RETHINKING LONG-TERM CARE

In the context of several proposals for financing long‐term care (LTC), this article suggests three areas in which reform of the structure of LTC is needed to create more appropriate incentives for better care. The interfaces between short‐ and long‐term care can be addressed by either a number of specific changes or more global approaches, such as one or another form of capitated care. Using the ratio of achieved/expected outcomes as a prominent part of a regulatory strategy offers a means to increase the flexibility of regulation to encourage innovation while retaining meaningful accountability. New combinations of housing and nursing care offer a way for both a better and more flexible way of living in the context of an approach that guarantees universal coverage of care together with an incentive to save to afford better accommodations. © 1990 The American Geriatrics Society