HCBS-A Cost-effective method of providing care

Last month, Governing ran a column by Dr. Christopher M. Kelly, U. Nebraska (Omaha) Gerontology Department and Jerome Deichert, Director of Center for Public Affairs Research at the U. Nebraska (Omaha). A Cost-Effective Way to Care for an Aging Population discusses the costs of nursing home care on the state's Medicaid budgets, using Nebraska as an illustration: "[i]n a state like Nebraska with an already large older population, the specter of future Medicaid long-term care costs looms quite large. These expenses totaled $742.5 million in fiscal year 2013 -- nearly 40 percent of the state's total Medicaid spending."  The article discusses the cost of skilled nursing care, reviews the limitations of ALFs as a solution, and takes the position that the answer to "lower long-term care costs, and to delay or prevent nursing-home placement, is through home and community based services (HCBS)."  The key, according to the authors, is

in the ability of state policy-makers, working with providers in both the public and private sectors, to delay or prevent unnecessary nursing-home placement through the expansion of more affordable alternatives, specifically HCBS. The greater availability of these options will enable states to meet their long-term care challenges in a way that provides more choices for our seniors and is economically sustainable.