President Trump and the US Congress have promised to reduce federal spending, through tactics that include cutting Medicaid and Medicare. What they fail to take into account is that sometimes investing in programs that work well can reduce spending while improving the health and well-being of people. A case in point: programs that help older adults and those who are disabled remain in their homes and out of long-term care facilities.
The proportion of the US population 65 years or older is expected to almost double by 2050, to more than 87 million, when surviving baby boomers will be older than 85 years and likely frail. Older adults’ needs for assistance in activities of daily living will increase, challenging both care delivery systems and costs. With the average annual cost of a private room in a nursing home now more than $100 000, keeping people in their own homes and communities could dramatically reduce federal Medicaid spending. But how can this be accomplished?
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