Paying for long-term care: the present and the future

With an increasing elderly population, the need for nursing home services will definitely increase. However, the number of Medicaid recipients probably will increase also. Even though revisions to Medicaid have occurred, reimbursement rates are still inadequate. Realistically, the government cannot afford to totally fund the care of the elderly. Plans to curb the costs of long-term care, such as private insurance and preadmission screenings, appear to be necessary. Perhaps some rationing of care will be necessary. If so, we will have a whole new set of problems with respect to ethical and moral issues.     

Health content can advance the clinical care process

Many health Web planners use health content as a way to encourage people to visit their site. Their goals often include offering the information as a service to the community, marketing their health services, or, for commerical sites, selling ads, But for a few organizations, the health content is an integral part of their care process.     

Health care systems: predictions for the future

What current forms of systems will ultimately lead health care in the direction of a high-quality, comprehensive, efficient, and more caring system of services for the future?     

The past and future of home- and community-based long-term care

For almost three decades researchers have sought to quantify the benefits of home and community care for the elderly, invariably assuming that such care would be an economical substitute for institutionalization. Twenty-seven studies that met rigorous criteria of design, size, and subject were analyzed and the results were synthesized to address the effects on institutional utilization and expenditures, and patient health status and well-being. Home- and community-based health care services are shown to raise overall utilization and costs. Health status effects are limited primarily to patient and caregiver contentment and reduction of unmet needs. Recommendations are made for reaping this considerable benefit more efficiently.     

Health care philanthropies: how communities can participate

When a nonprofit hospital or health plan converts to for-profit status, the value of its assets endows a charitable foundation. As a result, billions of health care dollars are being shifted into new philanthropic institutions with an explicit mission to "improve the health of the community." But this issue of States of Health argues that mission can only be accomplished if consumers are involved significantly in the conversion process.     

Health care financing in the Netherlands: recent changes and future options.

Following a short outline of the structure of the Dutch health care system and the regulatory activities of the government, budgeting in health care is being considered at three levels: the national level, the level of the health care institution and the intermediate level of the region. The authors foresee that regional budgeting and regional policy-making will become more important. Instead of a nation-wide introduction of the Health Services Act, which means more government interference at regional and local levels in health care, the authors believe that a re-orientation on market-principles as the dominating mechanism in resource allocation in health care will take place in the coming years. This will coincide with strengthening the position of sickness funds and private insurers at the cost of that of provincial and local government.