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Medicaid home care programs offer various supports to family caregivers such as paid caregiving, self-directed services, respite care, and caregiver training. This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.
Increased payment rates for Medicaid home care workers are states’ key approach to addressing workforce shortages. This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.
Drawing from KFF’s 50-state survey of state Medicaid HCBS officials, conducted between May and August of 2023, this issue brief describes how states used the PHE authorities to strengthen their HCBS programs, changes as the PHE ends, and the role of family caregivers in providing HCBS.
This report illustrates through case examples the experiences and challenges of low- and modest-income people who rely on Medicaid to pay for nursing home expenses. These case examples were developed through in-person interviews with nursing home residents and their families in three states: Georgia, Kansas and Virginia. The first section of the report summarizes the themes and issues shared across the interviews Kaiser conducted, while the second section presents the individual stories of a subset…
Long-Term Care Spending In 1993, Medicaid spent $25.5 billion for long-term care services for elderly beneficiaries (Figure 5). This represents 58 percent of the $44 billion Medicaid spent on long-term care services for all population groups. The majority of spending was for care delivered in nursing facilities (84 percent) and ICFs-MR (2 percent). The remaining 14 percent of Medicaid long-term care spending went towards community-based care, including 3 percent for mental health services and 11…
As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs with different rules and financing incentives is complex for beneficiaries and providers, impedes efforts to improve care coordination and results in cost-shifting between programs that…
People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. This chartpack contains the briefing materials from the event held to release the survey. Chart Pack (.pdf)
This report summarizes the key national trends to emerge from the latest (2013) participant and expenditure data for the three main Medicaid HCBS programs: (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915 (c) HCBS waivers. It also highlights findings on 2015 eligibility, enrollment, and provider reimbursement policies.
Almost every state reported increasing Medicaid payment rates for home- and community-based services to recruit and retain workers as part of their strategy to address long-standing workforce challenges, according to a new report from a survey of state officials administrating those programs. Most states also report developing or expanding worker education and training programs and offering incentive payments to recruit or retain workers. All surveyed states reported shortages of care workers and most (43 states)…
This analysis uses nursing facility-level data reported by the federal government to track the increase in vaccination rates among nursing facility staff nationally and by state between August 2021 (when the vaccine mandate was first announced) and March 27th, 2022 (after the vaccine deadline for health workers had passed in all states). Additionally, this analysis provides state-level information on booster rates among nursing home staff and the prevalence of staffing shortages after all vaccination deadlines…
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