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States that boost home-care spending help older adults age in place
A JAMA Health Forum study found that among seniors with independent living difficulties, a 20-percentage-point higher HCBS spending share was linked to fewer moves into group quarters and less living with adult children.
HousingWire highlights findings from a JAMA Health Forum study examining how state spending on home- and community-based services, known as HCBS, relates to where older adults live as they age.
Using data covering 7.35 million older adults from 2009 through 2021, researchers analyzed U.S. Census Bureau American Community Survey records to see whether greater HCBS investment corresponded with fewer institutional placements, fewer moves in with adult children, and higher rates of staying in the same home.
The study found that among older adults with independent living difficulties, a 20-percentage-point increase in the state share of long-term services and support spending directed to HCBS was associated with a 2.6-percentage-point lower likelihood of living in group quarters such as institutional or other congregate settings.
The same spending increase correlated with an 0.8-percentage-point decrease in living with adult children and a 1-percentage-point increase in remaining in the same residence, alongside lower rates of both in-state and out-of-state moves, with the researchers noting evidence that expanded HCBS availability may increase Medicaid enrollment.