Who Should Pay for Long-Term Care for the Elderly?

Rivlin, Alice M.; Wiener, Joshua M.; Hanley, Raymond J.; Spence, Denise A.

doi:10.2307/20080037

Cited by 5 publications

(5 citation statements)

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“…The demand for this type of care is expected to expand rapidly in the near future because of the aging of the baby boomer cohort. Early projections for the expansion required to meet this need suggests a 54% increase in nursing homes (i.e., about 8,000 additional nursing homes) by 2030 (Rivlin, Wiener, Hanley, & Spence, 1988). More recent studies project the nursing home population to be 10% to 25% higher than such estimates by a simple extrapolation of past declines in disability (Lakdawalla et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

et al. 2015

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Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes.

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Section: Discussionmentioning

confidence: 99%

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

et al. 2015

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“…While regulatory changes and subsidies could increase the role of private insurance somewhat, underwriting and limited demand constrain its ability to spread remaining uninsured out-of-pocket expenses. Public insurance could be enacted to spread the uninsured risk of incurring substantial outof-pocket expenditures, and many proposals have been suggested to do so (Rivlin and Wiener 1988;Scanlon 1992;Wiener et al 2001). The principal obstacle to doing so is political.…”

Section: Discussionmentioning

confidence: 99%

“…Public insurance could be enacted to spread the uninsured risk of incurring substantial outof-pocket expenditures, and many proposals have been suggested to do so (Rivlin and Wiener 1988;Scanlon 1992;Wiener et al 2001). The principal obstacle to doing so is political.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

Kemper

Komisar²,

Alecxih³

2005

INQUIRY

126

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The leading edge of the baby boom generation is nearing retirement and facing uncertainty about its need for long-term care (LTC). Using a microsimulation model, this analysis projected that people currently turning age 65 will need LTC for three years on average. An important share of needed care will be covered by public programs and some private insurance, but much of the care will be an uninsured private responsibility of individuals and their families-a responsibility that will be distributed unequally. While over a third of those now turning 65 are projected to never receive family care, three out of 10 will rely on family care for more than two years. Similarly, half of people turning 65 will have no private out-of-pocket expenditures for LTC, while more than one in 20 are projected to spend $100,000 or more of their own money (in present discounted value). Policy debate that focuses only on income security and acute care-and the corresponding Social Security and Medicare programs-misses the third, largely private, risk that retirees face: that of needing LTC.

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“…Elders with limitations performing ADLs are more likely to be older (Rivlin, Wiener, Hanley, Hanley, & Spence, 1988), experience limitations in the more complex instrumental activities of daily living (IADL) (e.g., laundry, shopping, preparing meals) (Stoller & Cutler, 1992), and have limited economic resources (Clark, Stump, Hui, & Wolinsky, 1998). Additionally, Black and Hispanic elders are more likely than their White counterparts to experience ADL limitations (Shih, Song, Chang, & Dunlop, 2005).…”

Section: Literature Reviewmentioning

confidence: 99%

The Prevalence of Older Couples With ADL Limitations and Factors Associated With ADL Help Receipt

Shen

Feld

Dunkle

et al. 2014

Journal of Gerontological Social Work

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Using the Andersen-Newman model, we investigated the prevalence of Activities of Daily Living (ADLs) limitations in married couples, and couple characteristics associated with ADL help receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1% and 3.6% were couples in which neither, one or two partners had limitations, respectively. Logistic regression results indicate help receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners’ health problems.

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Who Should Pay for Long-Term Care for the Elderly?

Cited by 5 publications

References 0 publications

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

The Prevalence of Older Couples With ADL Limitations and Factors Associated With ADL Help Receipt

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