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Medicaid and Long‐Term Care for the Elderly: Implications of Restructuring
Author(s) -
Feder Judith,
Lambrew Jeanne,
Huckaby Michelle
Publication year - 1997
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/1468-0009.00065
Subject(s) - medicaid , beneficiary , liberian dollar , restructuring , payment , incentive , business , long term care , per capita , flexibility (engineering) , block grant , public economics , economics , finance , economic growth , health care , medicine , nursing , environmental health , market economy , population , welfare , microeconomics , management
Because it absorbs about a third of Medicaid spending, long‐term care would be affected by any major changes in the financing or structure of this federal–state program. Analysis of the implications for long‐term care of the Medicaid restructuring proposals that Congress considered in the 1995–96 federal budget debate leads to this conclusion: the fiscal pressure and incentives that would be created by fixed dollar or block grants, or by limits on federal spending per beneficiary (per capita caps), when combined with enhanced state flexibility in program design, could significantly hinder service choice and quality, reduce access to care, and increase out‐of‐pocket payments by Medicaid beneficiaries or their families.