004, approximately 3.8% of the elderly population, or about 1.3 million individuals, reside in nursing homes at any given time.

Long-Term Care Settings

The majority of long-term care services are provided at home, often by informal caregivers who are family members or close relatives.

Financial Expenditures on Long-Term Care

Nursing homes account for 67% of long-term care expenditures, while home care constitutes the remaining 33%.

Payers for Nursing Home Care

Medicaid is the primary funding source for nursing home care, covering 32.8% of costs, and provides limited support for in-home care (35.6%).

Long-Term Care Insurance Characteristics

About 80% of long-term care insurance is sold to individuals, unlike most medical insurance sold to groups.
Coverage typically includes nursing homes, home care, assisted living, case management, and caregiver training.
Policies often require a deductible of days of care (30 to 100) before benefits are effective.
Most plans include maximum lifetime benefits and daily payment limits for care.
Premiums are influenced by service costs and the risk of needing services, with higher premiums for inflation protection.

Factors Influencing Long-Term Care Insurance Demand

Demand for private long-term care insurance is limited by external factors and market imperfections.

Trends in Long-Term Care Financing

The growing elderly population and limitations in government funding suggest that financial support for long-term care will likely decrease rather than increase.

The CLASS Act

Established alongside the Affordable Care Act (ACA), this program allows contributors to receive a cash benefit if they have two or more functional limitations for over 90 days, starting at $75 per day, adjusted for inflation.

Support for the CLASS Act

Proponents argue that the CLASS Act will help lower Medicaid costs by encouraging home care, which is less expensive than institutionalization.

Opposition to the CLASS Act

Critics warn it may become an unfunded federal entitlement, exacerbating the federal deficit, as premiums may be used for general spending rather than dedicated to CLASS benefits.

Cash and Counseling Program

This Medicaid initiative allows beneficiaries to choose their long-term care services by providing funds instead of relying solely on Medicaid services.
Participants tend to be more satisfied and report fewer unmet needs compared to those using traditional Medicaid services.

Description

Test your knowledge with these flashcards focusing on Chapter 35 of healthcare. Explore important statistics regarding the need for long-term care among different age groups. This quiz will enhance your understanding of nursing home demographics and elder care.