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Managed Care and Multilevel Long-Term Care Providers

Reluctant Partners

^a Associate Professor, University of California at Los Angeles, School of Public Health and Borun Scholar, Borun Center for Gerontological Research, Los Angeles, CA
^b SCAN Health Plan, Los Angeles, CA
^c Borun Center for Gerontological Research, UCLA School of Medicine and UCLA School of Public Health, Reseda, CA
^d University of Minnesota Institute for Health Services Research, Minneapolis, MN
^e Formerly Jewish Home for the Aging, Reseda, California, and Borun Center for Gerontological Research. Currently Wesley Woods Center of Emory University and Atlanta V.A. Rehabilitation Research and Development Center, Atlanta, GA

Correspondence: Steven P. Wallace, PhD, Associate Professor, University of California at Los Angeles, School of Public Health and Borun Scholar, Borun Center for Gerontological Research, UCLA Box 951772, Los Angeles, CA 90095-1772. E-mail: swallace{at}ucla.edu.

Decision Editor: Vernon L. Greene, PhD

Managed care is reshaping our health care system, although long-term care is only beginning to feel its effects. We report on the managed care involvement of 492 multilevel, long-term care facilities (MLFs; including skilled nursing and assisted/independent living) nationally. Organizational structure and culture and especially environmental characteristics are associated with whether facilities have contracts with managed care organizations (MCOs), plan to have contracts, are only gathering information on MCOs, or intend to do nothing in the near future. Resource dependence theory best explains MCO contracting patterns with MLFs appearing to be responding more to survival than to growth.

Key Words: Long-term care • Managed care • CCRC • Assisted living • Organizational change