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Evaluating the Affordable Care Act's Long‐Term Services and Supports Rebalancing Programs

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Analysis shows Balancing Incentive Program increased HCBS workforce in states with performance targets, suggesting funding strategies.

BIP increased the HCBS workforce by 13.24%, indicating successful state engagement in community services.
States meeting BIP performance targets saw a higher growth of 16.18% in HCBS workers, suggesting funding effectiveness.
Data from the American Community Survey shows workforce dynamics from 2005 to 2021 across states.
Findings highlight the importance of performance targets for effective federal funding in HCBS expansions.

Ari Ne’eman (2025) studied this question.

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