Medicaid home- and community-based services (HCBS) are designed to allow people with long-term services and supports (LTSS) needs to live in their homes or a home-like setting in the community. While all states operate HCBS programs under various optional flexibilities in the Medicaid statute and provide services to a diverse population, there is limited research and data on how spending and utilization, a measure of access to HCBS, may vary across subpopulations of LTSS users.
We partnered with Mathematica to analyze Transformed Medicaid Statistical Information System (T-MSIS) data for calendar years 2019 through 2021 to understand differences in HCBS spending and utilization. In this session, we presented on the key findings from this analysis, including a brief background on HCBS, limitations of previous analyses, a comparison of beneficiary characteristics, and an overview of HCBS spending and utilization by taxonomy and by subpopulation.