Long-Term Services and Supports Technical Assistance Center - Centers for Medicare & Medicaid Services

Long-Term Services and Supports Technical Assistance Center - Centers for Medicare & Medicaid Services

HCBS and the cost of LTSS

A new study from The Commonwealth Fund found that out-of-pocket costs for elders living at home who need long-term services and supports (LTSS) were at least double the costs of living for those who did not need LTSS.

These costs can cause elders to skip meals, miss rent or utility bills, or experience other consequences. These problems can then lead to elders needing assisted living or nursing home care earlier than they would if they were receiving more home- and community-based services (HCBS), which include health and personal care services designed to help people stay in their homes instead of moving to a facility. Cynthia LaCounte, Director of the Administration on Aging's Office for American Indians, Alaska Natives and Native Hawaiians Programs at the Administration for Community Living, says expanding HCBS can be difficult if tribes rely only on Older Americans Act Title VIfunding. LaCounte says some tribes are starting to fill the gap by seeking Medicaid reimbursement for HCBS. This funding helps them provide additional services to their Medicaid-eligible elders, including meals, transportation, and personal care. "That seems to be our solution to building our aging programs and home- and community-based services to make sure our elders are well-cared for," she says. LaCounte adds that her office is currently working on a guide to assist tribes looking to bill Medicaid for qualifying HCBS. We'll follow up with another story when that guide is available.