Long-term care in nursing facilities is very expensive and is paid for by both public and private payer sources. Long-term care is defined as services needed by a person when their ability to care for themselves has been diminished by an illness, aging process, or a disability. Most persons living in the U.S. at sometime or another will require some sort of long-term care whether it is given in a facility or at home. It is estimated that there are about 9.5 million Americans with long-term care needs, but this number is only expected to grow with the aging of the population and the growing numbers of persons on disability (Kaiser, 2007). The elderly population is expected to double by 2030, and the 85 and older population, the group most likely to have long-term care needs, are expected to quadruple by 2050 (Kaiser, 2007). According to the Kaiser Family Foundation, over $158 billion was spent on long-term care in 2004 and the average annual cost of nursing home care is $74,000. The consistently rising cost of long-term care in nursing facilities is prompting lawmakers and healthcare professionals to come up with more innovative ways of financing the cost of long-term care.
Medicaid, the program that I have learned about through many of my healthcare management courses is one of the ways that long-term care is financed and is the largest financer of long-term care. Other financers of long-term care at this time come from private pay, Medicare, and long-term care insurance.
Medicaid will cover the cost of a recipient in a nursing facility when he or she spends down there assets to the appropriate level to become eligible. Medicare will only cover the cost of a nursing home recipient up to a certain number of days and that is if they can be skilled for the services. The out-of-pocket comes from the individual or the individual’s family member, which is paid for by whatever financial income or
Cited: Arling, Greg., Hagan, Shelley., Buhaug, Harald. (Aug., 1992). The Feasibility of a Public-Private Long-Term Care Financing Plan. Medical Care, Vol. 30, pp. 699-717. Kaiser EDU. (March, 2007). Financing Long-Term Care: Background Brief Retrieved July 8, 2008, from www.kaiseredu.org Rice, Thomas. (Dec., 1989). The Use, Cost, and Economic Burden of Nursing-Home Care in 1985. Medical Care, Vol. 27, pp. 1133-1147. Rosko, Michael. D., Chilingerian, Jon. A., Zinn, Jacqueline. S., Aaronson, William. E. (Oct., 1995). The Effects of Ownership, Operating Environment, and Strategic Choices on Nursing Home Efficiency. Medical Care, Vol. 33, pp. 1001-1021