Containing use and expenditures in publicly insured long-term care programs

Area of Science:

• Health Policy
• Public Health
• Gerontology

Background:

• British Columbia and Manitoba possess North America's most comprehensive publicly financed long-term care (LTC) systems.
• These provincial programs serve as significant natural experiments for U.S. policymakers considering public LTC insurance.

Purpose of the Study:

• To evaluate the cost-containment strategies within Canadian publicly financed long-term care programs.
• To assess the applicability of these strategies for potential U.S. long-term care insurance implementation.

Main Methods:

• Comparative analysis of public expenditure trends in Canadian provinces during the 1980s.
• Examination of cost-control mechanisms for nursing home and home support services, adjusted for population changes.

Main Results:

• Both provinces successfully curbed the growth of public nursing home expenditures.
• One province demonstrated success in controlling public spending on home support services, accounting for population growth.

Conclusions:

• Canadian provincial cost-control methods are transferable to the U.S. context.
• Effective management of public expenditures is feasible with a publicly insured U.S. LTC program.
• Future U.S. public LTC expenditure levels will be influenced by compensation for LTC personnel.