Medicare Part D Data Shows Shift from Institutional to Home-Based Long-Term Care Pharmacy Services

Analysis of 2018-2022 Medicare Part D claims reveals growing pharmacy spending for beneficiaries in home and community-based settings, while nursing facility spending declined. This trend mirrors the broader shift in long-term services and supports delivery that Medicaid managed care organizations are navigating, particularly as states expand HCBS waivers and MCOs increasingly coordinate pharmacy benefits for dually eligible members receiving LTSS in non-institutional settings.

LTSS · Long-Term Care · Pharmacy · Managed Care

This is outside commentary from Avalere, not part of Medicaid Monitor's independently scored news coverage.

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