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Related Experiment Videos

State policy on long-term care for the elderly

J M Wiener, D G Stevenson

    Health Affairs (Project Hope)
    |June 25, 1998
    PubMed
    Summary

    States employ diverse strategies to manage long-term care spending, unlike the uniform approach for acute care. These methods include increasing funding, enhancing efficiency, and implementing traditional cost controls like limiting nursing home beds and reducing Medicaid rates.

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    Area of Science:

    • Health Policy
    • Healthcare Management
    • Public Health

    Background:

    • Long-term care spending is a significant and growing concern for state budgets.
    • Acute care cost-containment strategies, primarily managed care, differ markedly from those in long-term care.
    • The Assessing the New Federalism project provides data on state-level policy variations.

    Purpose of the Study:

    • To examine and categorize the diverse strategies states utilize to control the growth of long-term care expenditures.
    • To compare the approaches to long-term care cost containment with those used for acute care.
    • To identify the primary mechanisms states employ for managing long-term care spending.

    Main Methods:

    • Analysis of state-level data from the thirteen Assessing the New Federalism states.
    • Categorization of cost-control strategies into three broad approaches.
    • Comparative analysis with acute care cost-containment measures.

    Main Results:

    • States exhibit significant variation in their long-term care spending control strategies.
    • Three main strategic categories emerge: increasing revenue streams, improving system efficiency, and implementing traditional cost controls.
    • Traditional cost controls include managing nursing home bed supply and adjusting Medicaid reimbursement rates.

    Conclusions:

    • The heterogeneity of long-term care cost-control strategies reflects the complexity of the sector.
    • States are actively experimenting with multiple approaches to fiscal sustainability in long-term care.
    • Future research should explore the effectiveness and equity of these varied state-level interventions.

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