Patterns of Home and Community Based Service Use by Beneficiaries Enrolled in the Pennsylvania Medicaid Aging Waiver

Abstract

Background: This study examines multiple services are used across a population and the association between type and amount of services use with level of disability and living arrangement. Methods: This is a descriptive cross-sectional analysis examining HCBS use among older Pennsylvanians from 2014 to 2016 enrolled in Pennsylvania’s 1915(c) waiver program. Data were derived from Medicaid claims. Logistic regression and OLS regression were used to examine the association between service use and level of disability, controlling for age, gender, race, and other covariates. Results: People with Alzheimer’s or a related dementia were more likely to use adult day care. People with higher ADL and IADL limitations were more likely to use higher amounts of PAS and less likely to have delivered meals. Conclusions: These findings demonstrate HCBS is a complex package of services that are allocated regarding the level of need and resources available to individual program participants.