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Journal Article


Long-Term Care: Getting on the Agenda and Knowing What to Propose

The Issue

Despite many deficiencies in the current system of organizing and financing long-term care, little in the recently enacted health reform law is specifically focused on resolving these issues. In this article, published in a special supplement of Medical Care Research and Review, the author describes the "grab-bag of research and demonstration projects, administrative reorganizations, and additional options to state Medicaid programs" designed to reform long-term care in the United States.

What the Study Found

Citing results from The Commonwealth Fund Survey of Long-Term Care Specialists, the author notes that what is striking about potential long-term care reform is that "experts appear to be agnostic in their choices so long as the options bring more resources to long-term care." Almost 84 percent of experts agreed that the long-term care system should be rebalanced away from institutions and toward home and community-based services. Also, states are interested in funding residential care facilities, such as assisted living facilities, through Medicaid, largely through home and community-based services waivers.


With the aging of the baby boom generation, and the near-elderly status of the parents of that generation, there is growing momentum to find better long-term care solutions. "It may be the combination of the baby boomers and their parents that puts long-term care on the national political agenda sooner rather than later," the author writes.

Publication Details



J. M. Wiener, "Long-Term Care: Getting on the Agenda and Knowing What to Propose," Medical Care Research and Review, Aug. 2010 67(4 Suppl.):126S–140S.