Summary: Testimony was presented on GAO work in long-term health care. There is currently no coordinated national policy that promotes both adequate and efficient long-term care services for the elderly and disabled. When the elderly and their families look for long-term care services they are likely to find that: (1) there is a lack of information about available services; (2) community services essential to remaining at home may not exist; (3) there is often a lack of coordination among public and private community service providers; (4) eligibility for services varies across institutions and across States; and (5) professionals may recommend nursing home placement because they do not have the expertise or time to arrange for community care. Because community-based, long-term care is often expensive, the elderly often choose nursing home care subsidized by Medicaid. GAO has found that, by liberalizing eligibility and the coverage of services to ensure the expansion of community-based home health care, the Government would increase the longevity and improve the quality of life of the elderly. However, expansion of home health care may not reduce overall health care costs. Since community-based, long-term care services will continue to grow, attention must be given to developing efficient means of providing these services. GAO studies have found that basic program data on long-term care services are inadequate. GAO believes that the analysis of long-term care experiments should focus on the development of data on: the characteristics of the persons who are most in need of long-term care; the types of services that should be provided; who should be the providers; the method of payment that will provide services most efficiently; and the mechanisms that will allow the maximum support from family and friends.
