Home- and community-based services (HCBS) workforce shortages reduce Medicaid’s ability to serve people with long-term care needs in the home or community. Although some factors that affect the HCBS workforce are outside of Medicaid’s purview, many states are exploring ways to use Medicaid rate setting to expand the HCBS workforce and reduce worker turnover. In previous MACPAC public meetings (November 2023, March 2024, and December 2024), we discussed findings from a compendium of HCBS authorities, federal and state interviews, and a technical expert panel that explored strategies to ensure that HCBS payment rates are adequate to attract and retain a sufficient workforce. During this session, staff summarized the findings across all of our work and presented payment principles and a policy option to support the HCBS workforce.
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Medicaid and CHIP Payment and Access Commission
