The Columbus Dispatch had a great article on the success of Ohio’s program to keep elderly citizens in their homes instead of being institutionalized in long term care facilities.  The strategy: care for more Medicaid beneficiaries at home at a lower cost and serve fewer in nursing homes and other institutions at a higher price.  Nursing-home care on average costs about $64,000 in Ohio, while home-based services are half that or even less.

With Ohio’s aging population increasing demand for long-term care, state officials have stretched Medicaid dollars by boosting the number of elderly, disabled and mentally ill cared for at home.  The shift has been dramatic.

Ohio now serves 60 percent of those receiving long-term-care services through home and community care and 40 percent in institutional care. Less than a decade ago, the opposite was true. About 58 percent were in nursing homes and similar facilities and 42 percent at home. State officials project nearly two-thirds of Medicaid beneficiaries will be cared for at home by 2017.

Ohio Medicaid Director John McCarthy said most people prefer to live in their own homes. To help them do that, the state eliminated wait lists for the popular PASSPORT home-care program and has invested in other home and community-based services.  A shortage of available housing and lack of awareness about the alternatives seem to be the biggest hurdles to moving people out of institutional settings.

The Home Choice Program has been one of Ohio’s most successful efforts, moving more than 7,000 people from institutions and back into the community since 2008. About 1,400 more are working with caseworkers to locate housing and set up needed services.

“It’s helped Ohio re-balance its long-term-care budget,” McCarthy said.

According to the most recent statistics available, Ohio now devotes 62 percent of its long-term-care spending to home care, up from 50 percent a year ago.

A recent report by the Kaiser Family Foundation found Ohio was leading the nation in transitioning individuals with mental illness, helping more than 1,900 return to the community. Overall, Ohio moved more people out of institutional care than any of the 43 participating states but Texas.

Through the Home Choice Program, citizens can get help finding an apartment, home services including regular visits from an aide, physical therapist and nurse, and transportation to doctor appointments and the grocery.



With more than 2 million people 60 or older, Ohio ranks sixth in the nation for the size of its aged population. By 2050, university researchers project, those 60 or older will make up 30 percent of the state’s population.


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