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Sep 24th, 2013

After the CLASS Act was cut from the Affordable Care Act due to the lack of financial sustainability, the Commission on Long Term Care was created to address the long term care issues facing our country today. Among policy recommendations in the Commission’s final report is the suggestion that the Medicare 3-day hospitalization requirement for long term care be eliminated.

Background on Commission

The Commission was instructed to come up with recommendations to address the looming long term care crisis and the associated costs that are currently affects millions of Americans. However, many predicted that the short time frame and limited budget of the Commission would hinder any significant policy solutions.

In the end, the group was very divided in opinions and though they produced a number of policy recommendations related to quality and delivery of care, they were unable to agree on any widespread financing solution for the nation.

Cut 3-Day Rule

One of the policy recommendations included in the comprehensive report is that the federal government do away with Medicare’s 3-day hospitalization requirement. The intent of this suggestion is, assumedly, to increase public access to long term care support and services. Right now, a patient must be admitted to the hospital as an inpatient for a minimum of three consecutive days before they can receive nursing home coverage under Medicare.

The potential problem is, this increased access will lead to increased public health costs, which must be paid for somehow. In a letter to President Obama, Republicans in the Commission adamantly opposed implementing any new taxes to accomplish any part of the proposed long term care agenda, so it remains to be seen how this sharp increase in total expenditures on long term care would be funded.

With Democrats supporting a national insurance program and Republicans encouraging private insurance policies, coherent policy regarding long term care financing is not expected to be presented anytime soon. Although the Commission also recommended that another group resume their work on the matter, chairman Bruce Chernof said that "In a very short time frame, the commission did all it could to be transparent while also completing its work and to try to engage the public," he said.

Feasible Option?

While the concept of removing the Medicare 3- day requirement sounds appealing, the reality is that the idea may simply not be financially feasible, due to the large spike in people who will receive relevant long term care services under Medicare and the lack of structured funding for such care.

Congress is now supposed to consider the Commission’s recommendations in the report and the group has the option to respond with appropriate policy action if they are convinced by the report, which highlights the many issues facing the long term care industry right now.

An upcoming shortage of family caregivers and increase in the number of global Alzheimer’s cases will lead to a greater number of Americans receiving long term care. Preparing financially for this type of situation is crucial, as health care costs continue to skyrocket. Read more about the risk of needing long term care and how to prepare.

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