So far, private long-term care insurance has had virtually no impact on the organization or delivery of long-term care. This is because most of the financing for long-term care is either through Medicaid, Medicare, or directly from those needing long-term care. In 1998, Medicaid, the largest public payer of long-term care services, accounted for 45 percent of all long-term care expenditures. Medicare financed 16 percent overall. Families directly financed 27 percent and private insurance, from all types of private insurance, financed less than 7 percent of long-term care. Most private insurance payments, however, are not yet from long-term care insurance. Analogous to Medicare, the financing of long-term care is from the acute health insurance plans (and Medicare HMOs) using long-term care services, often as an alternative to inpatient hospital care.
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