Individually have Medicare, Medicaid, Medigap and private long-term care insurance deficiencies in the provision of comprehensive care for the elderly on Medicare includes long-term nursing care, some preventive services and high cost of prescription drugs from. Medicaid intervened belatedly, after the patient has been impoverished. Medigap includes, like Medicare, long-term care. Private insurance is too expensive for most older people, makes them vulnerable to a financial disaster and supports only a fraction of the long-term care. Together, these programs rarely promote the integration of acute and long-term care or the coordination of medical and social services. However, some pilot projects have shown that with the organized provision of services using a combination of public funds and private insurance comprehensive care for the elderly, including some long-term care can be adequately funded. Social Health Maintenance Organizations (Shmo) Shmo are funded by Medicare demonstration programs. They use Medicare, Medicaid and private payments from patients to cover a wide range of care services by nurses, social workers and doctors. Patients who do not qualify for Medicaid benefits, put private payments to to a limited degree, v. a. domestic to cover long-term care. A Shmo contributes as an HMO the financial risk for the cost of services and, therefore, resource-efficient to operate an incentive. Program of All-Inclusive elderly (PACE) PACE is designed to keep patients as long as medically, socially and financially possible in the community. An interdisciplinary PACE team assessed the patients’ needs and to develop and implement a care plan. PACE includes medical and dental care, adult day care (incl. Transport to the facility and back), medical and personal care at home, prescription drugs, social services, rehabilitation, meals, nutritional counseling and, if necessary hospital and long term care. PACE programs provide social and medical services primarily in day-Gesundheitszentrem for adults, supplemented by domestic services and transfer services. The PACE service package must include all Medicare and Medicaid and other services that have been defined by the interdisciplinary team for the care of the participants in PACE as necessary. PACE may require a monthly fee. By 2013, 31 states PACE providers had admitted. Advanced Care in Communities One Life Care Community or continuous care in a retirement community provides housing, health care and other services as part of bundled financing and management. These communities have a clinic, a clinic or even a nursing home on the site, and the living room is designed for disabled people. Many of these communities are affluent retirees who are willing to sign long-term contracts for their housing and care. Some life-care communities fail because inflation and an aging population incur costs for services that exceed the revenues. Some communities keep costs down by offering housing and minimum services with the option to purchase additional services.


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