Factors Associated With Initial Type of Long-Term Services and Supports Among Dual-Eligible Beneficiaries.

Medicaid home and community-based service coverage varied within and across states. The sample was too small to examine specific policies, long-term care workforce shortages, or funding variation. The data did not include physical functioning, which may have affected whether people started with home services or nursing home care. The sample was limited to dual-eligible traditional Medicare beneficiaries in southeastern states, so it may not apply to the rest of the United States or to Medicare Advantage enrollees. Household size and other survey characteristics were measured at baseline and may have changed before long-term care use. The sample was too small to examine racial groups other than Black and White participants.

The authors declared no conflicts of interest.

Do not read these patterns as instructions for choosing home services or nursing home placement. The study did not test an intervention, did not measure physical functioning, and could not examine state policies or funding.