The cost-effectiveness of noninstitutional long-term care services: Review and synthesis of the most recent evidence

Medical Care Research and Review

Volumn 63, Issue 1, 2006, Pages 3-28

  Grabowski, David C ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

Author keywords

Capitation; Case management; Consumer directed care; Home and community based services; Medicaid waivers; Postacute services

Indexed keywords

CAREGIVER; COMMUNITY CARE; CONSUMER; COST EFFECTIVENESS ANALYSIS; DEMENTIA; HEALTH CARE; HEALTH CARE COST; HEALTH CARE QUALITY; HEALTH PROGRAM; HEALTH SERVICE; HUMAN; LONG TERM CARE; MEDICAID; REVIEW; WELFARE;

COMMUNITY HEALTH SERVICES; COST-BENEFIT ANALYSIS; DEMENTIA; EVIDENCE-BASED MEDICINE; HOME CARE SERVICES; HUMANS; LONG-TERM CARE; UNITED STATES;

EID: 33645790806     PISSN: 10775587     EISSN: 15526801     Source Type: Journal    
DOI: 10.1177/1077558705283120     Document Type: Review

References (52)

1. Alecxih, L. M. B., S. Lutsky, J. Corea, and B. Coleman. 1996. Estimated cost savings from the use of home and community-based alternatives to nursing facility care in three states. Working Paper 9618, American Association of Retired Persons, Washington, DC.
2. Alecxih, L. M. B., C. Neill, S. Zeruld, and B. Olearczyk. 2002. Wisconsin Family Care implementation process evaluation: Final Report III. Falls Church, VA: The Lewin Group.
3. APS Healthcare, Inc. 2003. Family care independent assessment: An evaluation of access, quality and cost effectiveness for calendar year 2002. http://www.dhfs.state.wi.us/LTCare/ResearchReports/IA.HTM (accessed March 4, 2004).
4. Benjamin, A. E. 2001. Consumer-directed services at home: A new model for persons with disabilities. Health Affairs 20 (6): 80-95.
5. Benjamin, A. E., and R. E. Matthias. 2001. Age, consumer direction, and outcomes of supportive services at home. The Gerontologist 41 (5): 632-42.
6. _. 2004. Work-life differences and outcomes for agency and consumer-directed home-care workers. The Gerontologist 44 (4): 479-88.
7. Benjamin, A. E., R. Matthias, and T. M. Franke. 2000. Comparing consumer-directed and agency models for providing supportive services at home. Health Services Research 35 (1): 351-66.
8. Border, S., H. Morrison, J. Dyer, and C. Blakely. 2002. Medicaid Managed Care Waiver Study: An independent assessment of access, quality, and cost-effectiveness of the STAR+PLUS Program. College Station: Public Policy Research Institute, Texas A&M University.
9. Chatterji, P., N. R. Burstein, D. Kidder, and A. White. 1998. The impact of PACE on participant outcomes. Cambridge, MA: Abt Associates.
10. Dale, S., R. Brown, B. Phillips, J. Schore, and B. L. Carlson. 2003. The effects of cash and ounseling on personal care services and Medicaid costs in Arkansas. Health Affairs W3:566-75.
11. Department of Health and Human Services. 2003. Report to the Congress on evaluation results for the Social/Health Maintenance Organization II Demonstration and evaluation results for the ESRD Managed Care Demonstration. Washington, DC: Department of Health and Human Services.
12. Evans, D. A., H. H. Funkenstein, M. S. Albert, P. A. Scherr, N. R. Cook, M. J. Chown, L. E. Hebert, C. H. Hennekens, and J. O. Taylor. 1989. Prevalence of Alzheimer's disease in a community population of older persons: Higher than previously reported. Journal of the American Medical Association 262 (18): 2552-56.
13. Foster, L., R. Brown, B. Phillips, J. Schore, and B. L. Carlson. 2003. Improving the quality of Medicaid personal assistance through consumer direction. Health Affairs W3:162-75.
14. Frytak, J. R., R. A. Kane, M. D. Finch, R. L. Kane, and R. Maude-Griffin. 2001. Outcome trajectories for assisted living and nursing facility residents in Oregon. Health Services Research 36 (1): 91-111.
