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Journal Article
Maybe Elephants Can Dance
2025
Overview
The United States initially developed a long-term care system that prioritized nursing home care over in-home care, particularly for those supported by the Medicaid program. Legislation in 1981 attempted to change that strategy, but progress was slow. Today, however, the long-term services system has been altered in most states to emphasize home- and community-based services as a major option supported by the Medicaid program. Using Ohio as a case study, the system change is highlighted in this article, and policy issues for tomorrow are discussed.
