Does Consumer Direction Affect the Quality of Medicaid Personal Assistance in Arkansas

This report presents the first impact analysis results from a three-state demonstration in which disabled Medicaid enrollees eligible for personal assistance services get a cash allowance so they can hire whom they please or use the money to buy equipment or supplies, instead of obtaining services through a home health agency. The results show that the Arkansas program greatly increases consumers' satisfaction with the quality and reliability of care. The program also reduces unmet needs for assistance, preserves health and safety, and improves outlook on life. The findings from this random assignment design provide strong support for the many states considering Medicaid program modifications that promote increased consumer direction.