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LTC Bullet: Tennessee Advocates Invite Unintended Consequences

Thursday August 20, 1998


TennCare, Tennessee's health insurance program for the poor and disabled, faces pressure from senior advocates to expand funding for home care services. Advocates want to redirect Medicaid monies from nursing homes to home care.

State officials insist that TennCare was not designed to cover long-term home health care.

Expanding publicly-funded home care will only exacerbate the problem advocates hope to solve: How to provide top-quality care at the appropriate level. Experience in other states has shown that expanding public financing of more desirable home and community-based care results in induced demand which more than offsets any cost savings from delaying nursing home admission. What may sound like a good deal for any one particular TennCare recipient jeopardizes the whole program's viability.

States are beginning to promote private financing alternatives such as long-term care insurance to reduce the demand for publicly-financed care. LTC insurance guarantees access to top-quality care at the appropriate level across the spectrum of care settings.

Expanding state-funded home care programs will impede these efforts. Why would someone pay insurance premiums to receive the same care they can get for free? Advocates should applaud states' efforts. After all, it's fruitless to advocate more spending from a public program that goes bankrupt trying to provide something for everyone.

Source: "Change Could Force Some to Nursing Homes," Knoxville News, August 17, 1998 --