The federal government is upping its efforts to keep more seniors out of nursing homes, and in home and community-based long-term care programs, according to a report published on Monday.

Data published by the Associated Press shows that in 2013, 51% of the $146 billion spent on long-term care benefits for seniors and those with disabilities was spent on home and community-based services, compared to 49% on institutional LTC services. That year marked the first time where more federal money was spent on home and community-based LTC services than institutional care.

That spending includes money put toward initiatives to keep seniors living in their homes, like home care aides and coverage for seniors to take Ubers to doctors’ appointments, the AP reported.

Legislators have also focused on improving the quality of care for home and community-based programs, implementing regulations where federal LTC funding for states hinges on seniors being able to choose where they live and be treated with dignity.

The push for home and community-based care has some senior advocates worried, as demand for LTC services increases along with the government’s need to control Medicaid costs. Programs for keeping seniors in their homes often “wind up on the chopping block,” according to the AP.

Blogger comment:

Unfortunately CMS is not going to respond to input from the providers … in these flawed theories there is a distinct avoidance of reality by the academic solutions offered by CMS … the boomers are not healthy and reimbursement forces the use of skilled nursing for bundled payment … how are we the implementers going to balance this bi polar governance. At the same time the providers are quietly hoping they will get more money for less quality due to the oxymoron definitions by our over regulating payer of last resort. Such as lower re-hospitalizations, less use of ER and more very expensive home care without any justification other than the Medicare budget … while we still have no definitions of quality outcomes just threats on incomes.