State Long Term Care Programs At a Glance
This report highlights What states have been doing to reduce their expenditures on long term care while maintaining access to needed services. In our analysis of the major strategies employed by the states we found that they fell into several categories:
(1) Delivery system activities include strategies to reduce or control the number of nursing home beds available in a state, strategies to encourage the development of alternative delivery settings such as assisted living and home and community-based services, and strategies to increase the power of the consumer in planning and receiving long term care services;
(2) Payment system activities include strategies to encourage consumers to plan for their care needs through purchasing long term care insurance;
(3) Combined payment and delivery system activities include strategies that encourage the development of managed care plans for long term care services; and
(4) Eligibility and diversion activities include those strategies to strengthen the eligibility criteria for nursing home coverage of nursing facility care and strategies to divert consumers from expensive nursing home care to less expensive home care services.
The accompanying matrix (Appendix A) shows which strategies have been used state-by-state. None of the strategies described will solve all of the crises in the Medicaid long term care budget by themselves. As the population ages and the number of people who need long term care services increases, states will continue to wrestle with making appropriate services available and controlling the cost of those services. As the long term care service delivery system continues to evolve, responding to consumer demand and financial incentives, the strategies that states employ to contain costs will likely have to evolve as well.