Healthcare Policy and Politics- Healthcare Delivery Systems Essay

Healthcare Policy and Politics- Healthcare Delivery Systems Essay

Discussion •Choose one sector of health care delivery and financing that interests you (medical technology; outpatient and primary care services; inpatient facilities and services; managed care and integrated organizations; or long-term care). What are two challenges facing the sector you have chosen? What are two policies to address those challenges? What are the politics of those policy recommendations, if any? Make clear in your entry if they are policies already adopted; proposed/under consideration; and/or ones that you would recommend. Healthcare Policy and Politics- Healthcare Delivery Systems Essay.

Challenges Facing Long-term Care Sector

Long-term care (LTC) or long-term services and supports (LTSS) include a variety of personal and medical care services that help older adults and individuals with disabilities and routine everyday activities. Financing is a key challenge facing the LTC sector. The need for LTTS presents an increasing financial burden on people receiving care and their families as well as state Medicaid budgets.  According to Favreault et al (2015), Medicare does not offer coverage for extended LTSS. Although Medicaid offers coverage for extended LTSS, it only covers individuals who meet specific eligibility criteria required by the state that limits benefits to individuals with limited wealth and income and those with disabilities. Nevertheless, because individuals who need LTSS might qualify for Medicaid after depleting their resources, it is projected that Medicaid will be paying for around a third of lifetime costs for individuals with severe LTSS needs.

Staffing shortage is another challenge facing the long-term care sector. According to Thomas & Applebaum (2015), workforce challenges continue plaguing the LTC industry. There are increased turnover rates, the rate of recruitment and retention rates are very low, and there have been constant concerns about the quality of work environments, and the quality of workers. Healthcare Policy and Politics- Healthcare Delivery Systems Essay.  Innovation work in the LTC quality arena constantly indicates that a qualified workforce critically determines a positive consumer experience.

The demand for LTC is predicted to surpass the supply of skilled professionals with the qualifications to deliver required services, which will result in severe workforce shortages. According to Spetz et al (2015), it is projected that by 2030 there will be over seven million individuals aged sixty-five years or more, representing twenty percent of the entire population.  Presently, a quarter of older adults requiring long-term care services reside in nursing homes and other residential institutions, with three-quarters of the elderly population needing long-term services and support receiving then at home and other settings based in the community.   There have been concerns about the capacity of the LTC workforce to provide care and services to the growing number of individuals who will need LTC services in the coming decades.


Two policies to address the challenges

The Community Living Assistance Services and Supports (CLASS) Act was a policy aimed at ensuring sustainable financing of the LTSS.  According to…, congress passed the   CLASS Act, which is part of the ACA in 2020, forming a national program of voluntary LTC insurance.  Nevertheless, the law was not implemented by president Obama administration and was revoked by Congress in 2013(Favreault et al., 2015). Healthcare Policy and Politics- Healthcare Delivery Systems Essay. A policy that would require the government to make payments for LTC costs above what is covered is in a private LTSS insurance policy is an approach that ensures sustainable financing of the LTSS sector. This strategy will offer lifetime coverage without requiring individuals to purchase an expensive private LTSS insurance policy that offers lifetime benefits.

The workforce challenge can be addressed by increasing support and training for caregivers.  With informal, unpaid caregivers being a crucial part in the operation of community-based settings for the elderly and thus lessening dependence on Medicaid programs, there is the need to ensure caregivers get sufficient support essential to offer the significant majority of LTSS. Caregiver stress is a significant risk factor for caregiver morbidity and even mortality. Thus, there is a need to avail supports to minimize caregiver stress and burden (Thomas & Applebaum, 2015).



Favreault, M. M., Gleckman, H., & Johnson, R. W. (2015). Financing Long-Term Services and Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending. Health Affairs (Millwood), 34(12), 2181-2191.

Spetz, J., Trupin, L., Bates, T., & Coffman, J. M. (2015). Future Demand For Long-Term Care Workers Will Be Influenced By Demographic and Utilization Changes. Health Affairs, 34, 6.

Thomas, K. S., & Applebaum, R. (2015). Long-term Services and Supports (LTSS): A Growing Challenge for an Aging America. Public Policy & Aging Report, 25(2), 56-62. . Healthcare Policy and Politics- Healthcare Delivery Systems Essay.