Home and community-based services (HCBS) are a range of medical and non-medical services provided in the home and community that support individuals with functional limitations, enabling them to reside in the community rather than in institutional settings. Analyzing use of HCBS at the national level by type of service can be challenging due to variation in Medicaid coverage, codes used on claims, and terminology across states. To support analysis of Medicaid-funded HCBS use, this brief describes a methodology for identifying and classifying HCBS claims reported to the Transformed Medicaid Statistical Information System (T-MSIS) by service category.
This research was conducted under contract between HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Mathematica Policy Research. Additional research in this area is available at the ASPE Aging & Disability page, the ASPE Behavioral Health page, the ASPE Long-Term Services & Supports/Long-Term Care page, and the ASPE COVID-19 page.
Available Reports:
Additional Resources
- Direct Care Worker Wages Landing Page (2023)
- Caregivers and Long-Term Services and Supports Landing Page (2023)
- An Overview of Medicaid Home and Community-Based Services 1915(c) Policy Flexibilities States Adopted During the COVID-19 Public Health Emergency Issue Brief (2023)
- Mitigating Direct Care Workforce Injuries in Homecare: A Summary of the Evidence (2022)
- COVID-19 Intensifies Home Care Workforce Challenges Issue Brief (2021) [HTML version also available]
- How Many Older Adults Can Afford to Purchase Home Care? Research Brief (2019) [HTML version also available]
- An Overview of Long-Term Services and Supports and Medicaid: Final Report (2018) [HTML version also available]
- Older Adults' Living Expenses and the Adequacy of Income Allowances for Medicaid Home and Community-Based Services Research Brief (2016) [HTML version also available]
- Does Home Care Prevent or Defer Nursing Home Use? (2016) [HTML version also available]
- Impacts of Waiting Periods for Home and Community-Based Services on Consumers and Medicaid Long-Term Care Costs in Iowa (2014) [HTML version also available]
- Understanding Medicaid Home and Community Services: A Primer 2010 Edition (2010) [HTML version also available]
- Public Financing of Home and Community Services for Children and Youth with Serious Emotional Disturbances: Selected State Strategies (2006) [HTML version also available]
- Cost-Effectiveness of Home and Community-Based Long-Term Care Services (2000) [HTML version also available]
- Understanding Medicaid Home and Community Services: A Primer (2000) [HTML version also available]
- The Role of Home and Community-Based Services in Meeting the Health Care Needs of People with AIDS: Final Report (1998) [HTML version also available]
- Home and Community-Based Care: The U.S. Example (1996) [HTML version also available]
- An Examination of Issues Related to How Home and Community-Based Services Programs Operate Within Fixed Budgets and to the Administrative Linkages Between Eligibility Determination, Needs Assessment and Care Planning Functions (1994) [HTML version also available]
- Home and Community-Based Care in the USA (1991) [HTML version also available]