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Strengthening home and community-based care through Medicaid waivers

Miller, Nancy A., Rubin, Andrea, Elder, Keith T., Kitchener, Martin James and Harrington, Charlene 2006. Strengthening home and community-based care through Medicaid waivers. Journal of Aging & Social Policy 18 (1) , pp. 1-16. 10.1300/J031v18n01_01

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Abstract

States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care (LTC). We examined state predictors of waiver utilization and expenditures for waivers serving both older and working-age individuals. State level data for the period 1992 to 2001 were used to estimate random effects panel models. States with increased community-based care (e.g., home health agencies) and decreased nursing home bed capacity were positively associated with state per capita rates of use, expenditures, and the share of Medicaid LTC dollars supporting 1915c waivers. States appeared to substitute Medicare for Medicaid services for individuals eligible for both. State per capita income was positively related to each measure. State policies that facilitate decreased institutional and increased community-based capacity appear essential to state efforts to expand access to community-based services. Federal policies that address state resource issues may also spur growth in community-based LTC, which, in most states, continues to be limited.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Business (Including Economics)
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
H Social Sciences > HJ Public Finance
H Social Sciences > HV Social pathology. Social and public welfare
J Political Science > JK Political institutions (United States)
R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Uncontrolled Keywords: Community-based care; Medicaid; long-term care
Publisher: Taylor & Francis
ISSN: 0895-9420
Last Modified: 04 Jun 2017 04:38
URI: http://orca.cf.ac.uk/id/eprint/41899

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