(L-R) Mark McClellan of the Brookings Institution, Carol Raphael of the Visiting Nurse Service of New York, Steven Dawson of PHI

Nearly two dozen eldercare experts convened in Washington, DC, on January 28 for a long-term care forum held at the Brookings Institution, a public-policy think tank.

The day-long event, entitled “Health Care Reform and Older Americans: Achieving Better Chronic Care at Lower Costs,” comprised four separate panel discussions:

• Perspectives on Health Care Reform and Older Adults
• Performance Measurement for Older Adults
• New Opportunities in Improving Care for Older Adults
• Putting It All Together: Integrating Payment Reforms, Performance Measurement, and Delivery Models That Work

Direct-Care Workforce Issues Addressed

PHI President Steven Dawson was a featured speaker during the panel “Perspectives on Health Care Reform and Older Adults.” Dawson spoke to the role direct-care workers might play in a redesigned health care system that more effectively and efficiently meets the needs of older adults living with chronic conditions.

He pointed out that 70 percent of eldercare workers in the U.S. are direct-care workers, and that the direct-care workforce is expected to grow to 4.3 million by 2018.

However, he said, the business model governing the workforce is a “low-investment, high-turnover, low-return model.”

“Everyone nods their head,” Dawson told the attendees, “but no one really responds politically to the argument that these are poor workers and they’re exploited and they should be paid more.

“Even though that’s true, what we really have to do is create a very positive argument that, in fact, these workers are of enormous value to the system, but they’re really underutilized…. We need to design models in which the direct-care workforce and family caregivers together are supported so they can play a much more value-added role,” Dawson continued.

Other Panel Discussions

The event’s three other panels addressed numerous related topics, including

• reforming health care,
• improving care for dementia patients, and
• making eldercare delivery systems more efficient and effective.

Speakers included Mark McClellan, the director of Brookings’s Engelberg Center for Health Care Reform; Mary Naylor, a professor of gerontology at the University of Pennsylvania; Kathy Greenlee, assistant secretary at the Administration on Aging at the US Department of Health and Human Services (HHS); and Richard Frank, the director of the Office of Disability, Aging, and Long-Term Care Policy, also at HHS.

An informal session introducing the new Long-Term Quality Alliance immediately followed the forum.

– by Matthew Ozga