This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Grabowski, D. C. Search for Related Content PubMed PubMed Citation Articles by Grabowski, D. C. Social Bookmarking                   What's this?

The Cost-Effectiveness of Noninstitutional Long-Term Care Services: Review and Synthesis of the Most Recent Evidence

Harvard Medical School

There has been significant expansion and change in the financing, coverage, and delivery of home-and community-based services during the past decade. This article reviews the cost-effectiveness of Medicaid waiver programs, consumer-directed care, capitated models that blend acute and long-term care services, and case management and subsidized community services for individuals with dementia. Generally, these new care models were found to be associated with increased costs, but greater client and caregiver welfare. Depending on the specific features of the program, capitated care models and consumerdirected care were identified as potential mechanisms toward providing services more efficiently. Importantly, however, most recent evaluations have relied on potentially confounded research designs, which leaves open the question of whether the findings relate to the programs or biased selection across the treatment and comparison groups.

Key Words: home and community-based services • postacute services • Medicaid waivers • capitation • consumer-directed care • case management

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?