Advocacy

Strengthening Aging and Chronic Care Services

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October 2017

THE ISSUE
Americans are living longer and increasingly face long-term care needs and challenges related to chronic illness. In fact, over 90 percent of current Medicare spending is for the treatment of chronic illness

The Catholic health ministry advocates public policies that promote a high quality, accessible and affordable continuum of care to address the needs of those who, because of frailty or chronic conditions, require continuing care, services and supports.

As people in our communities live longer and the need for chronic care, services and supports grows, the Catholic health ministry is challenged to provide a compassionate continuum of services to address physical, social, psychological, and spiritual needs. This requires a shift in the focus of the health care system, from treating episodes of acute illness to an emphasis on maximizing health and independence and managing chronic illnesses. The essential challenge for policy makers and providers alike is to design a system that is adequately structured and financed to provide quality services along a continuum.

MINISTRY TRADITION
The mission of the Catholic health ministry is to serve those in need, with special concern for those who are vulnerable through poverty or disability, and to create a society in which everyone has the necessary resources to achieve physical, mental, spiritual, emotional and social health. Ensuring the availability of continuing care throughout illness and in frailty is at the heart of our commitment.

CHA'S POSITION AND ACTIVITIES
CHA strongly supports efforts to coordinate and integrate person-centered health care and social services along the continuum of care, to ensure the best outcome for everyone. CHA activities have included:

  • Researching how long term care organizations are improving care and decreasing costs by reducing the number of discharged hospital patients from being readmitted  
  • Monitoring how Medicaid managed care is including long-term care services and support in serving older Medicaid beneficiaries and others who are dually eligible for Medicare and Medicaid
  • Sharing information about  how CHA members are creatively developing a continuum of services, including more home and community-based services; the use of tele-health; health homes; and population health management
  • Developing educational resources for health care organizations to work with faith congregations in order to support older persons and their care givers in the community
  • Disseminating findings from pilot projects for creating "Age-Friendly Health Systems"
  • Studying how to achieve a high quality and stable work force.

CHA supports policies that:

  • Provide adequate and sustainable financing to ensure the ability of long-term care facilities and services to provide quality and compassionate care
  • Promote improved coordination of care for those with chronic or serious illness
  • Provide the elderly and persons with disabilities options to receive long-term care services and supports in the most appropriate care setting, whether at home, in the community (such as PACE) or in a residential  facility
  • Include participation of the full continuum of care, including long-term care facilities in federal demonstrations and other program such as  bundled services, accountable care organizations and medical homes
  • Promote access to affordable senior housing with the necessary and appropriate services and supports
  • Improve access to high quality palliative care for all

CHA will address these issues in collaboration with partners in the long-term care continuum, including the LeadingAge, the American Health Care Association and other faith-based and consumer organizations.

CHA supports the following legislation:

  • The Improving Access to Medicare Coverage Act of 2017 (S 568) and Medicare Coverage Act of 2017 (HR 1421), to allow for the time patients spend in the hospital under "observation status" to count toward the requisite three-day hospital stay for coverage of skilled nursing care.
  • Repeal of the limits on Medicare coverage of medically-necessary therapy. The caps should be repealed in favor of more realistic means of ensuring against over-utilization of therapy coverage.