Local Medicaid Home- and Community-Based Services Spending and Nursing Home Admissions of Younger Adults

Kali S. Thomas PhD, Laura Keohane MS, and Vincent Mor PhD

Abstract
We used fixed-effect models to examine the relationship between local spending on home- and community based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states’ efforts to expand HCBS for this population should continue.