Over one million Americans rely on nursing homes for care, yet nursing homes face challenges in recruiting and retaining staff. Nursing homes rely on registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) to provide care, but staff shortages that increased during the COVID-19 pandemic have persisted.
Long-Term Services & Supports, Long-Term Care
ASPE conducts research, analysis, and evaluation of policies related to the long-term care and personal assistance needs of people of all ages with chronic disabilities. ASPE’s work also highlights the financing, delivery, organization, and quality of long-term services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL). This includes assessing the interaction between health care, post-acute care, chronic care, long-term care, and supportive services needs of persons with disabilities across the age spectrum; determining service use and program participation patterns; and coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and needs of people with long-term care needs, including older adults and people with disabilities.
Noteworthy
Most Older Adults Are Likely to Need and Use Long-Term Services and Supports
More than one-half of older adults, regardless of their lifetime earnings, are projected to experience serious LTSS needs and use some paid LTSS after turning 65.
Older adults with limited lifetime earnings are more likely to develop serious LTSS needs than those with more earnings.
However, fifty-six percent of older adults in the top lifetime earnings quintile receive some paid LTSS, and the likelihood of nursing home care does not vary much by lifetime earnings. Learn more.
Reports
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Assessing the Feasibility of Creating a National Behavioral Health Workforce Database
The U.S. behavioral health (BH) workforce faces significant shortages and distribution disparities, hindering access to quality care and worsening health outcomes. A comprehensive, centralized database of BH providers is vital for advancing patient-centered outcomes research (PCOR), comparative effectiveness research (CER), and evidence-based policymaking.
ASPE Issue Brief
Operationalizing the Definition of Intellectual and Developmental Disabilities in Administrative Claims Data for Research
The existence of multiple operational definitions for intellectual and developmental disabilities (ID/DD) in analyzing administrative claims data for health services and public health research limits translation of study findings to inform policies, programs, and practice.
ASPE Issue Brief
Treatment for Children and Adolescents Enrolled in Medicaid and CHIP During COVID-19
The first brief below provides insight into children’s and adolescents’ mental health service use in Medicaid and CHIP during the pandemic, by using a national Medicaid claims database.
Report
New Jersey Home Care Workforce Case Study: Final Report
This New Jersey case study provides insights into the daunting challenges states face in seeking to address the home care worker shortage, which has become more acute as New Jersey and other states have striven to “re-balance” Medicaid long-term services and supports use and spending away from institutional care toward home and community-based services.
A Framework for Evaluating the Impact of the Center for Medicare and Medicaid Innovation
This ASPE issue brief lays out a proposed comprehensive analytic framework to fully evaluate the impact of the CMS Innovation Center’s efforts on the Medicare program and the broader health care system as a whole to test innovative payment and service delivery models that reduce program expenditures while preserving or enhancing the quality of care.
ASPE Issue Brief, Report
Direct Care Worker Wages
Direct care workers (DCWs) such as nursing assistants, home health aides, and personal care assistants play an essential role in the health and well-being of over 20 million Americans. Yet DCW wages are not enough to make jobs competitive with entry level positions in other industries with similar job requirements which exacerbates the challenges in recruitment and retention of these workers.
ASPE Issue Brief
Bridging Healthcare and Social Services for People Living with Dementia and Their Caregivers
People living with dementia often have complex health and social support needs that can best be met by health care and community-based providers working together. This brief examines promising practices for bridging community-based organizations and health care systems in the providing comprehensive dementia care.
ASPE Issue Brief
Use of Medicare-Covered Telerehabilitation for PT/OT/SLP Services during the COVID-19 PHE
This study examined the extent therapist practices and nursing homes adopted telehealth services for physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP); explored the major challenges and facilitators in adopting telerehabilitation services, and whether these services were effective in addressing patient care and staffing needs during the public health emergenc
ASPE Issue Brief
Identifying Employer Supports for Family Caregivers of Older Adults Issue Brief
Recruiting and retaining a talented workforce requires employers to implement supports for family caregivers who are balancing the dual roles of working and caregiving.