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Med Care Res Rev. 2010 Aug;67(4 Suppl):82S-101S. doi: 10.1177/1077558710366863. Epub 2010 May 4.

Supporting home- and community-based care: views of long-term care specialists.

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Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA.


A significant rebalancing of the long-term care system away from nursing homes toward home- and community-based services (HCBS) has occurred over the past two decades. This article reports the results of the Commonwealth Fund Long-Term Care Opinion Leader Survey (N = 1,147) on issues related to supporting HCBS. Respondents expressed strong enthusiasm for rebalancing of the long-term care system toward HCBS. In particular, respondents supported system-based approaches for this expansion, with the majority indicating that greater care coordination was the single most preferred approach for rebalancing the system, helping consumers make informed long-term care choices, and supporting caregivers. Building on the long-term care specialists' enthusiasm for system-based reforms, we encourage state policy makers to pursue HCBS models that are linked to Medicare, engage primary care physicians, and are based on rigorous evaluations.

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