Factors associated with state adoption of the 1915(i) state plan and 1915(k) community first-choice Medicaid home and community-based services programs
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View abstract on PubMed
Summary
This summary is machine-generated.Federal funding expanded home and community-based services (HCBS) for vulnerable populations during COVID-19. State adoption of optional Medicaid HCBS benefits, like 1915(k) Community First Choice, was influenced by political and economic factors.
Area Of Science
- Health Services Research
- Public Health Policy
- Health Economics
Background
- The COVID-19 pandemic disproportionately affected older adults and individuals with chronic conditions requiring long-term services and supports (LTSS).
- Federal investment of nearly $13 billion aimed to expand home and community-based services (HCBS) for older adults and persons with disabilities.
- States can utilize optional Medicaid benefits, such as the 1915(i) HCBS benefit and 1915(k) Community First Choice program, to deliver these services.
Purpose Of The Study
- To model state adoption patterns of two optional Medicaid HCBS benefits: the 1915(i) benefit and the 1915(k) Community First Choice program.
- To identify factors influencing state-level decisions to implement these specific HCBS programs.
Main Methods
- Event history analysis was employed to examine the temporal dynamics of state adoption for the 1915(i) and 1915(k) programs.
- Statistical modeling was used to assess the association between various state characteristics and the adoption of these Medicaid benefits.
Main Results
- State adoption of the 1915(k) Community First Choice program was associated with a Democratic governor and the state's unemployment rate.
- Adoption of the 1915(i) HCBS benefit was linked to the unemployment rate and the existing supply of home health agencies.
- Identified both common and distinct factors influencing the uptake of different Medicaid HCBS programs.
Conclusions
- Political and economic conditions, alongside healthcare infrastructure, play a significant role in state decisions regarding optional Medicaid HCBS benefit adoption.
- Understanding these factors is crucial for policymakers aiming to effectively expand HCBS access for vulnerable populations.
- Program-specific attributes may contribute to differential adoption rates influenced by unique state contexts.
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