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The Gerontologist, Vol 39, Issue 1 86-93, Copyright © 1999 by The Gerontological Society of America
ARTICLES |
W Leutz
Heller Graduate School, Brandeis University, Waltham, MA 02254, USA. [email protected]
This article reviews the authority and processes for issuing Medicare and Medicaid waivers, highlights waiver-based differences in states' home- and community-based (HCB) service systems, and critiques emerging efforts to capitate, integrate, and privatize the long-term care system. Potential pitfalls relate to payment rates, risk, service substitution, accountability, and drains on HCB infrastructure. Before merging HCB services into larger prepaid systems, policy makers are advised to examine implementation challenges, resist ad hoc fixes, clarify HCB entitlements, and strengthen current infrastructure.
This article has been cited by other articles:
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S. A. Robert Community Context and Aging: Future Research Issues Research on Aging, November 1, 2002; 24(6): 579 - 599. [PDF] |
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M. Stuart and M. Weinrich Home- and Community-Based Long-Term Care: Lessons From Denmark Gerontologist, August 1, 2001; 41(4): 474 - 480. [Abstract] [Full Text] [PDF] |
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