WASHINGTON – Three provisions of the Affordable Care Act (ACA) intended to enhance care transitions and prevent avoidable outcomes for the Medicare population are found to have inadequately addressed the needs of older, vulnerable recipients of long-term services and supports, according to George Washington University School of Nursing Assistant Research Professor Ellen Kurtzman, MPH, RN, FAAN.
Ms. Kurtzman was one of six authors of the paper examining the consequences of select ACA provisions on this subgroup of frail older adults. In the paper "Unintended Consequences Of Steps To Cut Readmissions And Reform Payment May Threaten Care Of Vulnerable Older Adults" published first online in the medical journal, " Health Affairs ," three provisions were reviewed: the Hospital Readmissions Reduction Program, the National Pilot Program on Payment Bundling and the Community-Based Care Transitions Program.
The research found that these provisions inadequately address the unique needs of elderly Americans receiving long-term services and supports, and in some instances, produce unintended consequences that contribute to avoidable poor outcomes.
"While the Affordable Care Act makes significant investments in improving care transitions and reducing fragmentation, there are significant gaps for a vulnerable subgroup of older adults receiving long term services and supports," said Ms. Kurtzman. "To address potential gaps and emerging risks, we recommend policy makers carefully monitor the law's implementation, advance payment policies that integrate care more fully and support providers in delivery system changes. Without anticipating unintended consequences and retooling the payment and delivery systems, reform could fall short of its transformative promise."
The research was funded under a grant awarded to the Long-Term Quality Alliance (LTQA) by the Commonwealth Fund. The paper will also appear in the July print edition of " Health Affairs ."
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Health Affairs