“States are making tepid progress helping millions of elderly and disabled people on Medicaid avoid costly nursing home care by arranging home or community services for them instead, according to an AARP report released Wednesday.”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
If HCBS really were cheaper than institutional care, it wouldn’t take federal incentives and regulatory harassment to get states to make the change. Medicaid programs are learning the lesson LTCI carriers confronted and solved two decades ago: when you offer something people want (HCBS) instead something they’ll do anything to avoid (nursing homes), your beneficiaries are much more likely to avail themselves of anything and everything for which they’re eligible. So you have to underwrite well and enforce policy provisions or you’ll end up in receivership. Loose financial eligibility rules seriously exacerbate all these problems for Medicaid.