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Policy brief (Center for Home Care Policy and Research (U.S.))最新文献

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Strategies to support HCBS. 支持HCBS的战略。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2005-01-01
Pamela Nadash, Joann Ahrens
{"title":"Strategies to support HCBS.","authors":"Pamela Nadash,&nbsp;Joann Ahrens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>States are spending more money on home- and community- based services (HCBS) and are spending a greater proportion of their long-term care (LTC) dollars on these services rather than on institutional care. Some states have been more successful than others in supporting HCBS. This brief reviews strategies states have used to promote HCBS and summarizes existing research on the effectiveness of these strategies in increasing access, expanding revenues, and moderating institutional bed supply. Research shows that increased use of Medicaid waivers and Medicare home health services are important predictors of increased access to HCBS. Using regulation to constrain the number of institutional beds (and redirect resources to HCBS) shows mixed results. Research on the effectiveness of capitating LTC to increase access to HCBS has not been conclusive, though initial findings are promising and appear to be worth pursuing</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 26","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25619400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bringing managed care home to the long-term care population. 为长期护理人群提供居家管理式护理。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2004-01-01
Pamela Nadash, Joann Ahrens
{"title":"Bringing managed care home to the long-term care population.","authors":"Pamela Nadash,&nbsp;Joann Ahrens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Managed care has been proposed as a solution to the problems facing long-term care: its high costs, bias towards nursing homes, lack of coordination with acute and primary care, and inflexible service delivery. Kodner and Kyriacou (2003) argue that home care agencies may have considerable advantages in creating managed care systems for this population over traditional managed care organizations because of the experience home care organizations have in caring for older adults as well as people with disabilities. Although home care agencies are likely to better understand the needs of the long-term care population, they may lack the expertise and organizational resources to develop successful managed care organizations. Addressing these deficiencies will be key in order for home care organizations to successfully operate as managed care providers.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 18","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24882866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An overview of recent state HCBS budget cuts. 最近各州HCBS预算削减概述。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2003-01-01
Claudia Williams
{"title":"An overview of recent state HCBS budget cuts.","authors":"Claudia Williams","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This policy brief, covering the period FY 2002- FY 2004, examines state budget cuts and other state policy changes affecting long term care (LTC) services for the elderly, focusing on home and community based services (HCBS). In the second year of budget deficits, states made deeper Medicaid cuts and focused on LTC services because of their contribution to Medicaid budgets (fifteen states say LTC is one of the top three Medicaid spending drivers). In all, states made or planned an estimated 64 cuts to LTC services in the last three fiscal years. Reflecting overall budget-cutting strategies, many states first targeted LTC provider payments and have only more recently considered reducing LTC benefits or eligibility.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 16","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying "appropriate" applicants for home and community based services: the MI Choice screening system. 确定家庭和社区服务的“合适”申请人:MI选择筛选系统。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2003-01-01
Brant E Fries, Mary James
{"title":"Identifying \"appropriate\" applicants for home and community based services: the MI Choice screening system.","authors":"Brant E Fries,&nbsp;Mary James","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This research brief describes an initiative to design and test a screening system for Michigan's home and community based (HCBS) long-term care programs. The core of the system is 32 items from the Minimum Data Set for Home Care (MDS-HC), 1 which can be used as a series of questions asked over the telephone or as part of a complete assessment. The telephone screen is used to direct some individuals immediately to information and referral services, while others, determined to be potentially eligible for supportive services, receive an in-person evaluation that, among other things, suggests the \"most appropriate\" level of care. Testing of the system found that nearly a quarter of callers seeking long-term care assistance did not require costly in-person assessments. It also found that the MI Choice screening algorithm performed far better than other screening tools in predicting the appropriate level of care, as determined by the expert opinion of \"gold standard\" care managers. The study was supported by the Robert Wood Johnson Foundation and conducted through a collaboration of the Michigan Department of Community Health, the University of Michigan, and Boston's Hebrew Rehabilitation Center for the Aged.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 13","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of Medicare home health policy changes on Medicare beneficiaries. 医疗保险家庭健康政策变化对医疗保险受益人的影响。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2003-01-01
Nelda McCall, Jodi Korb
