HCBS Taxonomy: A New Language for Classifying Home- and Community-Based Services.

摘要

Medicaid expenditures for long-term care services have gradually shifted from institutional-based care to home- and community-based care. Between 1997 and 2009, the share of Medicaid long-term care spending devoted to HCBS increased from 24 percent to 44 percent. In fiscal year 2009, Medicaid spending on HCBS reached over $55 billion and accounted for 15 percent of all Medicaid expenditures (Eiken et al. 2011). Section 1915(c) waivers (HCBS waivers), authorized in 1981, were among the first efforts by CMS to encourage states to provide optional HCBS (DHHS 2000). By 2010, every state except Arizona and Vermont had implemented at least one Section 1915(c) waiver to provide more options for community-based long-term care services.