National Invitational Conference on Long-Term Care Data Bases: Conference Proceedings. Arnold R. Tompkins, Department of Health and Human Services


I would like to add my welcome to all of you as we begin this Conference.

My office, which is a part of ASPE, has had a longstanding interest in long term care issues. Much of our work is carried out in conjunction with other components of DHHS.

For example, the National Long Term Care Channeling Demonstration, which ended last year, was jointly funded and managed by our office, the Health Care Financing Administration, and the Administration on Aging.

We also provided considerable support to the Secretary's Catastrophic Illness Study, particularly the Technical Work Group on Private Financing of Long Term Care, chaired by Steve Grossman, our next speaker.

Several things have become clear as we grapple with the issues surrounding long term care. First, from a policy perspective, long term care is a hot topic. While acute care attracts the bulk of attention on Capitol Hill these days, long term care will inevitably become part of any resulting discussions.

Whether we are talking about the early discharges under the Medicare Prospective Payment System (PPS), the likelihood of an added Medicare Part B premium to offset catastrophic acute care expenses, or the expansion of home health care benefits, we are inevitably faced with the effects on the long term care system.

Above all, it is clear that the public sector alone cannot adequately address these issues. Private sector initiatives, like long term care insurance, and new financing mechanisms, like individual medical accounts, and home equity conversions are much needed.

Second, in spite of some exemplary research done to date, there is a great deal yet to be learned about the long term care system, including its beneficiaries, its services, and its payors.

We need ongoing research with respect to at least the following areas: the characteristics of persons with long term care needs, especially the disabled elderly; the changing patterns in the supply and use of long term care services; the particular characteristics of different types of nursing home residents, for example, short stayers, long stayers, and the terminally ill.

The use of home and community-based services; current and projected patterns in informal care long term care costs; and ways of addressing catastrophic long term care costs.

Third, in recent years, our capacity to examine the long term care system has grown significantly with the public availability of national long term care data bases, plus a number of demonstration programs and state and local surveys.

As Dr. Helms stated, we consider it critical to create and make available public use files from data collected under the sponsorship of the Department. This Conference is an outgrowth of all these developments.

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