The Medicaid program spent almost $776 million on 1915(c) waivers to cover home- and community-based services for older adults in fiscal year 2014, according to a new report from the Centers for Medicare & Medicaid Services. That’s almost 21% less than what was spent in the previous fiscal year, the agency said.
Minnesota was the state with the highest such waiver-related funding, at almost $266 million, according to the report, dated Sept. 9 and publicly released Nov. 2. The amount represented an increase of more than 11% over the previous year.
States use the waivers for HCBS-related expenses including case management, residential and day habilitation, supported employment, personal care, homemaker services, personal emergency response systems, assistive technology, home delivered meals, non-medical transportation and respite.
For waivers targeting older adults and/or people with physical disabilities, Medicaid spent more than $7.3 billion on HCBS in 2014, according to the report. The amount was 2% less than in 2013. Washington had five waivers totaling more than $678 million in such expenses, the highest amount of any state.
Programs targeting older adults and people with physical disabilities accounted for 25.1% of 1915(c) spending in 2014, a decrease from 26% in 2013.
Overall, according to the report, total state and federal expenditures for Section 1915(c) waivers totaled $41.5 billion in 2014, a 1.8% increase from 2013.
People with developmental disabilities are the largest population served via the waivers, accounting for 72.2% of 1915(c) programs, according to CMS. In addition to older adults and people with physical disabilities, other populations served include people with brain injuries, medically fragile children, people with HIV/AIDS, and people with serious mental illness or serious emotional disturbance.
The report based its finding on the quarterly reports that states submit on the CMS-64 form to claim federal financial participation for the Medicaid program, supplemented by data reported by states that have managed care programs with expenditures that are not completely described on the CMS-64.