Home- and Community-Based Services Spending and Living Arrangements Among Older Adults

Is higher state spending on home- and community-based services (HCBS) associated with better aging-in-place outcomes for older adults with functional limitations?In this repeated cross-sectional study of American Community Survey microdata including 7.35 million older adults, older adults with independent living difficulties residing in states that allocated a larger share of long-term services and supports spending to HCBS exhibited a lower likelihood of group quarters residence, residence with adult children, and migration.The study findings suggest that higher shares of HCBS spending allow older adults in the most need of assistance to age in their homes and lessen the need for informal care.

Corresponding Author: Momotazur Rahman, PhD, Department of Health Services, Policy and, Practice, Brown University, 121 S Main St, S-6, Providence, RI 02912 (momotazur_rahman@brown.edu).

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