Understanding costs of home and community based services.

With detailed cost information, home and community-based services (HCBS) providers can make intelligent choices that reduce costs without compromising quality and outcomes. Using cost and utilization data from a large HCBS program, monthly costs are estimated and related to demographic and clinical variables. HCBS costs are positively related to disability and cognitive impairment, but not to available social support. Costs vary significantly across the nursing home-eligible population, indicating that caution is warranted when seeking to capitate HCBS services. Per capita costs are strongly related to program volume and experience, falling from $508 to $423 (16.7 percent) over the course of the program.