{"title":"The impact of Medicare home health policy changes on Medicare beneficiaries.","authors":"Nelda McCall,&nbsp;Jodi Korb","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This brief presents results from an analysis of how a new payment system -- the Interim Payment System (IPS) - mandated by the 1997 Balanced Budget Act (BBA) affected Medicare home health service use and beneficiary outcomes. The study found that the IPS had a considerable impact on home health utilization, causing reductions in the overall proportion of Medicare beneficiaries who received the service; the number of home health visits per home health user; the average length of a home health episode of care; and overall Medicare home health expenditures. The study also examined the impact of these reductions on outcomes experienced by Medicare beneficiaries. Evidence presented in this brief shows that, overall, the impact of the IPS on beneficiary outcomes was minimal. Moreover, it appears that service reductions did not cause significant increases in the use of other types of post-acute care.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 15","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare home health use after the 1997 BBA. 1997年工商管理学士学位后的医疗保险家庭健康使用。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2003-01-01
Nelda McCall, Jodi Korb
{"title":"Medicare home health use after the 1997 BBA.","authors":"Nelda McCall,&nbsp;Jodi Korb","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 14","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Funding long-term care by applying the trade-off principle to public and private insurance. 通过将权衡原则应用于公共和私人保险来资助长期护理。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2003-01-01
Yung-Ping Chen
{"title":"Funding long-term care by applying the trade-off principle to public and private insurance.","authors":"Yung-Ping Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The uncertain need for long-term care (LTC) services is a risk that is best protected by insurance. However, current LTC funding in the United States relies heavily on personal payment and public welfare and only lightly on social insurance and private insurance. This method is akin to sitting on a two-legged stool, which is likely to be unstable. This brief describes a \"three-legged\" funding model where social insurance would provide basic LTC protection that would be supplemented by private insurance and personal payment. The model would mobilize public and private resources more effectively by linking LTC insurance to social security, private life insurance, and other financial products.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 17","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40833512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preventing medication errors in home care. 预防家庭护理中的用药错误。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2002-01-01
Joann Ahrens, Penny H Feldman, Dennee Frey
{"title":"Preventing medication errors in home care.","authors":"Joann Ahrens,&nbsp;Penny H Feldman,&nbsp;Dennee Frey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This practice brief highlights the results of two home health care studies on medication errors. The first study determined how often medication errors occur in home health care. The second study tested a strategy to reduce these errors. Although nearly one third of home care patients are at risk for potential medication errors, adding a simple, practical program can reduce the potential for errors. These results should encourage home care agencies to be more vigilant in monitoring medication errors and to institute programs that help prevent errors from occurring.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 12","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The use of nursing home and assisted living facilities among private long-term care insurance claimants: the experience of disabled elders. 私人长期护理保险索赔人对疗养院和辅助生活设施的使用:残疾长者的经验。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2002-01-01
Marc Cohen, Jessica Miller
{"title":"The use of nursing home and assisted living facilities among private long-term care insurance claimants: the experience of disabled elders.","authors":"Marc Cohen,&nbsp;Jessica Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Little is known about individuals in nursing homes (NHs) and assisted living facilities (ALFs) who receive private long-term care (LTC) insurance benefits. No one knows whether claimants and/or their families feel they are getting good value for their premiums, or whether the presence of private insurance influences the type of care people get. This brief provides descriptive information on disabled private LTC insurance policyholders receiving LTC benefits in these settings, comparing them to institutionalized elders who lack such insurance. The information shows that private LTC insurance benefits are targeted to individuals with significant functional and/or cognitive impairments; that claimants are satisfied with their policies although many report unmet needs; and that private LTC insurance gives claimants access to alternatives to nursing home care.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 10","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24423676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of private long-term care insurance on claimants: formal and informal care in the community. 私人长期护理保险对索赔人的影响:社区中的正式和非正式护理。
Policy brief (Center for Home Care Policy and Research (U.S.)) Pub Date : 2002-01-01
Marc Cohen, Jessica Miller
{"title":"The impact of private long-term care insurance on claimants: formal and informal care in the community.","authors":"Marc Cohen,&nbsp;Jessica Miller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Policy makers show continuing interest in the potential for long-term care (LTC) insurance to save public money by reducing pressure on the Medicare and Medicaid programs. Although the purchase of LTC insurance is being encouraged by government - through tax incentives and the offering of private LTC insurance as an option for public employees - little is known about how benefits are used, whether those claiming benefits feel they are getting good value for their money, and whether the patterns of formal (paid) and informal (unpaid) service use differ for insurance claimants compared to similarly disabled persons without private LTC insurance. This brief provides information on older people claiming LTC insurance benefits and compares their experiences to those of non-privately insured older people who need LTC. We conclude that LTC insurance is an important source of support for those who lack informal support from family and friends. However, LTC insurance remains a complex product; claimants need help in using their benefits to obtain the appropriate level and quality of care and in understanding at the time of purchase how much protection they need.</p>","PeriodicalId":87131,"journal":{"name":"Policy brief (Center for Home Care Policy and Research (U.S.))","volume":" 11","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24425334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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