Integrating the Financing and Delivery of Medical and Supportive Services for People Living With Dementia |
| |
| Affiliation: | 1. Division of Geriatric Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA;2. Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA;3. Department of Community and Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA;4. Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA;5. The Geriatric Research, Education and Clinical Center (GRECC) Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA;1. Global Brain Health Institute, Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland;2. Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom;3. University of Manchester, Manchester, United Kingdom;4. Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom;5. ENRICH Lead West Midlands NIHR Clinical Research Network (CRN), Birmingham, United Kingdom;6. Bradford District Care NHS Foundation Trust, Bradford, United Kingdom;7. Solent NHS Trust, Portsmouth, United Kingdom;8. Lancashire & South Cumbria NHS Foundation Trust, Preston, United Kingdom;9. Department of Linguistics, Macquarie University, Sydney, Australia;10. Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom |
| |
| Abstract: | The number of people living with dementia (PLWD) is expected to grow considerably in the coming years. PLWD often have substantial medical and supportive service needs and face fragmentation of services across payers and across health and social service systems; recently, efforts have been made to achieve greater integration of care and financing. This article considers issues related to integrating long-term services and supports (LTSS), medical care, and financing for PLWD; reviews the policy context and key clinical and delivery system challenges to these efforts; and describes key lessons regarding integration learned from examples in the field. Recommendations are provided and include the following: (1) assess carefully whether integration of medical and LTSS is required to achieve the intended outcomes of an intervention or program targeted at PLWD; if integration is needed, select carefully the types of medical and LTSS to integrate and the mode of integration; (2) use measures that evaluate quality across LTSS settings in which PLWD receive care; (3) assess whether and how eligibility and payment policies pose barriers to PLWD from receiving services they need, and evaluate ways in which policies might be reformed to meet beneficiaries’ needs; and (4) conduct research examining the potential of value-based payment efforts to improve the quality and efficiency of care received by PLWD, including their potential impact on out-of-pocket expenses and caregiving burden for PLWD and their families. |
| |
| Keywords: | Care integration dementia health care financing long-term social supports |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
