Consumer-Directed Personal Care in the New York Metropolitan Area: Trends in Use From 2017 to 2022.
Jennifer M Reckrey, David Russell, Julia G Burgdorf and 1 others
PMID 40037553WHAT IT FOUND
In one New York Medicaid plan, personal care increasingly was arranged by care recipients or their representatives rather than agencies.
The shift grew before 2020 and rose further after pandemic onset, especially among new enrollees.
Key findings
01The share of enrollees receiving only consumer-directed care rose from 10.3% in 2017 to 47.9% in 2022, while the share receiving only agency-based care fell from 86.8% to 47.0%.
02Overall consumer-directed care use rose 6.2% per year before the pandemic, increased 4% in the first pandemic month, and rose 7.9% per year afterward.
03New enrollees used consumer-directed care more than existing enrollees; among them, use rose 14.9% per year before the pandemic, increased 12.6% at pandemic onset, then the trend decreased 0.5% per year afterward.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only one New York Medicaid plan was studied, and most members lived in New York City, so the trends may not apply to other states or plans. The plan had more conservative growth in consumer-directed care hours than other regional plans, so its pattern may understate statewide growth. Claims data show which care model was used but not the individual reasons behind that choice. The article reports only personal care model use, average weekly hours, and enrollee characteristics; it does not report patient function, safety, satisfaction, or clinical outcomes. The analysis could not separate pandemic effects from pre-existing growth.
Declared interests
The article text does not provide a conflict-of-interest or funding statement; the supplied publication types list non-U.S. government and NIH extramural research support.
The easy way to misread this
Do not read the increase as proof that consumer-directed care is better, safer, or caused by the pandemic. The study used plan-level claims, did not measure patient outcomes, and only one New York plan was examined.