As America ages, states are investing in home-based care for the elderly and disabled in hopes of keeping people out of nursing facilities—and maybe saving money in the bargain. Before going too far, they should study how that approach has—and hasn’t—worked in New York. New York’s Medicaid program spends far more than any other on the nonmedical form of home care known as personal care or personal assistance, which covers services such as bathing, dressing, feeding and housekeeping for people who can’t manage those tasks on their own. According to a federal analysis of 2019 Medicaid spending, the Empire State’s annual personal-care outlays of $12 billion were the largest in the nation, and nearly as much as the other 49 states combined. Its per capita expenditures were eight times the U.S. average.

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