title: Unmet long-term care needs: an analysis of Medicare-Medicaid dual eligibles.
abstract: People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly "dual eligibles," this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference.
authors.affiliation: Health Policy Institute, Georgetown University, Box 571444, 3300 Whitehaven St., N.W., Suite 5000, Washington, DC 20057-1485, USA. komisarh@georgetown.edu
authors.forename: Harriet L
authors.initials: HL
authors.lastname: Komisar
authors.forename: Judith
authors.initials: J
authors.lastname: Feder
authors.forename: Judith D
authors.initials: JD
authors.lastname: Kasper
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004608:Eligibility Determination; D035082:Federal Government; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000458:organization & administration; D008297:Male; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D020380:Needs Assessment / Q000191:economics; D044469:Racial Groups; D013219:State Government