Skip to main content

Advanced Search

Advanced Search

Current Filters

Filter your query

Publication Types



Journal Article


Weighing Public and Private Options for Reforming Long-Term Care Financing: Findings from a National Survey of Specialists

The Issue

Debate around long-term care financing reform has traditionally focused on the public and private sectors’ relative roles in meeting the needs of the growing population of frail and disabled elders. Published in a special supplement to Medical Care Research and Review, results from the Commonwealth Fund Survey of Long-Term Care Specialists highlight the characteristics that predispose long-term care specialists to weigh one  approach—public or private—more than the other.


What the Study Found

Two-thirds of the 1,147 survey respondents ranked financing reform among the top three challenges facing long-term care. Approximately four-fifths of specialists favored or strongly favored both private sector financing and Medicare/Medicaid reform, while more than half favored or strongly favored bolstering the government role. Those who most strongly favored greater private sector financing tended to be younger, were less well-educated, identified themselves as Republicans or Independents, or had personal experience working in nursing home care. Those most strongly favoring Medicare/Medicaid reform tended to be better-educated, Democrats, and employed at a university or other academic institution. And those who most strongly favored increasing the government’s role in long-term care financing tended to be older, better-educated, Democrats who had spent more than five years working in long-term care as an academic, consumer advocate, or researcher/consultant.



Despite the differences in perspective they found, the authors note the apparent agreement among long-term care specialists that the current mix of financing options, both public and private, "is unsustainable, not only if we are to meet the increased demand for [long-term] care ahead but also if we are to satisfy substantial levels of unmet need among the current population of elders."

Publication Details



E. A. Miller, V. Mor, and M. A. Clark, "Weighing Public and Private Options for Reforming Long-Term Care Financing: Findings from a National Survey of Specialists," Medical Care Research and Review, Aug. 2010 67(4 Suppl.):16S–37S.