The U.S. needs to reform its elder care system so seniors have more options and nursing homes achieve higher levels of quality and safety, writes CMS Administrator Seema Verma.
In a Jan. 8 op-ed published by Newsweek, Ms. Verma wrote that COVID-19 has exposed deficiencies in the long-term care system that U.S. policymakers can no longer ignore.
Keeping nursing home residents safe despite community spread of COVID-19 has proven challenging, Ms. Verma writes, noting that infection control struggles in nursing homes aren't new, dating back long before the pandemic.
The long-term care system relies too heavily on nursing homes, according to Ms. Verma. Though necessary, nursing homes shouldn't be the default. Instead, the U.S. should first provide support in home- or community-based settings, which can be more cost effective and preferred by seniors, Ms. Verma writes. However, such services face numerous barriers, including reimbursement rates, workforce challenges and coverage limitations.
Nursing homes also face a variety of financial issues, exacerbated by the pandemic. The answer isn't more taxpayer funding, Ms. Verma writes, but instead fixing how Americans pay for care.
Currently, only about 2 percent of nursing homes' Medicare reimbursement is linked to quality outcomes. Ms. Verma believes the system should pivot, with nursing homes paid based on health outcomes.
Outcome-focused payment must be paired with outcome-focused regulations, Ms. Verma notes. CMS is moving toward using advanced analytics to proactively identify poorly performing nursing homes and work with them to overcome challenges, according to the CMS chief.