Graphic of the week: Home care costs Ohio Medicaid 22% less per person than institutional care

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Ohio Medicaid spends $12,000 less per enrollee for in-home care compared to institutional care, as illustrated above. Beyond cost savings, studies have found that accessing services and support at home is associated with positive outcomes like improved health and life satisfaction.
 
Thousands of Ohioans require long-term care to meet medical needs and get assistance with daily activities. These services were historically provided in institutions like nursing facilities.
 
Toward the end of the 20th century, the federal government began allowing state Medicaid programs to provide home- and community-based services (HCBS) through waivers, with the requirement that states demonstrate that the cost of home-care services does not exceed that of institutional care. All states cover HCBS through waivers granted by the federal government. Ohio ranks 31 on Medicaid spending per enrollee with long-term care needs and 27 for the percent of long-term care expenditures that go to HCBS (see HPIO’s May 22 data graphic). By comparison, Wisconsin spends the least of any state per enrollee for long-term care and also has the highest percentage of its spending going to HCBS.
 
To be eligible for home-based or institutional care in Ohio, individuals must meet strict eligibility criteria, which include financial requirements and a specific level of care. In 2023, approximately 132,000 Ohioans received home care services, mostly through Ohio's HCBS waiver programs, a number that has remained essentially unchanged since 2019.
 
For an overview of the Ohio Medicaid program, including eligibility, covered services, spending and recent policy changes, see HPIO’s Ohio Medicaid Basics.