What question did this study set out to answer?

This study aims to explore how increased state spending on home- and community-based services affects living arrangements and Medicaid enrollment among older adults.

July 4, 2026JAMA Health ForumOpen Access

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

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Authors

GSGavin J. SchillingCentral Connecticut State University FSFerdous Z. SardarCentral Connecticut State University CKCyrus M. KosarBrown University

Discussion

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Implication

Cross-sectional analysis reveals higher home-based service funding supports aging in place for older adults with care needs, suggesting service expansion benefits.

Key Points

This study aims to explore how increased state spending on home- and community-based services affects living arrangements and Medicaid enrollment among older adults.
Repeated cross-sectional study using state-year fixed-effect models.
Analysis of American Community Survey microdata from 2008 to 2020.
Focus on association between HCBS spending and living arrangements for older adults with and without independent living difficulties.
A 20–percentage point increase in HCBS share was linked to a 2.6–percentage point lower likelihood of group quarters residence (95% CI, −3.23 to −1.87).
It was associated with a 0.8–percentage point lower likelihood of coresidence with an adult child (95% CI, −1.11 to −0.49).
Among those with independent living difficulties, there was a 1.0–percentage point higher likelihood of residential continuity (95% CI, 0.64 to 1.29).

Cite This Study

Schilling et al. (2026) studied this question.

synapsesocial.com/papers/6a48a78b89561a0c2d78ee12 https://doi.org/10.1001/jamahealthforum.2026.2064

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July 4, 2026JAMA Health ForumOpen Access

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

View Full Paper

Ask AI

Bookmark

Authors

GSGavin J. SchillingCentral Connecticut State University FSFerdous Z. SardarCentral Connecticut State University CKCyrus M. KosarBrown University

Discussion

Member takes

Implication

Cross-sectional analysis reveals higher home-based service funding supports aging in place for older adults with care needs, suggesting service expansion benefits.

Key Points

This study aims to explore how increased state spending on home- and community-based services affects living arrangements and Medicaid enrollment among older adults.
Repeated cross-sectional study using state-year fixed-effect models.
Analysis of American Community Survey microdata from 2008 to 2020.
Focus on association between HCBS spending and living arrangements for older adults with and without independent living difficulties.
A 20–percentage point increase in HCBS share was linked to a 2.6–percentage point lower likelihood of group quarters residence (95% CI, −3.23 to −1.87).
It was associated with a 0.8–percentage point lower likelihood of coresidence with an adult child (95% CI, −1.11 to −0.49).
Among those with independent living difficulties, there was a 1.0–percentage point higher likelihood of residential continuity (95% CI, 0.64 to 1.29).

Cite This Study

Schilling et al. (2026) studied this question.

synapsesocial.com/papers/6a48a78b89561a0c2d78ee12 https://doi.org/10.1001/jamahealthforum.2026.2064

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