Program and policy issues affecting home and community-based long-term care use: findings from a qualitative study

Area of Science:

• Health Services Research
• Gerontology
• Disability Studies

Background:

• Medicaid-funded long-term care (LTC) services are vital for vulnerable populations.
• Access to and utilization of LTC services vary significantly among different demographic groups.
• Arkansas faces challenges in providing equitable and comprehensive LTC options.

Purpose of the Study:

• To explore factors influencing decisions regarding Medicaid-funded LTC services.
• To identify key themes for improving LTC service delivery in Arkansas.
• To inform policy recommendations for enhancing access to home and community-based services (HCBS).

Main Methods:

• Qualitative study design.
• Focus groups conducted with LTC service providers.
• Key informant interviews with consumers and decision-makers.

Main Results:

• Three emergent themes: (1) parity between HCBS and institutional services, (2) improved information dissemination and counseling, and (3) expansion of services to address unmet needs.
• Identified specific barriers and facilitators in the decision-making process for LTC services.
• Highlighted disparities in access and preference between HCBS and institutional care.

Conclusions:

• Policy changes are recommended to promote equitable access to HCBS.
• Enhancing consumer information and counseling is essential for informed LTC choices.
• Addressing unmet needs through service expansion is critical for improving overall LTC quality.