Agenda - 09-06-1983 - Laserfiche WebLink

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' I reached $2.7 billion in fiscal 1931 , over 43 percent of which was paid for by the federal government. A large proportion of these expenditures were for hospital care for the elderly---in 1978. approximately 43 percent of national public hospital expenditures went for services to patients 65 or older. Hospital cost savings should be achieved if providing home health care reduces hospital use by elderly patients. (5) ! ! Significant growth has also occurred in nursing home expenditures. For the elderly.1 nursing home care is second only to hospital care as the most expensive health service. Nationally. nursing home care expenditures totaled $20.7 billion in 1980. In North Carolina, public expenditures foci nursing home care (including skilled and intermediate care) were almost $9 million in Medicare payments, and almost 3148 million in Medicaid payments in 1981. About 70 percent of the public funding of nursing home care is for individuals 65 years of age and older. (5) 1 Expanding the availability of community-based services is being widely considered as a way of reducing the growth in nursing home costs. As pointed out earlier, studies indicate that some nursing home patients do not need the level of care provided in an institution and could remain in their own homes if community-based services were adequate. In response to this finding, a recent Congressional Budget Office report proposed a method for slowing the escalation of long-term (that is, nursing home) care expenditures under Medicaid.That method would impose a formula-determined ceiling on federal grants for long-term care expenditures and also give the states greater discretion in managing the delivery of these services. CBO estimated that federal expenditures would be reduced by about $3.4 billion for nursing home costs from 1983 to 1987 by the states expanding their in-home services. However, whetherjrFederal costs would actually result in a reduction in total health costs would depend on the extent to which expanded home health care achieved institutional savings for the present population. With a growing older population, taking care of more elderly for the same total expenditures and substantially retarding increased costs will be critical: IMMISMIOIX-AD_ DIJAD2-31t1a#34132 Another area of importance in the expansion of home health care is the potential for improving the physical. mental, and social well-being of the elderly. 'When confronted with the need for long-term-care services becausejof functional limitations or disabilities, the elderly usually prefer to receive assistance in their own homes rather than in institutions or other group care. Improvements in client situations are generally expected whenever the elderly are able to receive care in settings they choose. 1 As the home ;health care system currently exists, there are problems in obtaijning community-based long-term-care services. Without adequate community services. some chronically disabled elderly may deteriorate unnecessarily and thus become less able to function 7