Medicaid funds institutional and community based benefits for persons needing long term services and supports. Increasing the proportion of Medicaid expenditures made for community services responds to consumer preferences and in most instances is less expensive.

*Milestone details:

*Full name: Develop a strategy to increase the proportion of total Medicaid long term care services and supports spending devoted to home and community-based care.

*Relevance to the ACA:

Several provisions of the ACA provide policy direction to shift the balance of Medicaid long term services and supports expenditures towards community living.

§ 2402 - Requires the Secretary to issue regulations on home and community services to ensure that states develop systems designed to allocate resources to respond to the needs and preferences of persons receiving long term services and supports financed through Medicaid and other sources.

§ 2403 - Provides states enhanced matching payments for Medicaid home and community based supports provided to persons transitioning from institutional living to the community.

§10202 - Provides states with increased FMAP for Medicaid home and community based supports if they adopt service delivery systems reforms aimed at shifting the balance of Medicaid financing to community supports.