Money Follows the Person: Reducing Nursing Home Facility Utilization and Expenditures to Expand Home- and Community-Based Services


A major challenge to expanding home- and community-based services (HCBS) alternatives to institutional long-term care is finding funding sources to pay for HCBS. Unless states can develop policy interventions that actually reduce expenditures in institutional settings, any expansion in HCBS requires new state funds. This issue brief presents several approaches states can use to reduce nursing facility utilization and expenditures in order to make funds available to expand HCBS.

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