Articles

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...
Agentic AI in HCBS: Where Could Autonomous Digital Systems Safely Fit?
Agentic AI could move community-based care technology beyond passive alerts and administrative automation toward systems capable of coordinating tasks, responding to changing conditions and initiating defined actions. For Medicaid HCBS providers, health plans and state agencies, the opportunity is significant—but so are the questions of consent, clinical authority, accountability, privacy and safety. This article examines where bounded autonomy may be useful, where human decisions remain essential and how organizations can govern responsible adoption. Read more...
What Happens When AI Becomes Part of Everyday Community-Based Care?
Artificial intelligence is moving beyond administrative experimentation toward everyday decisions in community-based care. This flagship analysis examines how AI could reshape Medicaid-funded HCBS, LTSS, disability and behavioral health services, from workforce scheduling and documentation to risk identification and care coordination. It explores the implications for participant rights, provider governance, privacy, payment, workforce competence and the evidence needed to distinguish useful innovation from unsafe automation. Read more...
Could Technology Create New Professional Roles Across HCBS and LTSS?
Digital technology could reshape the HCBS and LTSS workforce by creating new roles in assistive technology, digital care coordination, remote support, data quality and AI oversight. This flagship analysis examines how emerging professions could complement direct support professionals, home care workers and clinicians, while addressing Medicaid funding, state regulation, competency standards, career progression, provider governance and the rights of people receiving services. Read more...
What Will the Direct Support Workforce of 2035 Look Like? Skills, Technology, Careers and Sustainable Community Care
By 2035, the direct support workforce may be more specialized, digitally enabled and professionally recognized—but those changes will depend on Medicaid funding, state policy, provider investment and the experiences of people receiving support. This article examines future DSP roles, compensation, career pathways, workforce technology, supervision, rights, quality assurance and the operational decisions that could determine whether community-based services become more sustainable. Read more...
The Future of Hospital-to-Home Care: Can Community Providers Prevent the Next Admission?
Preventing avoidable hospital readmissions requires more than a discharge plan. Community providers, hospitals, health plans and state agencies need reliable handovers, timely services, medication support, workforce capacity and shared accountability. This article examines how Medicare, Medicaid HCBS, managed care, home health and community-based organizations can strengthen hospital-to-home transitions while protecting choice, safety and long-term independence. Read more...
Can Community-Based Care Become a Preventive Infrastructure Rather Than a Crisis Response System in the United States?
Community-based care has the potential to become a preventive infrastructure that identifies emerging needs, sustains independence and reduces avoidable crises. This USA flagship analysis examines how Medicaid, HCBS, behavioral health, crisis systems, managed care and community partnerships could support that transition, including the funding, workforce, governance, data and accountability arrangements needed to demonstrate meaningful outcomes for people and families. Read more...
The Future of State Medicaid Oversight in an Increasingly Complex Provider Market
State Medicaid agencies are overseeing increasingly diverse provider markets spanning home- and community-based services, long-term supports, behavioral health, managed care and technology-enabled delivery. This flagship analysis examines how states can strengthen accountability without undermining provider capacity, access or innovation, and what changing oversight expectations mean for contracting, payment, workforce assurance, data quality, participant rights and sustainable community-based care. Read more...
What Could Outcomes-Based Contracting Mean for HCBS Providers?
Outcomes-based contracting could change how Medicaid-funded Home- and Community-Based Services providers are paid, evaluated and held accountable. This flagship analysis examines value-based payment design, state and managed care contracting, financial risk, workforce capacity, participant-defined outcomes and evidence requirements. It explores what providers need to negotiate, implement and govern arrangements that reward meaningful results without compromising access, choice or service sustainability. Read more...
Can Value-Based Payment Work in Community-Based Long-Term Services and Supports? Evidence, Incentives and Provider Sustainability
Value-based payment promises to connect Medicaid HCBS and LTSS funding more closely with quality, independence and outcomes, but community-based services face challenges that traditional healthcare payment models often overlook. This article examines federal and state policy, managed care contracts, outcome measurement, workforce costs, provider risk and practical payment design, showing when value-based arrangements can create genuine value and when they may undermine access and sustainability. Read more...
The Future of Managed Care Accountability in Medicaid HCBS and LTSS: Oversight, Quality, Access and Provider Performance
Managed care accountability in Medicaid HCBS and LTSS is moving beyond contract compliance toward stronger evidence of access, service continuity, participant experience and measurable outcomes. This flagship analysis examines federal and state oversight, managed care organization responsibilities, provider networks, authorization decisions, payment design, workforce sustainability, data integrity and corrective action, identifying what credible accountability should look like across increasingly complex community-based service systems. Read more...