ABSTRACT

In the early 1970s, case management programs serving older adults op-erated in a few sites around the country, running as time-limited demonstration projects with public funding. Though they differed in structure, setting, and operations, these programs served a common agenda: to increase older people's use of home-and community-based services in a way that would prevent or retard their need for nursing home care. At this writing, early in the 21st century, older Americans are likely to encounter a case manager in almost any care setting they enter. The most widespread programs operate with Medicaid and Older Americans Act funding, but others draw from private as well as public sources to support case management in hospitals, hospice care, protective services, respite programs, managed care organizations, and third-party insurance systems. While their objectives are as varied as their organizational settings, these case management programs have changed from their predecessors, focusing primarily on case management's potential to control the costs of care.