KCMU report on Medicaid spending on home- and community-based services: As states implement aspects of the Affordable Care Act (ACA), developing and expanding home and community-based alternatives to institutional care remains a priority for many state Medicaid programs. Most Medicaid spending on long-term services and supports for low-income seniors and people with disabilities is for institutional care; however, the percentage spent on home- and community-based services (HCBS) has more than doubled—from 20% in 1995 to 45% in 2010. A new report from the Kaiser Commission on Medicaid and the Uninsured (KCMU) examines the most current data on efforts by state Medicaid programs to expand HCBS. The 44-page report, Medicaid Home and Community-Based Service Programs: 2009 Data Update, summarizes key trends in expenditures and participation data for the three main Medicaid HCBS programs—the mandatory home health services state plan benefit, the optional personal care services state plan benefit, and optional Section 1915(c) HCBS waivers services—and describes policies shaping the administration of these programs. About 3.25 million people were served by HCBS programs in 2009, at a cost of $50 billion. Per-person spending averaged $15,371, although there was considerable variation among states and programs. The full report is available on the KCMU Web site at www.kff.org/medicaid/7720.cfm.