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Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
The November 1994 midterm elections were a watershed event, making possible a Repbulican majority in Congress for the first time in forty years. Contract with America, by Newt Gingrich, the new Speaker of the House, Dick Armey, the new Majority Leader, and the House Republicans, charts a bold new political strategy for the entire country. The ten-point program, which forms the basis of this book, was announced in late September. It received the signed support of more than 300 GOP canditates. Their pledge: "If we break this contract, throw us out". Contract with America fleshes out the vision and provides the details of the program that swept the GOP to victory. Among the pressing issues addressed in this important book are: balancing the budget, stopping crime, reforming welfare, reinforcing families, enhancing fairness for seniors, strengthening national defense, cutting government regulations, promoting legal reform, considering term limits, and reducing taxes.
Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.
This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.