title: Home-and community-based alternatives to nursing homes: services and costs to maintain nursing home eligible individuals at home.
abstract: This study analyzes home- and community-based services (HCBS) use patterns and determines the costs of purchasing in-home services comparable to those offered by SCAN(R), a Social HMO. METHODS. Administrative data on 8,229 nursing home certifiable members were used to profile use patterns; a telephone survey gathered data on the market value of these services. RESULTS. Frail Social HMO members used a variety of HCBS to remain independent at home. These individuals would spend an average of $4,900 out of pocket per year to purchase equivalent HCBS, if they were not enrolled in the Social HMO. DISCUSSION. Findings suggest that the costs of maintaining a Social HMO member at home are modest and affordable, yet offer a substantial benefit, particularly to low- and moderate-income older people. With the aging of the population, an integrated medical and social program, such as the Social HMO, offers a viable policy solution.
authors.affiliation: SCAN (R) Health Plan., USA
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Schwab
authors.forename: Kwan-Moon
authors.initials: KM
authors.lastname: Leung
authors.forename: Eve
authors.initials: E
authors.lastname: Gelb
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Meng
authors.forename: Jodi
authors.initials: J
authors.lastname: Cohn
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003153:Community Health Services / Q000191:economics*; D003365:Costs and Cost Analysis; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006279:Health Maintenance Organizations / Q000191:economics*; D006801:Humans; D008134:Long-Term Care / Q000191:economics* / Q000379:methods; D009735:Nursing Homes / Q000191:economics*; D014481:United States