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Pursuant to a congressional request, GAO surveyed the views of state agencies on aging and state Medicaid agencies on long-term care reform issues, focusing on: (1) how needs are best determined; (2) what services a long-term care system should offer; (3) how costs can best be controlled; and (4) what potential role the private sector may have in long-term care for the elderly. GAO noted that: (1) state agencies have consistent views on criteria and methods that are most useful in determining need and types of services that are most appropriate for inclusion in a long-term care system for the elderly; (2) state agencies have less consistent views on the efficacy of any single cost-control method and suggest the potential need to use multiple methods to control costs; and (3) state officials generally feel that private-sector approaches to long-term care could reduce government long-term care spending.

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