Wisconsin Family Care is scheduled to transition to an insurance plan. The medical needs are expected to be the focus of the benefit coverage. Long Term Care planners can interpret this to mean services delivered under a Medical Doctor and Registered Nurse will carry the primary weight inherent in the benefit.
This is a strategy to manage fund out flow by tightening the degree of assessed need eligible for reimbursement. This will likely require contracted providers to bill Medicare, Medicaid for services delivered for individuals when applicable. This will become further constricted with allowed time per task charts that define reimbursement.
The end result will be clear borders between medical verses non-medical provision. Medical delivery involves an employee performing cares under the direction of a Medical Doctor and Registered Nurse and certified by the Centers for Medicare and Medicaid. Non-medical delivery involves an employee performing all the tasks the elder needs to maintain an acceptable level of independence.
Simply, expect more long term care needs to be paid out of pocket from the senior's savings. Expect non-medical care delivery models to pick up a greater portion of the communities needs. More of the anticipated needs inherent in the typical process of aging will not make the medical standard.
This is legislative policy enacting change in provision as a means to manage limited resources. Long Term Care Planners are being encouraged to facilitate the development of service providers capable of effectively responding to these changing needs.
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Families and senior's will now become stronger shoppers when seeking help with an elders needs. The community is challenged to recognize non-medical senior care service as an expected expense. This is a relatively new idea to Wisconsin families.
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Sunday, December 6, 2015
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