Beyond Institutional Long-Term Care: The Community Care System

Summary

The trends of increasing long-term-care costs and a growing population of elderly over 75 are the prime incentives for rethinking current methods of organizing, financing, and delivering long-term-care services. Acknowledging a strong institutional bias in the current system, this chapter examines two of the emerging service and organizational approaches, namely, managed health care models and the social/health maintenance organization.

If current trends can be extrapolated into the future, the future continuum of long-term care may be more integrated, less medical, more institutionally based, based on supported housing, supported by increased family and consumer contributions, marked by a changed federal role, and more consumer oriented. The models and sources of future financing will be key determinants of the future community long-term-care system.