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ATI Advisory Releases Policy Blueprint for Creating Better Caregiving Jobs

WASHINGTON, Feb. 24, 2021 -- ATI Advisory (ATI) released its blueprint for reforming Medicaid long-term services and supports and developing a stronger caregiving workforce. With support from the Robert Wood Johnson Foundation, ATI developed a package of key policy proposals to increase access to home and community-based services, reduce biases toward institutional care in Medicaid, and create better caregiving jobs.

The release of this blueprint comes at a time when Congress is considering, as part of the rescue package, a one-year increase in the federal contribution to Medicaid-funded home and community-based services. ATI's recommendations build on this policy to provide states with improved financial support and predictability. The recommendations also tackle long-standing Medicaid eligibility policies that limit access to home- and community-based services aligning with the President's priorities around job creation and valuing the direct care workforce.1

"An increase in federal funding is an important first step on a longer-term path to a more equitable and balanced system," said Allison Rizer, Principal at ATI Advisory and co-lead researcher. But, she cautions, "More federal dollars will not make a big difference if they aren't combined with modernization of home and community-based eligibility criteria."   

"Workforce is the third leg of this stool," said Tyler Cromer, Principal at ATI Advisory, and co-lead researcher. "Home care workers make up the fastest growing job category in our country, but the average worker is paid $12.71 an hour and turnover is staggeringly high. We cannot sustain and support individuals in the community without a strong and supported workforce."

ATI Advisory's blueprint recognizes that for many Americans, everyday activities like bathing and cooking are incredibly difficult due to medical and functional needs. Home and community-based services can be a lifeline for these individuals – to help them live safely at home and age with dignity. But decades of policymaking have favored facility-based care, and too many of these individuals either go without formal supports or are limited to institutional care. This work underscores the aging demographics of our country and the impact of unmet need on individuals, their caregivers, and the broader healthcare system. Policymakers can immediately help by passing legislation that modernizes Medicaid eligibility policy, incentivizes states to cover these important services for those in need, and supports the caregiving workforce.

1The Biden Plan for Mobilizing American Talent and Heart to Create a 21st Century Caregiving and Education Workforce:

See Blueprint and Policy Briefs:

About ATI Advisory
ATI Advisory is a research and advisory services firm working to transform the delivery of healthcare and aging services for older adults. By providing insight and strategy backed by original research, ATI helps organizations lead and deliver change in senior healthcare and long-term services and supports systems. For more information, visit


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