Payment Rates for Medicaid Home- and Community-Based Services: States’ Responses to Workforce Challenges

The payment rates for Medicaid Home- and Community-Based Services (HCBS) have been a longstanding concern, further exacerbated by the COVID-19 pandemic. State HCBS programs prioritize addressing the associated workforce challenges. While the American Rescue Plan Act provided some flexibility and funding, many of these policies are ending, raising concerns about accessibility for the 4 million Medicaid beneficiaries who rely on HCBS. The Kaiser Family Foundation conducted a survey, capturing insights from state officials responsible for HCBS administration. Key findings reveal that all responding states have taken steps to combat workforce shortages, including raising payment rates. Additionally, most states reported shortages in HCBS workers, with many facing permanent provider closures, reflecting the critical need for sustained efforts to support this essential healthcare sector.