title: An examination of the woodwork effect using national medicaid long-term services and supports data.
abstract: A common concern in long-term services and supports (LTSS) policy is the "woodwork effect," which has two components: (1) more people will use publicly funded services if access to home- and community-based services (HCBS) is expanded; and (2) the additional beneficiaries will increase the growth rate of LTSS expenditures. Medicaid LTSS beneficiary and utilization data starting in 1999 indicate modest growth in beneficiaries and expenditures, after adjusting for inflation and the number of people with functional impairments. The data do not provide strong evidence that the shift in Medicaid funding toward HCBS significantly increased or decreased overall Medicaid LTSS spending.
authors.affiliation: Truven Health Analytics, Cambridge, Massachusetts 02140, USA. steve.eiken@truvenhealth.com
authors.forename: Steve
authors.initials: S
authors.lastname: Eiken
authors.forename: Brian
authors.initials: B
authors.lastname: Burwell
authors.forename: Kate
authors.initials: K
authors.lastname: Sredl
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000191:economics*; D003365:Costs and Cost Analysis; D004467:Economics; D004608:Eligibility Determination / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D005102:Health Expenditures / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D008134:Long-Term Care / Q000191:economics*; D008484:Medicaid; D011050:Policy Making; D012946:Social Welfare; D014481:United States