In the United States, home and community-based services (HCBS) are the primary approach to delivering long-term services and supports (LTSS). Medicaid is the primary payer for LTSS
and its expansion of HCBS coverage has shifted LTSS out of institutions and into homes.
In a new article published ahead of print today, Amanda Rae Kreider and Rachel Werner examine trends in the supply of home care
workers relative to Medicaid HCBS enrollment from 2008–2020.
Analyzing national data on home care workers and Medicaid HCBS participants in the United States, the authors find that the home care workforce grew by 76,000 workers per year between 2008–2013, but after 2013, growth slowed to 33,000 workers per year.
Conversely, Medicaid HCBS participation grew continuously from 2008–2020 and accelerated between 2013–2020.
The growth in HCBS participation increased overall demand for paid home-based care without an increased workforce capacity, resulting in a 11.6 percent decline in the number of home care workers per 100 HCBS participants between 2013 and 2019.
Today in Forefront, Stephen A. Martin and Arthur Robin Williams challenge the Drug Enforcement Agency's proposal that would require either an in-person visit within thirty days of a telehealth-initiated buprenorphine prescription or a qualified referral.
Charles Curran examines opportunities to streamline public health data usage and infrastructure to better prepare for future public health emergencies.
Health Affairs is the perfect place to advance your career while contributing to the leading research and analysis on improving health policy and health care.
Our team contains a deep bench of experienced professionals in health policy, dedicated to making health care better. Below are the current job openings at Health Affairs:
Health Affairs is the leading peer-reviewedjournalat the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking
content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.
Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.
