HCP Viewpoint: State of the long-term care industry

The world of long-term care is changing, and this will impact the future of care in Central New York, as well as the future of Loretto. 

Integration

Federal and state health and reimbursement policies are driving the market toward what’s called clinically integrated health systems. These involve facilities across the continuum of care jointly managing a person’s care to more efficiently move patients out of the hospital faster, to lower-cost settings like long-term care, skilled-nursing facilities, and ultimately back home. 

This presents new opportunities for organizations like Loretto, especially with rehabilitation programs. By coordinating the delivery of care with local acute-care providers, we can achieve lower lengths of stay for a patient, reduced hospital readmissions, and lower costs — with higher quality care. 

Aging population

As our population ages, the demands for state and federally funded health-care programs — Medicaid and Medicare — and for long-term care services will be greater than ever. 

But we must also be prepared for one of several possible futures with Medicaid and Medicare. For example, if Medicaid expansion is repealed, New York counties would lose more than $500 million in direct funding for this program that helps to create quality, affordable health coverage — including for long-term care services. And further, if Medicaid switches to block grants to the states, then New York state will have even less money available for its Medicaid program.

Complex needs

As more complex needs increase, long-term care and rehabilitation systems need to be more innovative in providing care to populations beyond what we think of as a “traditional” long-term care resident. 

These individuals have more complex health and rehab needs; behavioral, mental health and substance-abuse issues; or bariatric-care needs. And these are residents who require higher levels of clinical care. 

Alzheimer’s disease and dementia is another growing issue in our communities. This requires more specialized services, facilities, and training for providing memory care, which is why Loretto will be actively investing in the coming years to provide state-of-the-art care, programming, and residences for this growing population. 

Limited resources

Our programs are being stretched to their limits as we try to care for a larger population that’s living longer, while dealing with a nationwide shortage of nursing staff. 

While health-care systems across the country are trying to find ways to attract and retain nurses, Loretto is investing in our current and future employees by funding up to 90 percent of the education costs for certified nursing assistants and licensed practical nurses to pursue advanced degrees to build a strong registered-nurse workforce for the future.

Managed long-term care

You’re also going to start to see “managed long term care” become the main form of insurance, for example, through programs that offer medical services under a single payment that will cover all patient needs.

There are challenges ahead, and we continue to watch the state of potential issues like the repeal and replacement of the Affordable Care Act, while also creating opportunities to secure the future of long-term care in Central New York.                  

Kim Townsend is president and CEO of Loretto, a nonprofit network of elder-care providers. It provides long-term care services to more than 7,000 older adults annually in Central New York. Loretto employs more than 2,400 people.