title: Beyond managed long-term care: paying for home care based on risk of adverse outcomes.
abstract: Evaluations of home care for chronically ill elderly people have shown disappointing results for many years. Improvements in outcomes have been slight and costs high. We offer a system for setting budget targets based upon effectiveness of home care in mitigating certain adverse outcomes, the risk of those outcomes those outcomes. We believe that such a budgeting system will encourage improved measurement of outcomes and more rigorous justification for expenditures. Moreover, such a system is designed to reallocate resources to higher-risk patients and those more likely to benefit, focusing caregiving on specific outcomes and improving those outcomes.
authors.affiliation: Department of Health Management and Policy, University of Michigan School of Public Health, USA.
authors.forename: W
authors.initials: W
authors.lastname: Weissert
authors.forename: M
authors.initials: M
authors.lastname: Chernew
authors.forename: R
authors.initials: R
authors.lastname: Hirth
mesh_terms: D000368:Aged; D002017:Budgets; D015577:Geriatric Assessment; D015276:Health Care Rationing; D005102:Health Expenditures; D006699:Home Care Services / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D008134:Long-Term Care / Q000191:economics* / Q000458:organization & administration; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D012308:Risk Management / Q000458:organization & administration*; D014481:United States