Government spending on home and community-based services has risen dramatically, with a new report finding that growth doubled year-over-year as funding for institutions declined.

Some $167 billion in federal and state Medicaid funds went toward long-term services and supports across the country during the 2016 fiscal year, up from $159 billion the year prior.

Of that, 57 percent was devoted to community-based services, according to a new report produced for the Centers for Medicare and Medicaid Services.

Significantly, dollars for community-based services rose 10 percent from 2015 to 2016, twice the average rate of growth seen in the program between 2011 and 2015. And, community living accounted for the majority of spending in 29 states and Washington, D.C., up from 28 states the year prior.

Funding for institutions fell 2 percent during the same time period, the report found.

The trend toward community-based services appears to be largely due to shifting expectations for people with developmental disabilities, with 78 percent of spending on this population going to community-based settings.

Meanwhile, most funds for services aimed at people with mental health and substance use disorders as well as older adults and those with physical disabilities went to institutional settings.

However, even among services for people with developmental disabilities, the report found significant variation by state.

Michigan and Oregon allocated all of their money for this population to community-based options. Every other state sent at least half of their funds to the community except for Mississippi where just 23 percent of dollars for those with developmental disabilities went to such programs.

“A majority of Medicaid (home and community-based services) beneficiaries with developmental disabilities receive services in the home of a family member, however, showing the growing importance of informal supports for this population,” the report notes.

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