Aging & Disability

In an effort to better understand the impact of managed care on disabled populations, staff from the Office of the Assistant Secretary for Planning and Evaluation's Office of Disability, Aging and Long-Term Care Policy and the Office of Health Policy, in collaboration with HCFA, have developed a series of research and evaluation efforts focused on managed care and people with disabilities.

In 1985 there were about 5.5 million functionally disabled elderly persons (65+) in the United States (U.S.) living in the community and an additional 1.3 million in nursing homes. By 2020, these figures are expected to almost double to 10.1 million and 2.5 million respectively. The long-term care (LTC) system in the U.S. is large and complex.

In this article, the authors compare and contrast alternative approaches to administering programs, financed under the Medicaid personal care services (PCS) optional benefit, that make attendant services available to low-income elderly and disabled persons in need of help with daily living tasks.

U.S. Department of Health and Human Services

In Chapter 14 (United States), the long development of long-term care policy is described, giving particular emphasis to the functioning of the main programs introduced in the 1960s, and their progressive modification up to the 1990s. Finally, an outline is given of the main reform debates of the late 1980s and 1990s. [38 PDF pages]

Federal disability programs, which provide services such as cash support, health care coverage, and direct supportive services to eligible people with disabilities, are typically limited to people under the age of 65.

U.S. Department of Health and Human Services National Study of Assisted Living for the Frail Elderly: Literature Review Update Lewin-VHI, Inc. February 1996 PDF Version: http://aspe.hhs.gov/daltcp/reports/litrev.pdf (98 PDF pages)

U.S. Department of Health and Human Services Subacute Care: Policy Synthesis and Market Area Analysis Proponents of subacute care claim that subacute care is a cost-effective alternative to acute care services, that is, it can be provided in lower cost settings with no diminution of quality.

U.S. Department of Health and Human Services

After discusion about the possible approaches for conducting the international analysis, the International Collaborative Effort on Age research team concluded that the initial step in analysis should be to establish the 'context' of the research on outcomes of nursing home care.