Reducing the number of patients in nursing homes, and increasing those served in their own homes will help shave $900 million off nearly $3 billion in the state’s long-term care costs over the next 15 years, according to a report released Monday by the Connecticut Regional Institute for the 21st Century.

The report authored by Brian Renstrom, a partner in BlumShapiro, a Connecticut-based accounting firm, said Connecticut needs to undertake a rebalancing act and raise the percentage of people receiving care in their homes and communities.

He said currently those two systems of care, institutional and home care, are in conflict with each other. In order to rebalance the two systems of care, which are spread amongst at least four state agencies, will require leadership, he said at a Capitol press conference.

The report recommends increasing the percentage of people living and receiving care at home and in the community to 75 percent by 2025. Health care at home is 50 percent less expensive than care at a nursing home and studies show 80 percent of Connecticut residents prefer to be cared for in their homes.

But if Connecticut does nothing about its long-term care costs its annual Medicaid spending on it will grow to $5.8 billion, an increase of over $3 billion per year. Currently the state spends 13 percent of its expenditures on long-term care. In 2009 that was $2.49 billion.

Renstrom said Connecticut tried to tackle rebalancing institutional care with a home and community care pilot program called: Money Follows the Person. Under that pilot only 176 persons transitioned out of 84 different nursing homes back into the community.

Despite challenges, other states have successfully rebalanced their systems, Julie Evans Starr, executive director of the Commission on Aging, said. She said Connecticut ranks 34th among states in regards to its rebalancing efforts.

She said the state still needs nursing homes and they should be adequately supported. At the same time the home and community based system is struggling as well, she said.

Brian Ellsworth, president and CEO of the Connecticut Association for Home Care and Hospice, said rebalancing the system won’t work if the home care system is underfunded.

“Ultimately, it’s a leadership issue,” Ellsworth said Monday. “We’re going to have to make an investment and we’re going to have to pay for it.”

The report recommends the creation of a cabinet level position inside the governor’s office to help provide leadership on this issue.

“We think the situation is going to dictate that folks are going to have to take action,” Tony Rescigno, president of the Greater New Haven Chamber of Commerce, said. “We’re offering real solutions for leaders to, sort of, carry the ball forward.”

The report also recommends that the General Assembly pass legislation, which does not allow short-term budget pressures to interrupt investments in the long-term care system. And creation of a single-point of entry for long-term care information and encourage individuals to invest in their own long-term care costs by increasing the portion of long-term care cover by private health insurance to 25 percent by 2025.

Sen. Jonathan Harris, D-West Hartford, said the report released Monday was important, not just for what it recommended, but for the public-private partnership behind it.

The group of nonprofits, business leaders, and government officials will continue to present the state with ways to save money in the future.