Medicare And Medicaid In Long-Term Care

TLDR

Medicare and Medicaid cover long‑term care populations but are poorly coordinated, creating gaps, overlaps, inefficiencies, and confusion that signal a need for structural reform. Since 1999, spending on Medicare post‑acute and Medicaid long‑term care services has outpaced enrollment, with growing use of home and community‑based services that vary widely across states and target groups.

Abstract

Medicare and Medicaid, two publicly funded health programs, both cover populations in need of long-term care, but they are poorly coordinated. Gaps often exist in some services while there is overlap in others. This can lead to inefficient delivery of services and confusion among program recipients and providers alike. Spending on postacute services in Medicare and long-term care services in Medicaid has grown more rapidly than enrollment in either program since 1999. Although growing numbers of people receive home and community-based services paid for by the two programs, there are wide variations across states and among target groups. The system of long-term care is in need of structural reform.