This paper examines the extent to which private savings responds to the availability of a social insurance program. We focus on the Medicaid nursing home assistance program and uses variation in state Medicaid policies in the 1960s and 1990s to identify whether household wealth correlates...

In anticipation of the escalating costs of long term care, consumers and the federal and state governments are engaging in a variety of strategies intended to preserve the financial solvency of the respective party. For the consumer, this may mean planning in a way designed to maximize one's...

This article draws attention to the long-term implications of Congress' 1997-1998 budget resolution to Medicare's increased charges. Because Congress has only dealt with Medicare's short-term problems, the author contends, Medicare's long-term problems have become increasingly worse. Medicare is...

Medicaid provides a critical source of insurance for long-term care, and individuals may strategically offload assets (typically to children) to meet the means-tested eligibility requirement. In this paper, we quantify the extent of such behavior using variation in the penalty for improper...

Making a transfer in kind reduces its value to recipients but can improve targeting. We develop an approach to quantifying this tradeoff and apply it to home care. Using randomized experiments by Medicaid, we find that in-kind provision significantly reduces the value of the transfer to...

Many of the most important government programs make transfers in kind as opposed to in cash. Making transfers in kind has the obvious cost that recipients would often prefer cost-equivalent cash transfers. But making transfers in kind can have benefits as well, including better targeting...

Das deutsche Gesundheitswesen ist hochkomplex und für Außenstehende nur schwer durchschaubar. Sogar Experten haben Schwierigkeiten, die Struktur und Funktionsweise der verschiedenen Teilsysteme und Versorgungsbereiche insgesamt zu überblicken. Durch die zahlreichen Gesundheitsreformen wird es...

The price sensitivity of demand for nursing home care is a subject of considerable policy interest. Standard methods for measuring price responsiveness are difficult to apply to nursing home care, since accurate price information is usually unavailable and prices may reflect unmeasured quality...

In this paper I show that the Medicaid program can improve the access of financially indigent patients to nursing home care by raising the rate of return paid on Medicaid patients' care, but only at the cost of lower quality of care. To quantify the policy tradeoff, I derive expressions for the...

The Medicaid Home and Community-Based Services (HCBS) subsidizes long-term care to satisfy the increasing desire to age at home among older adults. The HCBS program may improve health outcomes of this population by allowing them to age-in-place, but less quality and quantity of home-based care...