Decrease Medicaid beneficiaries in nursing homes, CMS says

CMS urged states to continue the shift of Medicaid funds from institutional to community-based settings
CMS urged states to continue the shift of Medicaid funds from institutional to community-based settings

States should dedicate Medicaid funds to strengthening the home care workforce, rather than institutional settings, the Centers for Medicare & Medicaid Services advised in recently published bulletin.

In the guidance, published Wednesday, CMS said that a stable home care workforce is one of many steps the agency is taking to improve access to home- and community-based care and “remedy a longstanding imbalance” between institutional and community settings.

CMS suggests that states could create open registries of home care workers to “strengthen the identity” of the workforce and connect available, qualified workers with Medicaid beneficiaries.

“Because home care workers often deliver care on site in the homes of beneficiaries receiving services, and travel from home to home independently, home care workers may interact with their professional peers infrequently, which can promote isolation and disengagement, and make professional development challenging,” CMS said.

The bulletin also clarifies possible qualifications for home care workers, such as a valid driver's license and receipt of state training, and advises states to develop appropriate payment rates for homecare services.

While consumer advocates applauded CMS' focus on home care, some industry insiders expressed concerns that the bulletin is “a way for CMS to find cheaper options to care,” Modern Healthcare reported.

CMS data shows their efforts are working: In fiscal year 2014, 53% of Medicaid's long-term services and supports expenditures went toward home- and community-based services, compared to 45% in 2009.