This study will use data from the 2010 Medicaid Analytic eXtract (MAX) file and in-depth policy reviews and interviews in four states to examine differences in the use of institutional and home and community-based service (HCBS) use by older adults across urban and rural areas, and the policy and community factors that contribute to differences or comparability in use. The study is designed to inform federal and state policy goals of expanding use of HCBS alternatives to nursing home care.

Publications

• Are Rural Older Adults Benefiting From Increased State Spending on Medicaid Home and Community-Based Services?
  Policy Brief
  Maine Rural Health Research Center
  Date: 06/2016
  Little is known about variations in the availability or use of Medicaid Home and Community-Based Services (HCBS) within states, across rural and urban areas. This study used national claims data to examine differences in HCBS use and expenditures among rural and urban older adult Medicaid beneficiaries receiving LTSS.