The April 18 article on Medicaid budget cuts was very good. It is true that a greater percentage of Medicaid dollars is going for long-term care. Unfortunately, the article included just one very short paragraph about home-based long-term care. If we, as a nation, are ever going to contain health-care costs, we must reduce our emphasis on institutional care. This is particularly important in the field of long-term care.
We spend about $60 billion annually on long-term care, but only 18% of this is used for home-based care. This is an obvious underutilization of an important health-care resource. Most individuals in nursing and convalescent homes are not sick. They are there because they have difficulty with routine activities of daily living. These include bathing, dressing and preparing meals. Keeping these individuals in an institution costs from four to 30 times the cost of home-based care.