This article presents the findings of a national survey of Medicaid home and community-based care waiver programs established under Section 2176 of the Omnibus Budget Reconciliation Act of 1981. The article documents the ways states have used their waiver authority, the methods states use to target their programs to people who are at risk of institutionalization, the programs' service utilization and expenditure levels, and the quality assurance systems that have been established as of 30 September 1985. Based on these state-reported descriptions of Medicaid home and community-based waiver programs, the article discusses preliminary findings on the cost-effectiveness of the waivers and looks at some potential attributes of a cost-effective program.

You do not currently have access to this content.