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Study: NH among the worst for at-home care services to aging

New Hampshire Union Leader

June 15. 2017 12:47AM

About the series
Silver Linings is a continuing Union Leader/Sunday news report focusing on the issues of New Hampshire's aging population and seeking out solutions.

Union Leader Staff Writer Gretchen Grosky would like to hear from readers about issues related to aging.

She can be reached at or (603) 206-7739. See more at

New Hampshire is among the worst in the nation for spending on health care programs to keep people at home as they age, a study released today shows.

New Hampshire ranked 47th of all states in Medicaid spending on home- and community-based care services, according to the 2017 Long-term Services and Supports Scorecard compiled by The Commonwealth Fund, AARP, and The SCAN Foundation. It also ranked 46th in access to these programs for new Medicaid users.

These rankings point to a crisis in care spending that’s coming, said Doug McNutt, AARP New Hampshire associate state director of advocacy. He said it’s far cheaper to care for people at home — and 95 percent of Granite Staters told AARP that’s where they want to receive their care as they age.

“Nursing home care is about three times more expensive than home care, but we still spend eight out of 10 taxpayer dollars on this type of care,” McNutt said. “This fact, along with the desire of people to age in place, points to needed change and highlights the need to allocate resources differently as New Hampshire ages.”

New Hampshire has the third oldest population in the country. The New Hampshire Center for Public Policies predicts one-third of the Granite State’s population will be over the age of 65 by the year 2030.

McNutt said the state cannot sustain spending 80 percent of its Medicaid dollars on nursing homes and only 20 percent on less expensive home- and community-based care. He said the cost of home and community care in New Hampshire averages under $20,000 per patient per year, while nursing home care averages over $60,000 a year.

“We have to have a better system in place or we’re not going to be able to care for everybody,” McNutt said. “We haven’t made any significant progress and if we don’t make more changes, we won’t be able to keep up.”

This study is done every three years and looks at the affordability and access of long-term care, choices of setting and provider, quality of life and care, support for family caregivers, and the transitioning of patients to and from nursing homes, hospitals and the communities where they live.

According to the report, Washington state is the best for long-term care services for aging.

New Hampshire did see its overall rank rise from 32nd in 2014 to 16th in 2017, but McNutt said much of the improvements were made in policies, not performance.

“You can’t eat policy,” McNutt said. “Services are either there or they’re not.”

He did point to some bright spots, including New Hampshire being ranked second in its aging and disability resource centers, more commonly known throughout the state as ServiceLink. These centers provide support to Granite Staters, their caregivers and their families.

“This shows that New Hampshire can be a leader,” McNutt said. “But we need to do more and we need to do it soon.”

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