title: Supporting home- and community-based care: views of long-term care specialists.
abstract: A significant rebalancing of the long-term care system away from nursing homes toward home- and community-based services (HCBS) has occurred over the past two decades. This article reports the results of the Commonwealth Fund Long-Term Care Opinion Leader Survey (N = 1,147) on issues related to supporting HCBS. Respondents expressed strong enthusiasm for rebalancing of the long-term care system toward HCBS. In particular, respondents supported system-based approaches for this expansion, with the majority indicating that greater care coordination was the single most preferred approach for rebalancing the system, helping consumers make informed long-term care choices, and supporting caregivers. Building on the long-term care specialists' enthusiasm for system-based reforms, we encourage state policy makers to pursue HCBS models that are linked to Medicare, engage primary care physicians, and are based on rigorous evaluations.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA. grabowski@med.harvard.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Grabowski
authors.forename: Rebecca Orfaly
authors.initials: RO
authors.lastname: Cadigan
authors.forename: Edward Alan
authors.initials: EA
authors.lastname: Miller
authors.forename: David G
authors.initials: DG
authors.lastname: Stevenson
authors.forename: Melissa
authors.initials: M
authors.lastname: Clark
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D001291:Attitude of Health Personnel; D017028:Caregivers / Q000191:economics / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration*; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D008484:Medicaid / Q000191:economics / Q000458:organization & administration; D008511:Medicine / Q000458:organization & administration; D011050:Policy Making; D014481:United States