The Changing Role of Non-Profit Organizations in the U.S. Long Term Care System.

The American long-term care system has changed dramatically over the last several years as the need for care has increased steadily with the aging of the boomer generation. Arguably, the most important change has occurred in the Medicaid-funded part of the system as several states, with strong federal support, have moved toward contracting with large for-profit insurance companies to provide overall administration of Medicaid long-term care services, largely displacing the non-profit organizations that constitute the nation's Aging Network. We are concerned that the displacement of the mission-oriented model of long-term care that is administered by the Aging Network will negatively affect access, quality, and cost in state Medicaid long-term care programs.