Medicaid Use Shifts More Toward Home Care

Medicaid expenditures are shifting away from nursing homes and toward home and community-based care, according to recent findings by the Centers for Medicare and Medicaid Services (CMS). And that shift is seen as a positive development says AARP in response.  

Residents of nursing homes who rely on Medicaid funding are getting younger by the year, indicating that an aging population does not necessarily mean growth in the number of Medicaid beneficiaries, according to the CMS data. 

“Clearly, older people have not shifted responsibility for their care onto the Medicaid program in significant numbers,” AARP stated in reporting on the findings. 


AARP called the trend “encouraging,” citing an increase in the use of home and community-based services as an alternative to Medicaid-funded nursing home stays. 

“A major factor in these encouraging trends in Medicaid use among aged beneficiaries is the increased use of home and community-based service (HCBS) options, both private pay and Medicaid-funded. A just-released report from the Congressional Budget Office notes that increased HCBS have contributed to the declining use of institutional services and flat spending growth in that sector.”



Shifting resources to HCBS will further help turn reliance away from nursing home services funded by Medicaid, AARP writes in its analysis. 

These data suggest that the most effective way to further limit expenditures among older Medicaid beneficiaries is not by stringent measures to restrict participation, but by implementing more balanced programs that shift resources from institutional services to HCBS. Older people continue to lag far behind their younger counterparts in their access to HCBS that can enhance independence and generally have lower per-person costs.”

Written by Elizabeth Ecker

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