Reimbursment-Driven Written Assignment
In a one to two page essay, explain what we mean when we say that the long-term care system is reimbursement-driven and describe the impact this has on consumers and providers.
External Control
Long-term care providers are subject to a great deal of external control. By external control we mean control of how they function by other organizations, usually government agencies. While all health care providers are subject to external control, there seems to be more of it in long-term care. There are several reasons why that is so:
- The long-term care industry has a poor history of controlling itself.
- Consumers of long-term care are particularly vulnerable, often unable to look after their own self-interests, thus government agencies feel a need to protect long-term care consumers.
- The consequences of poor care are usually serious, often catastrophic, so it must be prevented.
- There is a very high proportion of government payment, thus the government agencies must protect their interests, trying to assure that such payments are justified and used wisely.
There are two types of external controls – public (government-mandated regulation, including licensing of facilities and individuals) and private (voluntary accreditation and certification). We will come back to discussing private control later, but for now, let us look more closely at public regulation. Some get confused about laws and regulations. The difference is quite simple: Laws are created by elected government agencies (Congress, legislatures, local boards), while regulations are created by government agencies to implement those laws
