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Related Experiment Videos

Managed long-term care: limits and lessons.

Michael S Sparer1

  • 1Joseph L. Mailman School of Public Health, Columbia University, USA.

Journal of Aging and Health
|March 5, 2003
PubMed
Summary
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Commercial health plans may not improve long-term care systems. States with successful managed long-term care initiatives, like Arizona and Wisconsin, should reconsider abandoning these models for competition.

Area of Science:

  • Health Policy
  • Public Health
  • Healthcare Management

Background:

  • States are increasingly involving commercial health plans in long-term care (LTC). Historically, these plans dominated primary and acute care.
  • This shift contrasts with previous state efforts to reduce reliance on commercial insurers for basic healthcare services.

Purpose of the Study:

  • To evaluate the effectiveness of commercial health plans in long-term care programs.
  • To assess whether commercial plans offer a viable solution for improving long-term care systems.
  • To examine alternative successful managed long-term care models.

Main Methods:

  • Analysis of state-level long-term care policies and program structures.
  • Comparative case studies of states with and without commercial health plan involvement in LTC.

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  • Review of evidence on the performance of managed long-term care initiatives.

    • Main Results:

    • Evidence suggests commercial health plans are not a "quick cure" for long-term care challenges.
    • Several states demonstrate successful long-term care management without commercial plans, prioritizing home and community-based services.
    • Oregon, Arizona, and Wisconsin (Community Options Program) are cited as examples of effective traditional managed long-term care.

    Conclusions:

    • States encouraging commercial health plans in LTC may be making a mistake.
    • Existing managed long-term care models in states like Arizona and Wisconsin show success in case management and community services.
    • Abandoning proven traditional models for market competition in LTC could be detrimental.