Pay for the Doc Fix by Fixing Medicaid LTC (LTC Embed Report #2)
Friday, August 5, 2011
LTC Comment: Could
stanching the Medicaid LTC financing hemorrhage fund the "Doc Fix?" We
think so. Read our new report
*** Today's LTC Bullet is
sponsored by The National LTC Network, proud supporters of the 3IN4
NEED MORE awareness campaign. Read more about how you and your
organization can support LTCI sales and referrals by using the 3in4
Need More campaign at
National LTC Network is an alliance of leading distributors of
long term care insurance. Network member firms place more than $50
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Contact a member firm to attend their Producer's Conference Oct.
2-4 in Dallas, where you'll learn how to sell over the internet and
*** NY TIMES MAGAZINE PROFILES VIDEOGRAPHER JAMES O'KEEFE. Read
"Stinger: James O'Keefe's Greatest Hits"
here. This long profile of the one-man scourge of
Acorn, NPR, and state Medicaid eligibility systems is fascinating.
Read it, then watch the five videos (and counting) that O'Keefe has
completed already catching Medicaid eligibility workers aiding and
abetting outright fraud. Find past and future videos in the series
*** DO YOU ENJOY A GOOD
THRILLER? Then I've got a tip for you. Read "Hunter: A Thriller," by my
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thriller, and part romantic suspense novel. I think it's as good as
anything I've read in the genre and better than most. The book is
available online for $3.99 as an e-book. You can read all about it, sample
the early chapters for free, or purchase it, at:
Amazon's Kindle Store,
Barnes & Noble.com (for Nook owners), or
Smashwords for other e-readers.
Amazon has the paperback for $15.95. This book has nothing to do with
LTC, but it is fiction that deals with serious ideas, in this case the
plight of crime victims. Enjoy! ***
LTC BULLET: PAY FOR THE
DOC FIX BY FIXING MEDICAID LTC
LTC Comment: Following
are excerpts (with footnotes omitted) from our newest report, posted today
www.centerltc.com/reports.htm. Read "Pay for the Doc Fix by Fixing
Medicaid LTC," by Stephen A. Moses,
The "Doc Fix" Problem
The sustainable growth
rate (SGR) formula the government uses to pay physicians is set to slice
nearly 30% off the doctors' Medicare reimbursement rates on January 1,
2012. Almost everyone agrees that can't be allowed to happen. But no one
knows how to pay for avoiding it. The "Doc Fix" is estimated to cost $30
billion per year, $300 billion over ten years, and $500 billion soon if
nothing is done.
In the meantime, Medicaid
long-term care is fraught with virtually boundless waste, fraud and abuse,
as Cato's Michael Cannon has documented. Recent exposÚs by
video-muckraker James O'Keefe dramatize the problem. All it would take to
save most of the cost of the "Doc Fix" is to think clearly about Medicaid
LTC and reform it. In other words, "Pay for the Doc Fix by Fixing
Medicaid LTC." Here's how.
[To see how we got from
this introduction to the following summary, read the whole report
- Medicaid is supposed to
be America's long-term care safety net for the poor. Instead, it is the
principal LTC payor for nearly everyone.
- Medicaid's LTC benefit
has become "inheritance insurance" for baby boomers, lulling them into a
false sense of security regarding their own future long-term care needs.
- Medicaid's generous LTC
eligibility and elastic income and asset limits create perverse
incentives that invite abuse and discourage responsible long-term care
- The conventional wisdom
that most people must spend down their life savings before they qualify
for Medicaid long-term care benefits is a myth, demonstrably false.
- If people's biggest
asset, their home equity, were at risk to pay for long-term care, most
people would plan early to save, invest and insure against that risk.
- Reverse mortgages
permit people to withdraw supplemental income or assets from their
otherwise illiquid home equity without giving up use of the home. This
extra cash can purchase services to help them remain at home and delay
or avoid Medicaid dependency altogether.
- The single most
effective step Congress and the President can take to fix Medicaid,
reduce its cost, and improve America's long-term care service delivery
and financing system is to replace Medicaid's home equity exemption with
a reverse mortgage as a pre-condition of eligibility.
- That simple measure
will pump desperately needed financial oxygen into the LTC service
delivery system, relieve the burden of Medicaid on taxpayers, enable
Medicaid to provide better access to higher quality care for the
genuinely needy, and expand the market for LTC insurance and home equity
conversion products, thus generating additional tax revenue for state
and federal coffers.
- It can also pay for the