Steering LTC toward an Steering LTC toward an Ideal SystemIdeal System

Text: John R PrattText: John R Pratt

Presented by: Dr. Kendall BrunePresented by: Dr. Kendall Brune

Toward an Ideal System-Criteria 1Toward an Ideal System-Criteria 1

• The LTC system should be based on recognition of the needs, rights, and responsibilities of individuals– LTC system should be:

• consumer driven~!• meet all the needs of the consumers~!• Should focus on the individual, recognizing that

individuals have unique needs~!

Toward an Ideal System-Criteria 1Toward an Ideal System-Criteria 1

• The LTC system should be based on recognition of the needs, rights, and responsibilities of individuals (cont.)– LTC system should be:

• Respectful of different cultures & cultural values~!• Promoting quality, dignity, and self-improvement

for consumers~!• Balancing consumer rights and responsibilities~!• Offering consumers a choice of services & delivery

modalities~!

Toward an Ideal System-Criteria 2Toward an Ideal System-Criteria 2

• The LTC system should be easily accessible– LTC system should be:

• Universally Accessible~!• User-friendly~!• Providing care in the least Restrictive

Environment~!• Encouraging Single-site care availability~!

Toward an Ideal System-Criteria 3Toward an Ideal System-Criteria 3

• The LTC system should coordinate professional, consumer, family, and other informal caregiver resources– LTC system should be:

• Integrating Professional, Community, Family, and other Informal Caregiver efforts~!

• Evolving from the current Medical Model to a Holistic Model of Service Delivery~!

• Evolving Families in Case-Management and Care Delivery~!

Toward an Ideal System-Criteria 4Toward an Ideal System-Criteria 4

• The LTC system should be an Integral part of the Health &” Social system, to promote integration, efficiency, and cost-effectiveness– LTC system should:

• Include a Full continuum of Services~!• Include a Full & Uniform Assessment (initial and

ongoing) of the Consumer’s Needs~!– Mind, Body, & Spirit

Toward an Ideal System-Criteria 4Toward an Ideal System-Criteria 4

• The LTC system should be an Integral part of the Health &” Social system, to promote integration, efficiency, and cost-effectiveness (cont. )– LTC system should:

• Provide emphasis on, and Reimbursement for, Illness Prevention efforts as an Integral part of the overall process~!

• Plan and coordinate Efforts to Reduce Facility Fragmentation and Inefficiencies~!

• Be Accountable for Operational Outcomes~!

Toward an Ideal System-Criteria 5Toward an Ideal System-Criteria 5

• The LTC system should be adequately and fairly Financed– LTC system should:

• Use Public and Private (consumer) Resources to ensure Universal Access to Services~!

• Provide Incentives for Consumers to use Services in an Appropriate and Cost-Effective manner~!

• Provide Incentives for Consumers to Self-Finance their care~!

Toward an Ideal System-Criteria 5Toward an Ideal System-Criteria 5

• The LTC system should be adequately and fairly Financed (Cont.)– LTC system should:

• Avoid causing Impoverishment of Consumers and Families~!

• Provide Incentives for Providers to Develop Cost-Effective Measures~!

• Develop Payment Mechanisms that allow Efficient Providers to adequately Compensate Staff~!

– Must have a Margin & ROI

Toward an Ideal System-Criteria 5Toward an Ideal System-Criteria 5

• The LTC system should be adequately and fairly Financed (Cont.)– LTC system should:

• Operate within the Limits of a Well-Conceived Budgets~!

• Provide Significant Flexibility to enable Consumers to meet LTC needs as each consumer Defines those needs~!

• Be based on Uniform Financial Eligibility Criteria~!

Toward an Ideal System-Criteria 6Toward an Ideal System-Criteria 6

• The LTC system should include an Education component to Create Informed Consumers, Providers, Payors, and Regulators – LTC system should:

• Include Community Education Models~!• Include Education for Providers~!• Educate Young Healthy persons to better Prepare

them to Cope with Chronic Illness~!

Toward an Ideal System-Toward an Ideal System-ConclusionsConclusions

• The LTC Ideal Models of Care – Will be Driven by Consumer girth and demands:

• combination of Increasing physical needs• Require new models of delivery that are effective and

efficient • Increased consumer Knowledge and Understanding (Internet

Support)• Increased demand for Quality~!• Increased Demand for Wanted Services~!• Prepare Programs to Educate Younger Consumers~!