Weighing Public and Private Options for Reforming Long-Term Care Financing: Findings From a National Survey of Specialists

Abstract

Deficiencies in current long-term care (LTC) financing models are substantial and must be addressed if the nation is going to meet the needs of the growing population of frail and disabled elders. Because debate over reforming LTC financing has traditionally focused on the relative roles of the public and private sectors, this article examines what characteristics predispose LTC specialists to weigh one approach--public or private--more than the other. Data are derived from a Web-based survey of 1,147 individuals with known or demonstrable experience with LTC, including consumer advocates, provider representatives, policy experts, and public officials. Results suggest that support for spurring private sector mechanisms, bolstering the government's role, and reforming Medicare and Medicaid vary with key characteristics of the respondents, including experiential, attitudinal, and background variables. Findings also suggest consensus that reform of LTC financing should improve on the current public-private partnership in this area.

Long-Term Care: Getting on the Agenda and Knowing What to Propose

“…If that happens, policy makers will turn to long-term care opinion leaders for advice. Grabowski et al (2010) and Miller et al (2010) will help them to understand what kind of advice they are likely to give.…”

“…The article by Miller et al (2010) finds predictable differences between Democrats and Republicans, with Republicans more strongly supportive of private sector initiatives and Democrats more supportive of Medicare-Medicaid liberalizations and increasing the government's financing role. However, what is striking is the broad political support across a broad range of possible policy options.…”

“…The articles by Miller, Clark, and Mor (2010) and by Grabowski, Miller, Stevenson, Clark, and Mor (2010) on the views of long-term care experts on the financing and service delivery are welcome contributions to the policy development process and help set the stage for reform. By identifying areas of agreement and disagreement on reform of the long-term care system by the people most knowledgeable about it, the articles help policy makers and advocates negotiate the labyrinth of issues, highlighting areas where proposed changes have broad support within the field and where they do not.…”

The Commonwealth Fund Survey of Long-Term Care Specialists

“…The articles included in this special issue of Medical Care Research and Review explore several issues areas in substantially greater depth, namely, reforming longterm care financing (E. A. Miller, Mor, & Clark, 2010b), improving long-term care regulation , adopting nursing home culture change (S. C. Miller et al, 2010), and rebalancing long-term care away from institutions toward home-and community-based services (HCBS; Grabowski et al, 2010). Analyses documenting the opinion networks of long-term care specialists and the relationship between network characteristics and attitudes toward reform are also reported (Clark, Linkletter, Wen, Miller, & Mor, 2010).…”

Evaluating the Application of Public-Private Partnership (PPP) Funding Models in Public Nursing Institutions in Hubei Province, China

“…Some research focuses on the delivery and management of LTC and discussion on the opportunities and challenges of PPP approaches. In addition, other research focuses on the overall situation of the PPP reform through reviewing and analysing LTC policy [9][10] .…”