Is Your State Next? 5 Signals from Colorado’s Medicaid Shift

Medicaid is the sole largest payer of long-term home care in the U.S., funding fully 61% of all Long-Term Services and Supports (LTSS) – roughly $415 billion in 2022. LTSS recipients are a tiny fraction of enrollees (just ~4–5%) yet consume about 42% of total Medicaid costs.

Home care and Medicaid HCBS agencies are on the front lines of this spending. For example, the Colorado home care Medicaid system alone serves about 80,800 distinct individuals through Medicaid LTSS programs, including over 50,000 on HCBS waivers.

In the face of soaring demand (an aging population, more chronic illness) and rising costs, many states are now rethinking how they fund Medicaid home care. Colorado’s recent policy shifts offer five important signals of what may lie ahead in other states – and how agency owners can gear up to respond.

In this guide, you will learn:

• Budgetary pressures and cost-containment measures
• Workforce and wage pressures
• Pandemic-era funding and the “Cliff” Effect
• New service limits and program redesigns
• Heightened oversight and coordination tools
• How to thrive at the Medicaid crossroads?

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