The HCBS Taxonomy: A New Language for Classifying Home- and Community-Based Services
- For calendar year 2010, 28 states spent almost $23.6 billion on HCBS, with 80 percent of expenditures categorized as round-the-clock, home-based, and day services.
- Other services, such as case management or equipment, modifications, and technology were widely used but are not particularly costly and do not account for a large proportion of expenditures in every state.
As states have sought to make home- and community-based services (HCBS) more accessible, researchers have become more interested in understanding service use by, and spending for, those Medicaid beneficiaries who need long-term services and supports. Because state Medicaid programs differ in the types of services they offer and in how they report these services in their data, analyzing HCBS at the national level is challenging. With the development of the HCBS taxonomy—a uniform classification system composed of 18 categories and more than 60 services—states and the Centers for Medicare & Medicaid Services now have a common language for describing and categorizing community-based long-term care services. Implementing the HCBS taxonomy in Medicaid Analytic eXtract (MAX) data for 2010 provides the first opportunity for a more detailed analysis of HCBS spending and service use based on claims data. This brief describes the HCBS taxonomy and presents findings on HCBS expenditures and users by type of service for the 28 states whose MAX data files were approved by June 1, 2013.