LONG TERM CARE REGULATION IN THE STATES: A SYSTEMIC PERSPECTIVE |
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| Authors: | Robert C. Myrtle William W. Lammers David Klingman |
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| Affiliation: | Associate professor of public administration at the university of Southern California, is the director of the school's program in Health Services Aciministration. His most recent work includes several published pieces on policy implementation and a co-authored text en titled Public Personnel Administration. He is currently studying the implementation of policy innovations in health services delivery for the elderly.;Professor of political science at the University of Southern California, has recently authored two books dealing with public policy and aging. He is continuing the comparative study of state agingrelated policies, while placing particular emphasis on federal-state relations and alternative interpretations of regulatory policy formation.;A research manager at SysteMetrics/McGraw-Hill, Inc., of Bethesda, Maryland, a consulting firm specializing in issues related to health-care finance. In addition to co-authoring a recent book on state aging-related policies with William Lammers, he has authored several articles on public policy development and diffusion a t the cross-state and cross-national levels. He is currently working on an evaluation of the Medicare hospice benefit and analyses of hospital utilization and expenditures under Nieaicaid. |
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| Abstract: | In recent years there has been growing interest in differing state roles in the regulation of the health care industry. Most of this attention has stressed the impact of regulatory policy with only superficial attention directed towards understanding the extent to which states can be counted on to act effectively in the area of health care regulation. Using the regulation of nursing homes as a focus, this study evaluates a variety of sociocultural, political, and economic conditions for their impact on the development of various regulatory policies. The findings suggest that the development of certificate of need legislation and reimbursement controls were not related to significant changes ir, states' budgets for Medicaid services or in bed/population ratios. Instead, regulatory efforts were more closely linked to the sociopolitical environments surrounding the policy arena. While these factors provide some indication of the potential for strong state action in the regulatory arena, ultimately the use of state regulatory policies will depend quite centrally on the innovative tendencies of the state, its organizational capacity for addressing policy issues, and the nature and extent of interest group politics. |
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