# EFFECTS OF PUBLIC SUBSIDIES ON USE OF LONG TERM CARE

> **NIH NIH R01** · VANDERBILT UNIVERSITY · 1992 · $136,265

## Abstract

The overall objective of this three-year research project is to gain a
better understanding of variation in state subsidies of long-term care
services and the effects of this variation on decisions families with
disabled elderly persons make about: living arrangements--living
independently versus living with younger persons versus
institutionalization, and on transfers of care and money from relatives
and friends to the disabled elderly.  We will document state variation
in Medicaid eligibility, benefit structures, and long-term care
reimbursement policies and entry (certificate of need) regulations by
surveying state agencies, state nursing home associations, and lawyers
specializing in obtaining Medicaid benefits for clients.  We will
develop a two-stage model to provide a framework for understanding the
elderly person's living arrangement choice and amounts of informal and
formal care and private cash transfers obtained at each site.  First,
the person decides on a living arrangement, given various anticipations.
Second, informal and formal care amounts are determined conditional on a
location having been selected.  Our model, which will consider
interactions between caregivers and receivers, will focus on the role of
public subsidies on family decisions.  We will also conduct a detailed
analysis of the process of spending down to Medicaid eligibility.
Differences among states as well as among individuals in the spenddown
process will be emphasized.  The empirical analysis of spenddown to
Medicaid, living arrangement, informal and formal care and private cash
transfers received, and caregivers' decisions about how much informal
care to provide will be conducted with national samples from the 1987
National Medical Expenditures Survey, the 1989 National Long-Term Care
Survey, and the 1984-90 Longitudinal Supplement on Aging.  We anticipate
preparing at least five papers.  The papers documenting state policies
and the spenddown process will have a policy orientation.  The papers on
living arrangements and private transfers, aimed at economic audiences,
will provide empirical tests of our model of family decisionmaking with
emphasis on the role of prices and state subsidies.

## Key facts

- **NIH application ID:** 3121329
- **Project number:** 5R01AG009468-02
- **Recipient organization:** VANDERBILT UNIVERSITY
- **SAM.gov UEI:** GTNBNWXJ12D5
- **Principal Investigator:** FRANK A SLOAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1992
- **Award amount:** $136,265
- **Award type:** 5
- **Project period:** 1991-09-01 → 1993-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3121329

## Citation

> US National Institutes of Health, RePORTER application 3121329, EFFECTS OF PUBLIC SUBSIDIES ON USE OF LONG TERM CARE (5R01AG009468-02). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3121329. Licensed CC0.

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