Articles

Why Is Affordable In-Home Care Becoming Harder for American Families to Find?
Affordable in-home care is becoming increasingly difficult for American families to secure, even as more older adults want to remain in their own homes. This flagship analysis examines rising care costs, Medicaid eligibility, Medicare coverage limits, workforce shortages, state funding, provider sustainability, and the growing burden on family caregivers. It also explores how better payment models, service coordination, workforce investment, and accountability could improve access. Read more...
Can Integrated Behavioral Health and HCBS Prevent People from Falling Between Services Across the United States?
People with behavioral health conditions, disabilities and complex support needs can experience serious gaps when clinical treatment and community-based services operate separately. This flagship article examines how integrated behavioral health and Medicaid-funded HCBS can strengthen transitions, reduce avoidable crises and improve continuity. It explores federal-state funding arrangements, managed care accountability, workforce coordination, closed-loop referrals, operational scenarios and the evidence needed to demonstrate sustainable integration. Read more...
What Will a High-Performing Community-Based Care Organization Look Like in 2035? The Future of US Services
By 2035, high-performing community-based care organizations may be defined less by the volume of services delivered and more by their ability to demonstrate continuity, independence, equitable access and sustainable outcomes. This flagship analysis examines how Medicaid policy, payment models, workforce redesign, digital infrastructure, governance and person-centered practice could reshape US HCBS, LTSS, disability and behavioral health organizations over the coming decade. Read more...
The Future of Home and Community-Based Care: From Scheduled Services to Responsive, Person-Centered Support
Home- and Community-Based Services are often organized around authorized hours, scheduled visits and fixed service plans, even as people's needs change throughout the day. This flagship analysis examines how Medicaid programs, managed care organizations and community providers could develop more responsive support through flexible service design, stronger care coordination, workforce capacity, reliable information and accountable decision-making—without compromising individual rights, funding integrity or service continuity. Read more...
The Future of IDD Services: From Program-Based Support to Personalized Community Infrastructure
The future of intellectual and developmental disability services may depend less on expanding traditional programs and more on building flexible community infrastructure around individual lives. This article examines how Medicaid HCBS, state disability systems, provider networks, workforce models, housing, transportation, technology, and payment reform could support more personalized services while strengthening rights, accountability, quality, and long-term sustainability. Read more...
Cybersecurity as a Quality-of-Care Issue in HCBS and LTSS
Cybersecurity failures in Home- and Community-Based Services and Long-Term Services and Supports can disrupt far more than information systems. They can interrupt essential visits, medication coordination, service authorization, safeguarding and communication with people receiving support. This flagship analysis examines the regulatory, operational, financial and governance responsibilities involved in protecting care continuity, managing cyber incidents and demonstrating that digital resilience supports real-world quality and safety. Read more...
Digital Exclusion and the Future of Technology-Enabled Community Care
As digital systems become central to US community-based care, people without reliable connectivity, accessible devices, digital confidence or appropriate support risk losing access to services and meaningful choice. This flagship analysis examines digital exclusion across Medicaid HCBS, LTSS, disability services, behavioral health and aging, connecting federal and state responsibilities with provider operations, funding, workforce capability, participant rights and evidence-led approaches to inclusive technology adoption. Read more...
The Future of Remote Monitoring in HCBS: Independence, Safety or Surveillance?
Remote monitoring could help people receiving Home- and Community-Based Services remain independent, prevent avoidable emergencies, and strengthen continuity of support. Yet the same technologies can introduce intrusive observation, uncertain consent, inequitable access, and new forms of control. This article examines the federal-state framework, Medicaid funding, provider operations, workforce implications, privacy safeguards, governance, and evidence needed to distinguish genuinely person-centered monitoring from surveillance. Read more...
The Interoperable HCBS System: What Would Seamless Data Exchange Actually Change for Community-Based Care in America?
Seamless data exchange could fundamentally change how Medicaid-funded Home- and Community-Based Services coordinate support, manage transitions, identify unmet needs and demonstrate outcomes. This flagship analysis examines what genuine interoperability would mean for people receiving services, direct support professionals, providers, managed care organizations and state Medicaid agencies—and why better technology alone cannot resolve fragmented accountability, inconsistent authorizations or gaps in community-based care. Read more...
The Interoperable HCBS System: What Would Seamless Data Exchange Actually Change for Community-Based Care in America?
Seamless data exchange could fundamentally change how Medicaid-funded Home- and Community-Based Services coordinate support, manage transitions, identify unmet needs and demonstrate outcomes. This flagship analysis examines what genuine interoperability would mean for people receiving services, direct support professionals, providers, managed care organizations and state Medicaid agencies—and why better technology alone cannot resolve fragmented accountability, inconsistent authorizations or gaps in community-based care. Read more...
Technology-Enabled Care and the Future of Community-Based Service Delivery
Technology-enabled care is reshaping how community-based services can be organized, delivered and evaluated across the United States. This flagship analysis examines the opportunities and limitations of remote support, digital coordination, assistive technology and hybrid service models across Medicaid HCBS, LTSS, disability and behavioral health. It explores the funding, workforce, rights, governance and quality requirements needed to turn technological capability into sustainable improvements in everyday support. Read more...
Ambient Intelligence in Community Care: Could Technology Detect Risk Without Constant Human Monitoring?
Ambient intelligence could help community-based care providers identify changes in movement, routines, environmental conditions and wellbeing without relying on continuous human observation. This USA flagship analysis examines the emerging technology, its limitations, Medicaid funding and state oversight, and the operational safeguards needed to protect autonomy, privacy and safety across HCBS, LTSS, disability services and aging in place. Read more...