National study finds substantial variation in LTSS use among dual-eligibles with ADRD across state Medicaid programs

Many state Medicaid programs have enacted policies to expand home and community-based services as an alternative to nursing facility care. Here’s how they’re doing.

News Story Banner Image

One of the first national studies describing the use of Medicaid long-term services and supports (LTSS) among dual-eligible beneficiaries with Alzheimer's disease and related dementias (ADRD) published in the Journal of the American Geriatrics Society shows state-by-state rates of LTSS use, including sub-types of LTSS (home-based, community-based, and nursing facility services).

We found a sizeable state variation in the percentage of dual-eligible beneficiaries with ADRD who used any form of LTSS (ranging from 61% in Maine to 96% in Montana). The type of LTSS used also varied widely across states. For example, home-based service use ranged from 9% in Maine, Arizona, and South Dakota to 62% in Oregon. Nursing facility services were the most common type of LTSS in most states. However, home-based service use exceeded nursing facility use in Oregon, Alaska and California.

Rates for individual states can be found on our interactive map, and the complete report is also available online.

Button for link to interactive map

About the Center for Health Systems Effectiveness

The Center for Health Systems Effectiveness at Oregon Health and Science University provides the analyses, evidence and economic expertise to improve the value of health care service delivery and build a more sustainable US healthcare system.

To learn more about the CHSE,  visit us on the web or email us at