In these challenging economic times, states are closely scrutinizing their long-term care budgets. This has resulted in many states opting for creative care solutions using their Medicaid funding. SeniorHousingNews.com reports that one choice is shifting the money to community-based and home health care instead of the traditional senior care institutional facilities, like nursing homes. The article explains that while a few states are planning on expanding funding for assisted-living type levels of care, most states are pushing for a more home-based approach.
Adding to hurdles states are facing to provide good care and keep an eye on costs are the shuffle of many state agency organizations and dealing with new budget restrictions. Citing a report by AARP’s Public Policy Institute, according to a survey by AARP and National Association of States United for Aging and Disabilities (NASUAD), and Health Management Associates, of the 49 states and District of Columbia surveyed, 80% reported their community and home services (HCBS) waiver census has been and will continue to increase.
Only 25 percent of the states surveyed reported some increases in Medicaid nursing home census numbers, with Indiana, South Carolina, and Oklahoma adding assisted living care to the HCBS waivers. The report says Medicaid was the largest national expenditure for long-term care with state and federal spending of $131 billion. While Medicaid long-term services are only 7 percent of all Medicaid benefit recipients, it accounts for 30 percent of total Medicaid disbursements.
With change becoming a constant in long term supports and services (LTSS), states will need to adapt to the new climate. The report concluded, “Cost containment and delivery reform strategies for people with LTSS needs are at the forefront of health policy actions. With the increased demand for publicly funded LTSS, state policy makers are transforming the ways in which LTSS are financed, delivered, and administered.”