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Using the learning materials to support your claims, respond to the following pr

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Using the learning materials to support your claims, respond to the following prompts in your initial post: 
Describe what surprised you in the learning materials around the cost of long-term care.
Explain the financial challenges and realities that older adults face as they age.
Describe the ways in which long-term care is paid for by aging adults and patterns over time.
Nursing home care is common and costly. Describe how accountable care organization (ACO) payment models have incentives for care that is better coordinated and less reliant on acute settings.
Describe ways in which long-term care is reimbursed for services and the impacts of pay-for-performance models. Does this have the potential to improve care for this high-cost population?
As a leader of a long-term care organization, do you think it is cost effective to provide a more comfortable setting through cultural change?
Does the pay-for-performance model for reimbursement have advantages?
How do low reimbursement rates impact the quality of care delivered to aging adults living in a long-term care setting?
Should be 300 to 500 words, with one to two supporting references included.
Discussion 2
After reading Payne (2015), respond to the following prompts in your original post:
Describe what the author refers to with the phrase Medicaid planning.
Describe ethical factors related to Medicare planning and spending down assets to qualify. Provide an argument for those who support this and those who oppose.
What are the consequences to the healthcare industry if an aging adult is allowed to “spend down” to access Medicaid to cover health care costs (that is, increasing costs and diminished quality)?
should be 300 to 500 words, with one to two supporting references included.
Useful readings
Braun, R. A., Kopecky, K. A., & Koreshkova, T. (2019). Old, Frail, and Uninsured: Accounting for Features of the U.S. Long-Term Care Insurance Market. Econometrica, 3, 981. Retrieved From:
Willink, A., Davis, K., Mulcahy, J., Wolff, J. L., & Kasper, J. (2019). The Financial Hardship Faced by Older Americans Needing Long-Term Services and Supports (PDF). Issue Brief (Commonwealth Fund), 2019, 1–12.
Brenda C. Spillman, & Peter Kemper. (1995). Lifetime Patterns of Payment for Nursing Home Care (PDF). Medical Care, 33(3), 280.
Lepore, M. J., Shield, R. R., Looze, J., Tyler, D., Mor, V., & Miller, S. C. (2015). Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change. Journal of Aging & Social Policy, 27(3), 215–231. Retrieved From:
Bowblis, J. R., & Applebaum, R. (2017). How Does Medicaid Reimbursement Impact Nursing Home Quality? The Effects of Small Anticipatory Changes. Health Services Research, 52(5), 1729–1748. Retrieved From:
Grabowski, D. C., Stevenson, D. G., Caudry, D. J., O’Malley, A. J., Green, L. H., Doherty, J. A., & Frank, R. G. (2017). The Impact of Nursing Home Pay-for-Performance on Quality and Medicare Spending: Results from the Nursing Home Value-Based Purchasing Demonstration. Health Services Research, 52(4), 1387–1408. Retrieved fRom:
Chang, C.-H., Mainor, A., Colla, C., & Bynum, J. (2020). Utilization by Long-Term Nursing Home Residents Under Accountable Care Organizations. Journal of the American Medical Directors Association. Retrieved From:
Becker, A. (2004). Deadly Inequality in the Health Care safety net: Uninsured Ethnic Minorities’ Struggle to Live with Life-Threatening Illnesses. Medical Anthropology Quarterly, 18(2), 258–275.
Ferrara, P. (2015). The Future of Social Security (PDF). National Affairs, 24, 85–99.
Quinn, J. F., & Cahill, K. E. (2016). The New World of Retirement Income Security in America. American Psychologist, 71(4), 321–333.
Payne, J. B. (2013). Ethical and Public Policy and Considerations Related to Medicaid Planning. Pennsylvania Bar Association Quarterly, 84(4), 139–150. Retrieved From:

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