The Gerontologist
 QUICK SEARCH:   [advanced]


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kitchener, M.
Right arrow Articles by Harrington, C.
Right arrow Search for Related Content
Right arrow PubMed Citation
Right arrow Articles by Kitchener, M.
Right arrow Articles by Harrington, C.
The Gerontologist 46:165-172 (2006)
© 2006 The Gerontological Society of America

Residential Care Provision in Medicaid Home- and Community-Based Waivers: A National Study of Program Trends

Martin Kitchener, PhD1, Mauro Hernandez, PhD(c)1, Terence Ng, MA1 and Charlene Harrington, PhD1

Correspondence: Address correspondence to Martin Kitchener, Associate Adjunct Professor, Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California Street, Suite 455, San Francisco, CA 94118. E-mail: Martin.Kitchener{at}

Purpose: While state policy and market factors are known to have contributed to the increased supply of residential care, little is known about efforts to accommodate demand from lower-income consumers. This study describes participation and expenditure trends for residential care services funded by Medicaid waivers and examines variation across programs. Design and Methods: We collected annually reported Center for Medicare and Medicaid Services (CMS) Form 372 data from state officials for each waiver that provides residential care services for the period 1995 to 2002. Descriptive statistics examined waiver program participation and expenditures while adjusting for population changes and inflation. Results: Between 1995 and 2002, national Medicaid waiver-funded residential care participants increased by almost threefold to 120,000 and expenditures more than quadrupled to $2.3 billion. However, Medicaid waiver program participation and spending varied considerably by state, by target population, and by level of care. Implications: This study highlights three important policy concerns: (a) Medicaid-supported residents remain underrepresented in residential care, (b) large interstate variation persists in Medicaid residential care service provision, and (c) state policy choices favor Medicaid spending on residential care for persons with mental retardation or developmental disabilities.

Key Words: Residential care • Medicaid • Home- and community-based services • Waivers • State policy

This article has been cited by other articles:

Home page
Journal of Health Politics, Policy and LawHome page
E. A. Miller and V. Mor
Balancing Regulatory Controls and Incentives: Toward Smarter and More Transparent Oversight in Long-Term Care
Journal of Health Politics Policy and Law, January 1, 2008; 33(2): 249 - 279.
[Abstract] [PDF]

Home page
GerontologistHome page
M. Hernandez
Assisted Living and Residential Care in Oregon: Two Decades of State Policy, Supply, and Medicaid Participation Trends
Gerontologist, December 1, 2007; 47(suppl_1): 118 - 124.
[Abstract] [Full Text] [PDF]

All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.