As states continue to implement various aspects of the Affordable Care Act (ACA), developing and expanding home and community-based alternatives to institutional care remains a priority for many state Medicaid programs. 2013 marked the first time that home and community-based services (HCBS) accounted for a majority (51%) of national Medicaid long-term services and supports (LTSS) spending, increasing from 18 percent in 1995. The share of Medicaid LTSS spending devoted to HCBS has continued to rise, reaching 53 percent in 2014.0F At the same time, state Medicaid programs are operating at a time when state revenues are slowing, forcing more moderate spending growth and, as of 2016, continue to face the competing priorities of implementing the ACA’s streamlined eligibility and enrollment processes, determining whether to adopt the ACA’s Medicaid expansion, and pursuing a variety of delivery and payment system reforms.
This report summarizes the key national trends to emerge from the latest (2013) participant and expenditure …
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Medicaid Home and Community-Based Services Programs: 2013 Data Update