State Model for Estimating the Use and Cost of Home Care

We will develop a prototype PC-based state forecasting model to enable policy-makers, andanalysts to estimate the utilization and costs of expanded home and community-based servicesprograms. Based on a Lotus 1-2-3 platform, the architecture of the model will be designed to ensure thatall assumptions are easily accessible and can be changed. As new information becomes available, it willbe possible for users to modify model inputs in a straightforward fashion and conduct multiple sensitivityanalyses. The development of an easily accessible forecasting model for home and community-basedservices would represent an important and timely new analytic tool for state policy-makers, in part,because the Clinton health care reform proposal assigns the states greater responsibility for financingand delivering such services. Currently, many states only have available rigid micro-simulation modelswhich are difficult to understand, require major computing capacity, and require a reliance on outsideconsultants for their proper use and interpretation. Moreover, sensitivity analyses are difficult toperform. The proposed model will enable policy-makers to assess the impact of alternative economicand demographic assumptions as well as alternative program configurations on service utilization, costsand payment source.