There’s been a long-time struggle on the part of states to effectively shift the way Medicaid provides long term services “away from services provided in institutional settings and toward home and community-based services,” Mathematica reported in late August.

Citing three new reports from the Center for Medicare and Medicaid Services, the research and data analytics consultancy’s news summary noted that “a total of 1.5 million institutional service users accounted for $67.0 billion in institutional spending in 2021. Institutional users and expenditures fell by 18.0 percent and 7.2 percent, respectively, from 2019 to 2021.”

Naturally, progress hasn’t been made to the same degree from state to state, and Mathematica has analyzed the changes and found that the following states have been most successful at making the shift, in alphabetical order: Colorado, Georgia, Michigan, Minnesota, Nevada, New Mexico, Oregon, Ohio, Pennsylvania, West Virginia and Wisconsin.

The states that are lagging include Arkansas, California, Florida, Indiana, Kentucky, Louisiana, Maine, Mississippi, Missouri, Nebraska, Oklahoma, South Dakota and Utah. 

“As demand for [long-term services] continues to rise, giving states a better view of their expenditures and users is vital to ensuring all beneficiaries who use Medicaid LTSS receive the best care possible,” said Andrea Wysocki, senior researcher with Mathematica.

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