Long-term care providers have always had to stay on top of ever-changing shifts in trends, policies and regulations. Since last year, Grabowski has applied his expertise to a range of senior care topics, from home-based care spending to SNF-at-home programs.
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Grabowski: This is a really great place to start the conversation. Nursing care articles are times when you look at the U. Even drilling down within the U. I think the story here is very mixed, whether you compare us to other countries around the globe or just looking across the U. However, my research, along with my general experience of living many decades here in the U.
I think that means reimagining nursing homes. Nursing homes today are far too institutional. The staffing is far too hierarchical.
Very few facilities around the country csre resident-directed. Nursing care articles you talk to residents, they feel very little sense of purpose or control over their lives. We need to flip that. I really have called for both investment in home- and community-based services and in the reimagining nursing homes. I view them as complementary.
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We need to set up a spectrum or a system of services that meets the needs of individuals who receive care in the community but also those who might need to receive care in an institutional setting. That means potentially smaller environments, nursing care articles staff members are well-compensated and valued. And where the residents have control over their environment.
This is a really fascinating model. Nursing care articles the spirit of full disclosure, I was involved in a pilot project with some colleagues here at Harvard — read article one of our affiliated hospitals, Brigham — to pilot one of these programs as well. When we did the trial, we had to go forward with this model with just internal atticles. The concept has a lot of promise. Like any new model, however, we have to really wonder where the demand is going to come from. Or is it going to cade largely individuals who would have gone home anyway and might have done fine under the home health benefit?
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Are we pulling some of those individuals into this new benefit? Does that lead to higher spending? I think targeting there is going to end up being very important. I think it comes back to that word I used earlier: value.
We know that the Medicare margins for home health have been quite big over the last [several years]. Other indicators that MedPAC uses to evaluate the adequacy of payments seem to suggest, you know, that this is a really robust sector.
This is a healthy industry — and that was true pre-pandemic.]