Medicaid spending on home-and-community based services out-gained spending on institutional care, like nursing homes, for a seventh year in a row, according to a new analysis from the Kaiser Family Foundation.
The report found that Medicaid spending for HCBS accounted for 59% of all long-term services spending, while 41% went toward institutional care settings during 2019 — which is its highest share to data. For 2018, HCBS spending accounted for 56% for all LTSS and 44% went toward institutional care.
“State Medicaid programs must cover LTSS in nursing homes, while nearly all HCBS are optional,” KFF report authors Molly O’Malley Watts, MaryBeth Musumeci and Meghana Ammula wrote. “States have made significant shifts in addressing this historical bias toward institutional LTSS, with spending on HCBS surpassing spending on institutional care for the first time in FY 2013.”
The authors also suggested that more support for HCBS could be coming from states due to the COVID-19 pandemic and its impact on the long-term care industry.
“Permanent enhanced funding for Medicaid HCBS, if authorized by Congress, could support state efforts to not only recover from the pandemic but also improve the HCBS delivery infrastructure and expand services to fill existing unmet needs and prepare to serve the growing aging population,” they concluded.
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