The ACA Can Mean a Better Future for America's Elders

Aging Today, May/June 2012 | Go to article overview

The ACA Can Mean a Better Future for America's Elders


In late March 2012, while the Aging in America (AiA) conference convened in Washington, D.C., the Supreme Court heard three days of arguments over the constitutionality of the Affordable Care Act (ACA). The ACA's potential for elders was discussed in-depth by advocates in aging during AiA's March 29 "National Forum on the Affordable Care Act: A Way Toward Aging with Dignity in America."

The Forum, hosted by ASA's Public Policy Committee and underwritten by a grant from The SCAN Foundation, was inspired by the Spring 2011 issue of ASA's journal, Generations, which focused on "The Affordable Care Act: A Way Toward Aging with Dignity in America." Moderated by ASA Immediate Past President Cynthia Stuen, expert panelists included Dr. Bruce Chernof, The SCAN Foundation; Dr. Bruce Leff1 Johns Hopkins University; Brenda Sulick, formerly with the National PACE Association; Kirsten Sloan, National Partnership for Women & Families; Carol O'Shaughnessy, National Health Policy Forum; Diane Justice, National Academy for State Health Policy; and Richard Kaplan, University of Illinois College of Law.

"These are controversial times," Chernof said, and the current healthcare system "is not adequate to meet the needs of older adults." He noted that public policy is hard to generate, and "we now live with a legacy of public policy that is made in the past, with an eye toward the future that is a 'best guess' on what the future would look like. And guess what-the future looks really different than what was predicted." In the last century, medical advances have given people many more opportunities to live with chronic illness, but "the public policy to keep up with the broader range of needs that people have really isn't there." Policy solutions have been "born on the back of the medical system and somewhat on the economic security system." A case in point: the Medicare system, one of the most important purchasers of long-term care in America, is ever straining to provide long-term services and supports to older adults.

The focus now, Chernof said, is to try to solve problems through solutions across the spheres of health, economic and functional security. What's needed to bolster policy change is data from disease and chronic condition management. But that data isn't there. "The net we're using to capture data is too large." The net must be narrowed to accurately identify the population being served and at what cost.

There will be, Chernof said, enormous pressure to act in the aging policy arena vis a vis the current budget deficit proposals and the ongoing cries for draconian cuts. He believes the policy solutions on the table exist in and across healthcare silos, and in how people pay for and afford care.

Then there's language. "Our policies are riddled with the kind of language that is not effective in engaging the broader public about issues in aging," Chernof said. Language should focus on the function and abilities people retain as they age, not on capacities lost. "Rationalizing our language and focusing our platforms on dignity, choice and independence are the ways toward a broader health policy argument that includes the things we all care about."

The ACA Drives New Care Models

The ACA can transform the current system by finding new ways, via innovative care delivery models, to pay for and deliver healthcare services. Presentations by Dr. Bruce Leff, policy expert Brenda Sulick and federal health issues expert Kirsten Sloan focused on the potential of different care models-or Accountable Care Organizations (ACO)-that can "bust" and cut across extant self-contained healthcare silos. Leff discussed four silo-busting models-Guided Care, Medical House Calls, Hospital at Home and the Geriatric Care Portfolio-all involving a team-based approach that consolidates service delivery, eases access to care, brings medical services in-home, helps patients stay out of the hospital- and, in the event of unavoidable hospitalization, uses a business-model "portfolio" approach to help older patients navigate the care system safely and make a good transition home. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

The ACA Can Mean a Better Future for America's Elders
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.