Community support systems are proving effective in addressing unmet needs among older adults with dementia, according to recent research. The study highlights the critical role of home- and community-based services (HCBS) within Medicaid’s long-term services and supports (LTSS) framework.
Impact of HCBS Allocation on Unmet Needs
Analyzing data from the Health and Retirement Study spanning 2008 to 2020, the research examined 2,722 respondent-waves of older adults diagnosed with dementia. The focus was on assessing whether a higher proportion of Medicaid LTSS funding directed towards HCBS could reduce instances where individuals struggled with daily living activities without adequate assistance.
Methodology and Key Findings
Employing generalized linear models and instrumental variable analysis, the study found that increasing the share of HCBS in Medicaid expenditures significantly decreased unmet needs for activities of daily living (ADL). Specifically, the odds ratios indicated a substantial reduction in unmet ADL needs with greater HCBS allocation. Conversely, the total amount of Medicaid LTSS spending did not show a significant correlation with unmet needs, underscoring the importance of how funds are allocated rather than the total expenditure.
• Shifting resources to HCBS can effectively bridge care gaps for dementia patients
• The total Medicaid LTSS budget alone does not address unmet daily living needs
• Policy adjustments towards HCBS may enhance support for community-dwelling older adults
The findings advocate for a strategic realignment of Medicaid funding towards home and community services. By prioritizing HCBS, the study suggests that states can better meet the unique needs of older adults with dementia, ensuring they receive essential support in their living environments.
Effective allocation of resources is pivotal in long-term care strategies. Policymakers and stakeholders should consider the tangible benefits of HCBS in reducing unmet care needs, which not only improves quality of life for individuals with dementia but also alleviates potential strain on institutional care facilities. Implementing these insights can lead to more sustainable and person-centered care models within the community setting.
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