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

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PROBLEM FOR PEOPLE SUFFERING FROM ALZHEIMER'S DISEASE.
AN INDIVIDUAL WITH ALZHEIMER'S DISEASE COULD BE MANAGED IN
A MUCH MORE COST EFFECTIVE MANNER IF THE SYSTEM WAS
DESIGNED AS A COMBINATION OF A MEDICAL AND SOCIAL MODEL OF
CARE.
*2. PROVIDERS OF CARE ARE NOT TRAINED IN PROVIDING THE
APPROPRIATE LEVEL OF CARE, ESPECIALLY IN THE AREA OF
DEMENTIA CARE.
*3.THE LACK OF A COORDINATED SERVICE DELIVERY SYSTEM
FOSTERS THE CURRENT EXPENSIVE AND COMPLEX SYSTEM OF
LONG TERM CARE.
MY RECOMMENDATIONS REGARDING MANAGED CARE MODELS FOR FRAIL
ELDERS INCLUDE:
*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
STRENGTHSAND DEFICITS IN EACH CLINICAL SITUATION, AND TO
MAXIMIZE ALL AVAILABLE COMMUNITY RESOURCE OPTIONS.