National Long-Term Care Channeling Demonstration: Summary of Demonstration and Reports

This paper presents an overview of the results of the National Long-Term Care Channeling Demonstration, conducted in ten states to test the impact of a community-based system of long-term care upon the functionally disabled elderly. The study examines: program management; federal planning of the project; the objectives of the demonstration; the two Channeling models, which emphasized case management and cost containment; services offered by the demonstrations; major phases of the projects; data collection and evaluation activities; and results. Findings include that: (1) Channeling did not affect nursing home or hospital use, nor did it have a significant impact on clients' longevity; (2) there was no evidence that Channeling led to substitution of formal for informal care in the case management model, but there was some evidence of substitution in the Financial Control Model; (3) Channeling led to an increase in the total subsistence, medical, and long-term care costs per client (i.e., the case management model increased costs by about $1,500 per client, and the Financial Control Model increased costs by about $3,500 per client); (4) Channeling improved the well-being of caregivers, by some measures, especially in terms of satisfaction with care arrangements and overall satisfaction; and (5) Channeling reduced unmet needs and increased overall confidence in service. [31 PDF pages]