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Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Medicare spending for home health care rose from $3.7 billion in 1990 to $17.8 billion in 1997, making it one of the fastest growing components of the program. To control spending, Congress passed an act which required HHS to develop a prospective payment system to replace cost-based payments for home health agencies. This report: documents the objectives, findings, & costs of the research & demonstration projects the Health Care Finance Admin. has funded that were related to the design of the prospective payment system; & assesses how these projects contributed to the proposed prospective payment system design & determines which design decisions were based on incomplete information. Charts & tables.