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May 11, 2016

Report says long-term care a 'looming budget crisis for MassHealth'

Courtesy Photo A report discussed at the state house laid our concerns for long-term care funding.

As the Massachusetts population ages, the state's system of long-term services and supports represents both a growing priority in health care and a "looming budget crisis for MassHealth," according to a report out Tuesday.

The report, released by the Blue Cross Blue Shield of Massachusetts Foundation, calls for a series of "fundamental reforms" its authors say would turn a fragmented system into a more integrated and accountable one.

The report's recommendations include calls to improve access to services, support "informal caregivers" and increase the capacity of the direct-care workforce.

Foundation president Audrey Shelto said that Massachusetts is currently "on an unsustainable path" when it comes to long-term services and supports.

"It is imperative that we develop new and better methods of caring for a chronically ill and aging population, one that rightfully cherishes independence, and doing so in a way that is sustainable for the Commonwealth," Shelto said in a statement.

Approximately 750,000 Massachusetts residents report having a disability and the number of people age 65 and over in the state will grow by almost half in the next 20 years, according to the Blue Cross Blue Shield of Massachusetts Foundation.

The report says that long-term supports and services account for nearly one-third of all MassHealth spending, hitting $4.5 billion in 2015.

To improve access to the services, the report recommends streamlining eligibility across state agencies and making the system more user-friendly and easier to navigate. It suggests building awareness of existing tax incentives for family caregivers and allowing MassHealth to pay spouses as family caregivers, after implementing protections against potential fraud and abuse.

Support for "informal caregivers" such as relatives will help the state cope with "an oncoming workforce crisis" as demand for long-term services grows, the report says.

Other workforce-focused recommendations include setting a minimum wage for all direct-service workers and supporting efforts to professionalize the long-term support workforce, such as offering benefits, full-time employment opportunities and ongoing skills trainings.

"We believe the Commonwealth must implement these options for reform, some of which will require new investments or reallocation of existing resources," said Manatt Health senior advisor Carol Raphael, one of the report's authors. "Massachusetts has demonstrated its ability to lead in health care system reform and can continue to that legacy of leadership and innovation by taking on comprehensive LTSS reform; the stakes are too high not to act."

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