Why do LTCF/nursing homes play an important role in the continuum of care?
Goldberg, T., (2014), explained how Medicare and Medicaid supports nursing homes in the continuum of care for the elderly. He stated that from their establishment in 1965 as a part of the Social Security Act both Medicare (Health Insurance for the Aged and Disabled) and Medicaid (Medical Assistance for the Poor) cover aspects of long-term care (LTC) but in different ways. He added, that Medicaid covers long-term nursing home care for those who qualify financially and medically, but generally does not cover residential care/assisted living. The coverage provided under Medicare is more complicated because of its four different parts:
• Medicare Part B covers physician services and therapies, generally regardless of location (i.e. physicians bill Medicare Part B for patients seen in hospitals, outpatient or LTC settings, but using different billing codes based on setting).
• Medicare Part A covers hospitalizations, hospice, home care, and skilled nursing home care, but only temporarily after a three consecutive day hospital stay.
• Medicare Part D covers drugs and vaccines regardless of settings.
• Medicare Part C consists of various managed care plans, which vary in benefits but always cover at least whatever traditional
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Sridhar, R., Naughton, B., (2010), stated that the U.S. population is aging and associated with this group is an increase in the incidence and prevalence of chronic diseases, with consequential increase in health care expenditure. They stated that in 2000, the total Medicare expenditure was $239.5 billion. By the year 2010, this expenditure is estimated to increase to $519 billion. The concept of aging in place is one method proposed to reduce cost, while maintaining the quality of life for the elderly. The elderly will be supported in their environment of their choice while avoiding institutionalization and or nursing home