PolicyGuy

Wednesday, July 26, 2006


Forcing Granny Out of Her Nursing Home?
The WSJ (link for subscribers) reports that the Centers for Medicare and Medicaid Services, is encouraging states to get nursing home patients to go ... back home.

One reason for the move is the thought is that most people would prefer to be treated at home than in an institution. No doubt that's true. The other reason is that it's usually cheaper to treat someone at home. This is true as well, but from the numbers I saw (about a year ago) while part of a long-term care committee, the costs are still substantial. In other words, home care does give financial savings, but the costs are still substantial. If the state takes the per-person savings and adds more beneficiaries to Medicaid, the result is no lessening in overall demand.

Federal aid will come in two parts. The first is $1.75 billion in one-time grants to help states move people out of institutions. The second part will be ongoing, in the form of a higher matching rate for state funds spent on home care.

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"Justice Louis D. Brandeis'?s metaphor of the states as "laboratories" for policy experiments ... had almost nothing to do with federalism and everything to do with his commitment to scientific socialism. .... To this day, it continues to inhibit a truly experimental, federalist politics." -- Michael S. Greve

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