Medicaid spending for home- and community-based care soars, report finds

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Nursing home admins, DONs see salary bump in latest report
Nursing home admins, DONs see salary bump in latest report
Medicaid spending for home- and community-based services (HCBS) skyrocketed by 81.5% between fiscal years 2001 and 2007, according to a report released Tuesday by the National Center for Assisted Living. Meanwhile, spending on nursing homes grew by a modest 9.8% during that time.

Nursing home spending expanded to $46.9 billion in 2007 from $42.7 billion in 2001, while HCBS spending rose to $16.7 billion from $9.2 billion during that period, the study said. The number of people receiving Medicaid coverage for services in licensed assisted living settings increased by 43.7% between 2002 and 2009, the study found. HCBS Medicaid waivers cover services in residential settings in 37 states, while 13 states provide coverage directly through state Medicaid plans. That marks a departure from the past when Medicaid paid only for nursing home care. Medicaid now pays for assisted living care for some 131,000 elderly adults nationwide.

Non-institutional options for long-term care typically cost less to states, are preferred by consumers, and have "created a shift in the supply and utilization of nursing homes over the past several years," according to the report. Between 2001 and 2008, the national supply of nursing homes declined by 1.6%.

The report, "State Medicaid Reimbursement Policies and Practices in Assisted Living," can be found online at www.ncal.org.