A new policy brief from the SCAN Foundation details nine ways in which the implementation of the Affordable Care Act (ACA) has affected healthcare delivery and long-term services and supports (LTSS) for older adults since it was signed into law in 2010.
“Given the rapid growth of America's aging population, particularly those over age 85 who often have substantial health and daily living needs, provisions in the ACA presented significant opportunities for transformation,” according to the brief.
Five elements have helped improve the coordination of care across providers, the authors say:
- Accountable care organizations.
- The community-based care transitions program.
- Health risk assessments to support care coordination.
- Dual-eligible demonstration projects.
- Health homes.
Four elements have expanded access to Medicaid-funded home and community-based services, they add:
- The community first choice option.
- The Section 1915(i) home- and community-based services state plan option.
- The money-follows-the-person rebalancing demonstration project.
- The balancing incentive payment program.
Care delivery can be transformed further, the brief continues, through the establishment of principles of person-centered care and the development of person-centered assessment processes as well as the recognition and support of family caregivers and by making LTSS more affordable.
“Continued efforts are critical, building on successes and lessons learned, including understanding which components work best to meet the range of needs among a diverse older population,” the authors write.