Home Care Might Be Cheaper, But States Still Fear It

Interesting series from NPR. This is just one piece of it.

For states, it's the big unanswered question about expanding opportunities for elderly and disabled people to get their long-term care at home: How much is all this going to cost?
In 1999, the U.S. Supreme Court ruling in Olmstead v. L.C. said that the unnecessary institutionalization of people with disabilities is a form of discrimination. State Medicaid programs are required to provide alternatives so that the elderly and disabled can choose to get their care at home, instead of in state institutions or nursing homes. But the Supreme Court said there were limits. A doctor, representing the state, has to determine that the person is capable of living at home. The person has to want to get that care at home. And a state when considering its responsibility to move people out of institutions can consider its own budgetary constraints.
That makes the cost issue important. But there's disagreement over whether moving people out of institutions and nursing homes and into home-based care will save or cost money.