Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA.
Health Aff (Millwood). 2010 Jan-Feb;29(1):22-8. doi: 10.1377/hlthaff.2009.0494.
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.
医疗保险和医疗补助是两个公共资助的健康计划，都覆盖有长期护理需求的人群，但它们之间协调不善。在某些服务中存在差距，而在其他服务中则存在重叠。这可能导致服务提供效率低下，并且计划接受者和提供者都感到困惑。自 1999 年以来，医疗保险中急性后期服务和医疗补助中长期护理服务的支出增长速度超过了两个计划的参保人数增长速度。尽管越来越多的人接受由这两个计划支付的家庭和社区为基础的服务，但各州和各目标群体之间存在很大差异。长期护理系统需要进行结构性改革。
