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Medicare Changes May Lead More Seniors to Stay at Home

Nationwide, there is a growing movement among state legislatures to push for reforms aimed at keeping seniors out of nursing homes. This push comes from a lot of places. For some, concerns about abuse and neglect make people avoid admission as long as possible. Others simply feel dehumanized by being taken out of their home environment, only to live out their final years in relative solitude. Some of these fears are warranted and some may not be. Nevertheless, one concern cannot be overstated – cost. Nursing home costs have grown exponentially in the last 10 years.

Medicaid struggles to foot the bill

Medicaid, being the primary source of payment for nursing home care, already covers the majority of the country’s long-term care costs. However, sources differ on how much. The Associated Press lists roughly $146 billion each year going directly to long-term care expenses. Yet, numbers from the Kaiser Family Foundation illustrate a much clearer breakdown of the data. The Foundation estimates over $118.7 billion in Medicaid funding is allocated to long-term care. With some qualification, the Foundation is able to at least estimate that about $2.9 billion of this number goes to paying for long-term care expenses in the Sunshine State alone.

Therefore, already strapped and struggling under Medicaid expansion, the program can only do so much. Even states that did not adopt expansion, such as Florida, recognize the huge financial impact Medicaid expenditure has on the economy.

Need for better options

According to the Associated Press, by 2050, the number of seniors who are 85 or older is expected to grow to as much as triple current numbers and reach 18 million. This astonishing wave of seniors reaching the typical age of nursing home admission is expected to lead to a steep increase in demand for long-term care. Yet, as demand increases, the question for many experts is whether supply can keep up. And logic dictates that if supply must be quickly increased without proper funding, care may suffer.

What Medicare is doing about the situation

Under new federal regulations, seniors would have more options for community-based care. This emerging trend means that people will have options that include periodic in-home nursing care, around-the-clock attendant services and similar protections guiding staff behavior, which will be aimed at protecting dignity and preventing abuse. One way this helps is reducing the high cost of nursing home care. Whereas some states report nursing home rack rates as high as $10,000 per month, the per-patient cost for providing community-based care can be as low as $860 per month, as is the case in Illinois. Under the new regulations, states would be eligible to receive federal support from Medicare, which is federally funded, as an incentive for increasing community-based care options.

The specifics of these new regulations are still unknown, and it is difficult to know how they will be applied, if the regulations are finally adopted. This change, however, is being harkened as a move in the right direction by elder advocate groups. Only time will tell how effective the program will be.

Long-term planning in Florida

Laws are always changing, both state and federal. Many times the laws sharply change how seniors plan their futures. What was once thought to be a wise investment plan may now be obsolete or inadvisable. The best way to protect your savings and assets in retirement and plan for potential long-term healthcare is to speak with a local Florida elder law attorney who understands these changes and can provide clarification on the issues that affect you most. If you are retiring or are facing potential nursing home residency, contact the Millhorn Elder Law Planning Group to set up a consultation at one of three convenient locations in The Villages. It is the first step in protecting your future and preparing for whatever changes may be coming.

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