Long-Term Care:

Current Issues and Future Directions

HEHS-95-109: Published: Apr 13, 1995. Publicly Released: May 11, 1995.

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Pursuant to a congressional request, GAO provided information on long-term care, focusing on: (1) the conditions that give rise to long-term care; (2) which groups require long-term care; (3) long-term care costs and strategies to contain them; and (4) its future demand.

GAO found that: (1) long-term care is designed to help people with chronic conditions compensate for limitations in their ability to function independently; (2) the need for long-term care is not determined on the basis of a diagnosis or illness alone; (3) of the over 12 million Americans requiring long-term care, 60 percent were elderly; (4) people in need of long-term care primarily require nonmedical assistance with daily living activities; (5) 70 percent of the $108 billion that was spent on long-term care in 1993 paid for institutional care; (6) Medicaid and Medicare are the two largest government payers of long-term care; (7) families pay over one-third of long-term care costs and can purchase private long-term care insurance to help with the financial burden, but they also suffer nonmonetary burdens in caring for relatives; (8) states and other countries have been working on new ways to control long-term care costs, including service delivery models that emphasize home and community-based care, capping budget and provider fees, consolidating program administration, and using case management more often; and (9) the number of people needing long-term care is expected to increase, although the extent of future long-term care needs is uncertain.

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