Medicaid Managed Care - U.S. Senate Special Committee on Aging

MY RECOMMENDATIONS REGARDING MANAGED CARE MODELS FOR FRAIL
ELDERS INCLUDE:
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1. MANAGED CARE MODELS MUST RECOGNIZE THAT THE OLDER ADULT AND
HIS OR HER INFORMAL SUPPORT NETWORK OF FAMILY AND FRIENDS ARE
THE CENTRAL FOCUS OF THE PLAN OF CARE.
2. MANAGED CARE MODELS MUST PROVIDE QUALITY SERVICES WHICH
RESPOND SPECIFICALLY TO THE NEEDS OF FRAIL ELDERS. WHILE THE
'HIGH TECH' INTERVENTIONS OF THE LAST DECADES RESPOND TO THE
NEEDS OF SOME POPULATIONS, SERVICES FOR ELDERS MUST INCLUDE
'LOW TECH-HIGH TOUCH- SERVICES SUCH AS: HOMEMAKER, COMPANION
AND HOME DELIVERED MEALS.
3. MANAGED CARE ORGANIZATIONS MUST UTILIZE A COMPREHENSIVE CARE
MANAGEMENT MODEL IN ORDER TO IDENTIFY THE UNIQUE STRENGTHS
AND DEFICITS IN EACH CLINICAL SITUATION, AND TO MAXIMIZE ALL
AVAILABLE COMMUNITY RESOURCE OPTIONS.
4. MANAGED CARE MODELS MUST PROVIDE APPROPRIATE ACCESS TO
SPECIALTY CARE WHEN NECESSARY. IN VIEW OF THE INCREASING
PREVALENCE OF ALZHEIMER'S DISEASE AND RELATED DISORDERS, IT IS
IMPERATIVE THAT THE SERVICES OF GERIATRICIANS, GERIATRIC
PSYCHIATRISTS, NEUROLOGISTS, NURSES AND SOCIAL WORKERS BE
AVAILABLE TO ADDRESS THE NEEDS OF THESE ELDERS AND THEIR
CAREGIVING FAMILIES.
5. SPECIAL ATTENTION MUST BE PAID TO THE ROLE OF RESPITE CARE
SERVICES FOR INFORMAL CARE PROVIDERS. IT IS NATIONALLY
RECOGNIZED-THAT A FULL 80% OF ALL CARE TO FRAIL ELDERS IS
PROVIDED BY THEIR INFORMAL CARE SYSTEMS; SPOUSES, CHILDREN,
GRANDCHILDREN, AS WELL AS SIGNIFICANT FRIENDS AND NEIGHBORS.