Abstract
Overlap and coordination among four federal programs which are responsible for financing and/or delivering health services to the elderly (Medicare, Medicaid, Older Americans' Act, Title XX of the Social Security Act) are examined in an attempt to assess the effectiveness of the overall federal policy toward elderly health. Reasons for poor coordination include reluctance on the part of the agencies involved to coordinate their efforts, intergovernmental programmatic arrangements, and the overall fragmentation of the national health system. Three local programs, Triage, Inc., of Connecticut. ACCESS of Monroe County, New York, and the Community Care Organization of Wisconsin, are presented as examples of organizations which have achieved a degree of coordination, and consequently effectiveness, in the delivery of health services to the elderly in their communities. Prospects and strategies for future coordination in the elderly health arena are discussed.
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