State Expenditures on Home and Community-Based Care for Disabled Elders

Publication Date:

Publisher: New York: Center for Home Care Policy and Research, Visiting Nurse Service of New York

Author(s): C.M. Murtaugh; D.G. Stevenson; P.H. Feldman; M.R. Oberlink

Research Area: Health

Type: Report

Abstract:

Though the 1990s were a time of widespread implementation of Medicaid Home and Community-Based Services (HCBS) waiver programs for disabled elders, advocates raised questions about whether public funding of long-term care remained institutionally biased in most states. This fact sheet summarizes an analysis of Medicaid and other state spending on HCBS in an effort to determine the extent to which states changed the allocation of their long-term care resources during the 1990s.



Key Findings:



* Medicaid spending on HCBS is growing faster than spending on nursing home care.
* Despite rapid growth in HCBS spending, the share of Medicaid long-term care resources going to HCBS is still small in most states.
* A small number of states do spend a substantial share of their Medicaid long-term care resources on HCBS.



The authors conclude that the majority of states continue to spend a relatively small share of their long-term care resources on HCBS despite the fact that state HCBS spending for elders has grown faster than expenditures for nursing homes in the same time period. The authors go on to state that two policies—public funding of assisted living and managed long-term care—have the potential to reallocate resources for long-term care.