NCPA - National Center for Policy Analysis

Affordable Care Act Program Encourages In-Home Care

January 24, 2014

A new program in the Affordable Care Act encourages in-home care rather than nursing home care for the elderly, says Stateline.

The Balancing Incentive Payments Program is intended to keep as many people as possible out of nursing home care. Nursing home care is expensive, and a 2010 AARP survey found that 9 out of 10 older Americans would prefer in-home care to nursing home care.

  • According to the U.S. Department of Health and Human Services, the average cost of nursing home care in 2010 was $6,235 per month.
  • In 2010, almost two-thirds of nursing home residents had their care covered by Medicaid.

The program provides an incentive to states to participate: states will receive a higher federal spending match for all state spending on home and community care through September of 2015.

  • To receive the federal matching, states must reduce red tape and confusion for those who try to find nursing home alternatives.
  • States must provide an independent case manager for every person who needs one (i.e. those who do not have nursing home ties or other health care services).

New Hampshire began participating in the program in 2011 when it spent almost half of its long-term Medicaid dollars on home and community care. Today, spending on community care exceeds 55 percent.

In addition to New Hampshire, Arkansas, Connecticut, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Mississippi, Missouri, New Jersey, New York, Ohio and Texas are participating in the program.

Source: Christine Vestal, "ACA Spurs State Shift in Long-Term Care," Stateline, January 17, 2014.


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