Persons with Disabilities: Issues in Health Care Financing and Service Delivery

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Joshua M. Wiener, Steven B. Clauser, David L. Kennell
Brookings Institution Press, 2010 M12 1 - 336 pages

A key issue in the debate about reforming the U.S. health care system is how to finance and organize the delivery of long-term care. This volume offers perspectives on several important facets of this problem, including the regulation of private long-term care insurance, catastrophic out-of-pocket costs, and the use of long-term care and acute care services by the chronically disabled elderly.

In addition to the editors, the contributors are Lisa Alecxih, David Kennell, and John Corea, Lewin-VHI; Brian Burwell and William Crown, SysteMetrics; Terry Coughlin, Korbin Liu, and Sharon Long, Urban Institute; Judith Kasper, Johns Hopkins University; Kenneth Manton and P.J. Eric Stallard, Duke University; Jennifer Schore, Mathematica Policy Research; Catherine Sullivan, Brookings; and Bruce Vladeck, Health Care Financing Administration.

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Contents

Introduction
1
Overall Perspectives
17
LongTerm Care The View from the Health Care Financing Administration
19
PublicPrivate Interactions
27
Private LongTerm Care Insurance Barriers to Purchase and Retention
29
Medicaid Estate Planning Case Studies of Four States
61
Use and Expenditures for Paid Services
93
Implications of Health Care Financing Delivery and Benefit Design for Persons with Disabilities
95
Cognitive Impairment in Older People and Use of Physician Services and Inpatient Care
164
Catastrophic Costs of LongTerm Care for Elderly Americans
182
Home and CommunityBased Care
213
Characteristics and Outcomes of Persons Screened into Connecticuts 2176 Program
215
Combining Formal and Informal Care in Serving Frail Elderly Persons
245
Regional Variation in the Use of Medicare Home Health Services
267
LongTerm Care for the Younger Population A Policy Synthesis
291
Copyright

Program Payment and Utilization Trends for Medicare Beneficiaries with Disabilities
117

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About the author (2010)

Joshua M. Wiener is a senior fellow in the Economic Studies program at Brookings. He is the coauthor of Sharing the Burden: Strategies for Public and Private Long-Term Care Insurance (Brookings, 1994) and Caring for the Disabled Elderly: Who Will Pay? (Brookings, 1988).

Steven Clauser is director of the Office of Research at the Health Care Financing Administration. David L. Kennell is a vice president of Lewin-VHI, Inc.

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