Participants were derived from 1,444 community-dwelling men and women aged 65 to 100 who lived in 19 counties in upstate New York, West Virginia, and Ohio. Participants were enrolled in the Medicare Primary and Consumer-Directed Care Demonstration, conducted by the Monroe County Long Term Care Program, Inc. (Rochester, NY) and the Center for Aging and Healthcare in West Virginia, Inc. (Parkersburg, WV). All participants were required to be enrolled in Medicare Part A and Part B, need or receive help with at least two Activities of Daily Living (ADLs) or three Instrumental Activities of Daily Living (IADLs), and have a recent history of significant use of health care services (hospital, nursing home, Medicare home healthcare, or emergency department). The Medicare demonstration involved a baseline assessment and two additional assessments taking place approximately 12- and 22-months post-baseline.
