From the summary:
Expansion of home and community-based long term care services (HCBS) can significantly help address the health care needs of many older adults.
Medicaid–which pays for half of all long term care services and supports–has a strong institutional bias. Changing Medicaid priorities can be cost effective.
Only a handful of states–New Mexico, Oregon, Washington, Alaska, and California –now spend more Medicaid dollars on HCBS than nursing homes.
As part of comprehensive health reform, we can improve support for Medicaid HCBS and for family caregivers.