Assessing Disparities in Medicaid Home- and Community-Based Services: A Systematic Review.

Area of Science:

• Health Services Research
• Health Equity
• Public Policy

Background:

• Expansion of home and community-based services (HCBS) is a U.S. national priority for older adults and persons with disabilities.
• Minimizing healthcare disparities is a key objective for lawmakers and providers.
• Addressing disparities in Medicaid HCBS is crucial for developing equitable policies.

Approach:

• Systematic literature review utilizing an adapted theoretical framework.
• Analysis of existing research on Medicaid HCBS disparities.
• Categorization of findings into four domains: availability, accessibility, accommodation, and acceptability.

Key Points:

• A significant lack of research exists concerning Medicaid HCBS disparities across all four domains.
• The domain of acceptability shows a particularly notable deficit in research.
• Few studies focus on specific marginalized groups, indicating a need for targeted research.

Conclusions:

• Current research inadequately addresses Medicaid HCBS disparities for diverse populations.
• There is a critical need for researchers and policymakers to evaluate existing policies.
• Future efforts should focus on conceptualizing and designing more equitable Medicaid HCBS programs.