title: Medicaid home and community-based services: national program trends.
abstract: Long-term care (LTC) policymakers face mounting pressures to expand Medicaid home and community-based services while the cost of institutional provision continues to rise and consume the bulk of Medicaid LTC spending. This paper presents the latest program trends in the three Medicaid home and community-based services programs (waivers, home health, and state-plan personal care) and reports a national survey of cost control policies used on waiver programs in 2002. The findings show slowing annual rates of participation growth on individual programs, widespread use of cost controls on waivers including waiting lists, and the persistence of large interstate variations in Medicaid's provision of these services.
authors.affiliation: Department of Social and Behavioral Sciences, University of California, San Francisco (UCSF), USA. martink@itsa.ucsf.edu
authors.forename: Martin
authors.initials: M
authors.lastname: Kitchener
authors.forename: Terence
authors.initials: T
authors.lastname: Ng
authors.forename: Nancy
authors.initials: N
authors.lastname: Miller
authors.forename: Charlene
authors.initials: C
authors.lastname: Harrington
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003153:Community Health Services / Q000191:economics / Q000639:trends*; D003363:Cost Control; D004608:Eligibility Determination; D008134:Long-Term Care / Q000191:economics; D008484:Medicaid / Q000191:economics / Q000639:trends*; D011050:Policy Making; D014481:United States