Rebalancing: Ensuring Greater Access to Home and Community-Based Services

States vary greatly in the proportion of Medicaid long-term care funds expended on home and community-based services. In 2005, Oregon and New Mexico spent over two-thirds of their Medicaid LTC dollars on HCBS while Washington, D.C. and Mississippi spent less than 20 percent on HCBS. To overcome the “imbalance” states, at varying rates, have been “rebalancing” the way that Medicaid LTC services are delivered and financed to allocate a higher proportion of dollars to HCBS.