Brief Describes Medicaid Rate-Setting Strategies to Promote HCBSImage Banner

Brief Describes Medicaid Rate-Setting Strategies to Promote HCBS

You are here

Brief Describes Medicaid Rate-Setting Strategies to Promote HCBS

May 14, 2012

The Center for Health Care Strategies, Inc. (CHCS) has released a policy brief outlining strategies that states can use to promote home and community-based services in managed long-term services and supports for Medicaid beneficiaries.

The brief notes that while long-term services and supports in HCBS settings have an average cost significantly lower than those provided in nursing facilities, less than half of Medicaid LTSS dollars nationally are spent on HCBS, due to nursing facility care being an entitlement whereas HCBS is usually offered only through waiver programs.

Strategies described in the brief include paying the same reimbursement rate regardless of the setting, using partial capitation (paying a set fee) for nursing facility care, financially rewarding transitions to HCBS and providing incentives for HCBS even when services are carved out of the program.