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Journal of Aging and Health
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Home- and Community-Based Alternatives to Nursing Homes:

Services and Costs to Maintain Nursing Home Eligible Individuals at Home

Timothy C. Schwab

SCAN® Health Plan

Kwan-Moon Leung

SCAN® Health Plan

Eve Gelb

SCAN® Health Plan

Ying-Ying Meng

UCLA Center for Health Policy Research

Jodi Cohn

SCAN® Health Plan

Objectives: This study analyzes home- and community-based services (HCBS) use patterns and determines the costs of purchasing in-home services comparable to those offered by SCAN®, a Social HMO. Methods: Administrative data on 8,229 nursing home certifiable members were used to profile use patterns; a telephone survey gathered data on the market value of these services. Results: Frail Social HMO members used a variety of HCBS to remain independent at home. These individuals would spend an average of $4,900 out of pocket per year to purchase equivalent HCBS, if they were not enrolled in the Social HMO. Discussion: Findings suggest that the costs of maintaining a Social HMO member at home are modest and affordable, yet offer a substantial benefit, particularly to low- and moderate-income older people. With the aging of the population, an integrated medical and social program, such as the Social HMO, offers a viable policy solution.

Key Words: HCBS • nursing home • Social HMO • frail elderly • use patterns and cost • Olmstead decision

Journal of Aging and Health, Vol. 15, No. 2, 353-370 (2003)
DOI: 10.1177/0898264303015002002
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