Consumer-directed services: lessons and implications for integrated systems of care

Area of Science:

• Health Policy
• Social Gerontology
• Disability Studies

Background:

• Growing policy focus on reforming long-term care (LTC) for the elderly and disabled in developed nations.
• Emergence of diverse LTC strategies, from integrated care to cash-benefit programs.
• Consumer-directed care (CDC) models grant clients control over home and community-based services.

Purpose of the Study:

• To explore the rationale and models of consumer-directed home care.
• To review the development, design, and outcomes of CDC programs in Austria, Germany, the Netherlands, and the US.
• To discuss how CDC experiences can inform integrated care system improvements for vulnerable populations.

Main Methods:

• Policy paper analyzing existing literature and program data.
• Comparative review of consumer-directed care models across selected European countries and the US.
• Exploration of the relationship between consumer-directed and integrated care systems.

Main Results:

• Consumer-directed care models provide significant client and family carer empowerment.
• Diverse forms and degrees of CDC are implemented across Europe and North America.
• CDC principles offer lessons for enhancing integrated care responsiveness.

Conclusions:

• Consumer-directed care, while seemingly opposite to integrated care, offers crucial insights.
• Experiences with CDC can guide the development of more effective and person-centered integrated care models.
• Policy makers can leverage CDC lessons to improve long-term care for vulnerable populations.