15. Grabowski, D. C. 2001. Medicaid reimbursement and the quality of nursing home care. Journal of Health Economics 20 (4): 549-69.
16. Grabowski, D. C., R. L. Ohsfeldt, and M. A. Morrisey. 2003. The effects of CON repeal on Medicaid nursing home and long term care expenditures. Inquiry 40 (2): 146-57.
17. Hebert, L. E., P. A. Scherr, J. L. Bienias, D. A. Bennett, and D. A. Evans. 2003. Alzheimer disease in the U.S. population: Prevalence estimates using the 2000 census. Archives of Neurology 60 (8): 1119-22.
18. Hughes, S. L. 1985. Apples and oranges? A review of evaluations of community-based long-term care. Health Services Research 20 (4): 462-88.
19. Irvin, C. V., S. Massey, and T. Dorsey. 1997. Determinants of enrollment among applicants to the PACE Program. Health Care Financing Review 19 (2): 135-53.
20. Kane, R. A. 1988. The noblest experiment of them all: Learning from the National Channeling Demonstration. Health Services Research 23 (1): 189-98.
21. Kane, R. L., and P. Homyak. 2003. Minnesota senior health options evaluation focusing on utilization, costs, and quality of care. Final version. Prepared under HCFA Contract No. 500-96-0008 Task Order 3. Minneapolis, MN: Division of Health Services Research and Policy, University of Minnesota School of Public Health.
22. Kane, R. L., P. Homyak, B. Bershadsky, Y.-S. Lum, and M. S. Siadaty. 2003. Outcomes of managed care of dually eligible older persons. The Gerontologist 43 (2): 165-74.
23. Kane, R. A., and R. L. Kane. 1987. Long-term care: Principles, programs and policies. New York: Springer.
24. Kassner, E., and L. Shirey. 2000. Medicaid financial eligibility for older people: State variations in access to home and community-based waiver and nursing home services. Paper No. 2000-06. Washington, DC: American Association of Retired Persons.
25. Kemper, P., R. Applebaum, and M. Harrigan. 1987. Community care demonstrations: What have we learned? Health Care Financing Review 8 (4): 87-100.
26. Manton, K., R. Newcomer, J. Vertrees, G. Lowrimore, and C. Harrington. 1994. A method for adjusting payments to managed care plans using multivariate patterns of health and functioning: The experience of social/health maintenance organizations. Medical Care 32 (3): 277-97.
27. Matthias, R. E., and A. E. Benjamin. 2003. Abuse and neglect of clients in agency-based and consumer-directed home care. Health & Social Work 28 (3): 174-84.
28. McCall, N., and J. Korb. 1997. Utilization of services in Arizona's capitated Medicaid program for long-term care beneficiaries. Health Care Financing Review 19 (2): 119-34.
29. McCall, N., C. W. Wrightson, J. Korb, M. Crane, W. Weissert, and J. Wilkin. 1996. Evaluation of Arizona's Health Care Cost Containment System Demonstration. San Francisco: Laguna Research Associates.
30. McClellan, M., B. J. McNeil, and J. P. Newhouse. 1994. Does more intensive treatment of acute myocardial infarction in the elderly reduce mortality? Analysis using instrumental variables. Journal of the American Medical Association 272 (11): 859-66.
31. Miller, N. A., S. Ramsland, and C. Harrington. 1999. Trends and issues in the Medicaid 1915(c) Waiver Program. Health Care Financing Review 20 (4): 139-60.
32. Miller, R., R. Newcomer, and P. Fox. 1999. Effects of the Medicare Alzheimer's Disease Demonstration on nursing home entry. Health Services Research 34 (3): 691-714.
33. Newcomer, R., K. E. Covinsky, T. Clay, and K. Yaffe. 2003. Predicting 12-month mortality for persons with dementia. Journal of Gerontology: Social Sciences 58B (3): S187-98.
