A safety net for care services in the United States of America
Loading...
Date
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
World Health Organization
Abstract
Description
3 p.
This country report examines the organization, financing and purchasing arrangements of long-term services and supports (LTSS) in the United States of America, with particular emphasis on Medicaid as the principal public payer for long-term care. The publication describes the structure of the US LTSS system, which combines means-tested public coverage with limited private insurance and substantial out-of-pocket spending. It outlines the range of services provided to older persons and individuals with disabilities, including institutional and community-based care, and discusses eligibility criteria, assessment tools and state-level variations in access and coverage. The report analyses pricing and contracting mechanisms used within Medicaid-funded LTSS programmes, including fee-for-service and managed care approaches, as well as federal and state responsibilities in determining payment rates. It highlights policy efforts to reduce fragmentation of care, expand home- and community-based services, and improve coordination between Medicare and Medicaid. The publication also examines challenges related to affordability, inequities in access, financial risk for households and instability in the private long-term care insurance market. Lessons are presented regarding the need for more comprehensive and equitable long-term care systems capable of addressing growing care demands associated with population ageing and disability.
This country report examines the organization, financing and purchasing arrangements of long-term services and supports (LTSS) in the United States of America, with particular emphasis on Medicaid as the principal public payer for long-term care. The publication describes the structure of the US LTSS system, which combines means-tested public coverage with limited private insurance and substantial out-of-pocket spending. It outlines the range of services provided to older persons and individuals with disabilities, including institutional and community-based care, and discusses eligibility criteria, assessment tools and state-level variations in access and coverage. The report analyses pricing and contracting mechanisms used within Medicaid-funded LTSS programmes, including fee-for-service and managed care approaches, as well as federal and state responsibilities in determining payment rates. It highlights policy efforts to reduce fragmentation of care, expand home- and community-based services, and improve coordination between Medicare and Medicaid. The publication also examines challenges related to affordability, inequities in access, financial risk for households and instability in the private long-term care insurance market. Lessons are presented regarding the need for more comprehensive and equitable long-term care systems capable of addressing growing care demands associated with population ageing and disability.
Keywords
Aged, Aging, Aged, 80 and over, Long-Term Care, Caregivers, Home Care Services, Household Work, Housing, Activities of Daily Living, Self Care, Quality of Life, Community Health Services, Poverty, Disabled Persons, Skilled Nursing Facilities, Health Services Needs and Demand, Health Services for the Aged, Healthcare Financing, Health Expenditures, Financial Management, Cost Sharing, Quality of Health Care, Government, National Health Programs, Managed Care Programs, Medicaid, Medicare, United States, economics