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An Assessment of State-Led Reform of Long-Term Services and Supports.
- Source :
- Journal of Health Politics, Policy & Law; Jun2015, Vol. 40 Issue 3, p531-574, 44p
- Publication Year :
- 2015
-
Abstract
- Health care in the United States is fragmented, inefficient, and rife with quality concerns. These shortcomings have particularly serious implications for adults with disabilities and functionally impaired older adults in need of long-term services and supports (LTSS). Three strategies have been commonly pursued by state governments to improve LTSS: expanding noninstitutional care, integrating payment and care delivery, and realigning incentives through market-based reforms. These strategies were analyzed using an evaluation framework consisting of the following dimensions: ease of access; choice of setting/provider; quality of care/life; support for family caregivers; effective transitions among multiple providers and across settings; reductions in racial/ethnic disparities; cost-effectiveness; political feasibility; and implementability. Although the analysis highlights potential benefits and drawbacks associated with each strategy, the limited breadth of the evidentiary base precludes an assessment of impact across all nine dimensions. More importantly, the analysis exposes the interdependent, complex system of care within which LTSS is situated, suggesting that policy makers will require a holistic and long-term perspective to achieve needed changes. Addressing the nation's LTSS needs will require a multipronged strategy incorporating a range of health and social services to meet the complex care needs of a diverse population in a variety of settings. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL care for older people
BENCHMARKING (Management)
CAREGIVERS
CLINICAL medicine
CONGREGATE housing
CONTINUUM of care
COST effectiveness
DECISION making
FAMILIES
FEDERAL government
HEALTH care rationing
HEALTH care reform
HEALTH services accessibility
HEALTH status indicators
HOME care services
LONG-term health care
MANAGED care programs
MEDICAID
MEDICAL care
EVALUATION of medical care
HEALTH policy
MEDICARE
NURSING care facilities
PATIENTS
PEOPLE with disabilities
POLICY sciences
POLICY science research
PRACTICAL politics
QUALITY assurance
QUALITY of life
RESEARCH funding
STATE governments
HEALTH insurance reimbursement
SOCIAL support
KEY performance indicators (Management)
SOCIAL services case management
HUMAN services programs
PATIENT Protection & Affordable Care Act
Subjects
Details
- Language :
- English
- ISSN :
- 03616878
- Volume :
- 40
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of Health Politics, Policy & Law
- Publication Type :
- Academic Journal
- Accession number :
- 103196527
- Full Text :
- https://doi.org/10.1215/03616878-2888460