Miller N A
Long-Term Care Coverage Branch, Health Care Financing Administration, Office of Research and Demonstrations, Baltimore, MD.
Health Aff (Millwood). 1992 Winter;11(4):162-71. doi: 10.1377/hlthaff.11.4.162.
Budget reconciliation legislation in 1981 created a waiver program whereby states could provide home and community-based care under Medicaid for certain populations. States spent nearly $1.7 billion on services delivered under these waivers, known as 2176 waivers, in 1991, compared with $3.8 million in 1982, when only six states were participating in the program. Although these programs have not been rigorously evaluated for effectiveness, they continue to be a popular approach to delivering care outside of institutions for various groups. Across all states, states spent 13.4 percent of their Medicaid long-term care dollars on care outside of institutions (which includes the 2176 waiver program).
1981年的预算调节法案设立了一项豁免计划，据此各州可为医疗补助计划覆盖的特定人群提供居家和社区护理服务。1991年，各州在这些被称为“2176豁免”的豁免计划下提供的服务上花费了近17亿美元，而在1982年只有6个州参与该计划时，这一数字为380万美元。尽管这些计划的效果尚未得到严格评估，但它们仍然是为各类群体提供机构外护理的常用方式。在所有州中，各州将其医疗补助长期护理资金的13.4%用于机构外护理（其中包括“2176豁免”计划）。