34. Newcomer, R., C. Harrington, and R. Kane. 2002. Challenges and accomplishments of the second-generation social health maintenance organization. The Gerontologist 42 (6): 843-52.
35. Newcomer, R., C. Harrington, K. G. Manton, and M. Lynch. 1995. A response to representatives from the social HMOs regarding program evaluation. The Gerontologist 35 (3): 292-94.
36. Newcomer, R., R. Miller, T. Clay, and P. Fox. 1999. Effects of the Medicare Alzheimer's Disease Demonstration on Medicare expenditures. Health Care Financing Review 20 (4): 45-65.
37. Newcomer, R., M. Spitalny, P. Fox, and C. Yordi. 1999. Effects of the Medicare Alzheimer's Disease Demonstration on the use of community-based services. Health Services Research 34 (3): 645-67.
38. Newcomer, R., C. Yordi, R. DuNah, P. Fox, and A. Wilkinson. 1999. Effects of the Medicare Alzheimer's Disease Demonstration on caregiver burden and depression. Health Services Research 34 (3): 669-89.
39. Rudolph, N. V., and J. Lubitz. 1999. Capitated payment approaches for Medicaid financed long-term care services. Health Care Financing Review 21 (1): 51-64.
40. Sloane, P. D., S. Zimmerman, L. Hanson, C. M. Mitchell, C. Riedel-Leo, and V. Custis-Buie. 2003. End-of-life care in assisted living and related residential care settings: Comparison with nursing homes. Journal of the American Geriatrics Society 51 (11): 1587-94.
41. Smith, V., K. Gifford, and R. Ramesh. 2003. Medicaid spending growth: A 50-state update for fiscal year 2003. Washington, DC: Kaiser Family Foundation.
42. U.S. General Accounting Office. 1994. Medicaid long-term care: Successful state efforts to expand home services while limiting costs. GAO/HEHS-94-167. Washington, DC: U.S. General Accounting Office.
43. _. 2003. Federal oversight of growing Medicaid home and community-based waivers should be strengthened. GAO-03-576. Washington, DC: U.S. General Accounting Office.
44. Weissert, W. G. 1993. One more battle lost to friendly fire - Or if you spend too much it's hard to save money. Medical Care 31 (9): SS119-21.
45. Weissert, W. G., C. M. Cready, and J. E. Pawelak. 1988. The past and future of home- and community-based long-term care. The Milbank Quarterly 66 (2): 309-88.
46. Weissert, W. G., and S. C. Hedrick. 1994. Lessons learned from research on effects of community-based long-term care. Journal of the American Geriatrics Society 42 (3): 348-53.
47. Weissert, W. G., T. Lesnick, M. Musliner, and K. A. Foley. 1997. Cost savings from home and community-based services: Arizona's capitated Medicaid long-term care program. Journal of Health Politics, Policy and Law 22 (6): 1329-57.
48. White, A. J., Y. Abel, and D. Kidder. 2000. A comparison of the PACE capitation rates to projected costs in the first year of enrollment: Final report. Cambridge, MA: Abt Associates.
49. Wiener, J. M., and R. J. Hanley. 1992. Caring for the disabled elderly: There's no place like home. In Improving health policy and management: Nine critical research issues for the 1990s, edited by S. M. Shortell and R. E. Reinhardt, 75-110. Ann Arbor, MI: Health Administration Press.
50. Wiener, J. M., and J. Skaggs. 1995. Current approaches to integrating acute and long-term care financing and services. Paper No. 9516. Washington, DC: Public Policy Institute, American Association of Retired Persons.
51. Wiener, J. M., J. Tilly, and L. M. Alecxih. 2002. Home and community-based services in seven states. Health Care Financing Review 23 (3): 89-114.
52. Zimmerman, S., A. L. Gruber-Baldini, P. D. Sloane, J. K. Eckert, J. R. Hebel, L. A. Morgan, S. C. Stearns, J. Wildfire, J. Magaziner, C. Chen, and T. R. Konrad. 2003. Assisted living and nursing homes: Apples and oranges? The Gerontologist 43 (Special Issue 2): 107-17.