Site menu:


December 2013 Policy Study, Number 13-12


Iowans Want to Age in Place


Executive Summary



In order for Iowa to meet the needs of its growing aging population and to combat the rising cost of health care in general, understanding of the current health policy landscape and the opportunities to improve care delivery in both a cost-effective and beneficial manner in the patient-preferred setting should be at the center of the majority of policy considerations for the Iowa Legislature and Governor. Policy decisions should be aligned with patient-centered needs. Iowa has an opportunity to lead the way with innovative strategies related to care delivery to rural elderly through more efficient utilization of existing systems – both our health care and educational systems.


Access to long-term services and supports (LTSS), such as those provided through the less costly and more desired home and community-based services (HCBS) will need to increase. There is a 40-year history of the evolution of both health care and payment policies related to LTSS and HCBS, which is outlined here. In addition, an understanding of the needs unique to Iowa’s Baby Boomer generation is integral to policy formation related to both care delivery and payment models.


The nursing home industry has an opportunity to adapt and realign its business model to support the policy goals of lower-cost care with better outcomes in the patient-preferred setting. Iowa has an opportunity to lead the way in health care reform and educational innovation by merging these two sectors, allowing for “those in the spring of their lives to serve the needs of those in the autumn of theirs.” Both an increase in better health care outcomes and a reduction in the “brain drain” problem in Iowa are possible with just such an innovation as is proposed here.




Click here for pdf copy of this Policy Study


All of our publications are available for sponsorship.  Sponsoring a publication is an excellent way for you to show your support of our efforts to defend liberty and define the proper role of government.  For more information, please contact Public Interest Institute at 319-385-3462 or e-mail us at