Juanita B. Wood

The non-profit sector and community-based care for the elderly in the U.S.: A disappearing resource?☆

Non-profit health and social service agencies have traditionally been an extremely important element of non-institutional community-based care for the elderly in the U.S. Policy shifts, commencing in 1981, increasingly concerned with medical cost containment are challenging private non-profit sector agencies delivering care to the elderly. At issue is the ability of communities to maintain a viable service sector predicated on service needs and service accessibility, as opposed to a highly discrete, medicalized, and fragmented service delivery system that is available primarily (or only) to those who can pay.

Medicare Prospective Payment: Anticipated Effect on Hospitals, Other Community Agencies, and Families

The switch to prospective payment for hospitals under Medicare is expected to have ramifications in a number of different areas. This paper addresses a select number of those areas: hospital organization and management, other community agencies, and families. Questions are raised as to the capacity to provide adequate care in response to the increased demand for care outside the hospital setting that will result from the new payment system.