Medicaid home and community based services are vital for adults with intellectual and developmental disabilities: A descriptive study of service use among all adult enrollees, 2022.
Samuel Rosenberg, Josue Antonio Garcia Estrada, Salina Tewolde and 6 others
PMID 41764026WHAT IT FOUND
Most adults with intellectual and developmental disabilities used Medicaid home services, but those with autism alone were 18.3 percentage points less likely to receive any support.
Service availability varied widely by state, with rates ranging from 19.1% to 98.2%.
Key findings
0168.3% of adults with IDD used at least one Medicaid home and community-based service in 2022.
02Adults with autism without intellectual disability were 18.3 percentage points less likely to use any home and community-based services compared to those with intellectual disability alone.
03Rates of service use varied drastically by state, ranging from 19.1% in the US Virgin Islands to 98.2% in New Hampshire.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used claims data, which records service use but not unmet need or access barriers. The definition of intellectual and developmental disabilities was narrow, excluding conditions like cerebral palsy. Race and ethnicity data relied on CMS reporting, which has known quality issues, though missing data was imputed. The study could not distinguish which specific Medicaid waiver programs covered the services due to data limitations.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not interpret lower service use among adults with autism as evidence of lower clinical need. The authors suggest this may be due to eligibility pathways, as people with autism are more likely to qualify for Medicaid via income rather than disability, which can restrict access to these specific home and community-based services.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →