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Introduction to State Health Policy

Fundamentals of Financing & Delivering Long-term Care

Services for an Increasingly Elderly and Chronically Ill Population


Judy Feder,Ph.D., Co-Director, Center of Health Care Policy Studies, Georgetown University, Washington, DC.

Christine Williams, Director, Office of Health Care Information, Agency for Health Care Policy and Research, Rockville, MD.

As the demand for long-term care (LTC) services for the elderly and chronically ill grows, policymakers are increasingly interested in controlling costs while ensuring quality and access.

This session focused on the growing needs of the aging population by:

  • Examining issues related to the costs and financing of services to people with LTC needs.
  • Reviewing issues and problems in the coordination of health and non-health services for persons needing LTC.
  • Describing methods for ensuring that quality LTC services are delivered.

Christine Williams, Director of the Office of Health Care Information of the Agency for Health Care Policy and Research, provided a comprehensive overview of LTC and described the characteristics and projected growth in the numbers of LTC recipients and caregivers. Ms. Williams indicated that issues of quality related to LTC services are of utmost importance, as an increasingly large number of Americans will begin to utilize LTC services over the next 2-3 decades.

Judy Feder, Co-Director for the Center of Health Care Policy Studies at Georgetown University, examined the financing aspects of LTC. Medicaid dollars currently finance the majority of LTC services, while private insurance dollars cover very little. LTC spending for the elderly is projected to increase rapidly and reach close to $350 billion by the year 2040. Therefore, there is a significant need to determine how the increased demand will be met and how the increased service needs will be financed.


Weiner JM. Can Medicaid Long-term Care Expenditures for the Elderly be Reduced? Gerontologist 1996;36(6):800-11.

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