INTEGRATING ACUTE AND LONG-TERM-CARE

Advocates of health system reform are striving to assure that a valuab le new benefit for home, and community-based long-term care is include d. Yet in many legislative proposals, a long-term care benefit is kept separate from the rest of the benefit package. Experience from the so cial health maintenance organization (social HMO) demonstration shows that for the elderly at least, community long-term care can be integra ted with acute care, at a manageable cost. Acute and chronic disease a nd disability are experienced concurrently. Moreover, disability is no t confined to a small group of permanently disabled persons but affect s many other persons for short periods. Integration of long-term and a cute care in a managed care model serving a broad population may promo te more effective acute care and more efficient and affordable long-te rm care.