In collaboration with the Johns Hopkins Bloomberg School of Public Health and with support from the Commonwealth Fund, Hilltop examined the experience with Maryland’s Community First Choice (CFC) program to highlight lessons for state policymakers, as well as how CFC might inform the development of a new Medicare personal care benefit to help beneficiaries function independently at home. CFC is an optional Medicaid state plan benefit authorized by the Affordable Care Act that enables states to provide personal care services to Medicaid beneficiaries and receive an enhanced federal match of 6 percent for these services.
An issue brief published by the Commonwealth Fund highlights enrollment trends and costs per participant and concludes that a targeted benefit for Medicare beneficiaries could have a stable per-person cost and augment support from family and other unpaid caregivers, although take-up could increase over time to meet unmet need.
An article in the Journal of Applied Gerontology based on extensive interviews with Maryland stakeholders suggests that CFC has been financially feasible, contributed to an expansion in the personal care workforce, and supported a more equitable approach to personal care services.
Finally, a Hilltop data brief examines enrollment, utilization of personal care services, and the effects of CFC on the use of informal supports.