Does paying a family caregiver instead of an aide help people with disabilities stay at home and save public money?
Official title: Does switching to paid family care (versus paid aides) increase time at home or reduce publicly funded healthcare costs for Medicaid waiver beneficiaries with disability?
Funded at Duke University · NIH-11444909 · Data updated 2026-11-12
This project asks whether letting Medicaid beneficiaries with intensive home care needs pay a family member as their caregiver changes how long they can stay at home and how much public healthcare costs rise or fall.
Quick facts
| Grant type | NIH-funded research |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Duke University NIH-funded |
| Lab location | 1 site (Durham, United States) |
| Project start | August 5, 2026 |
| Project end | July 31, 2030 |
| Funding year | 2026 |
| Award (this year) | $3,272,015 |
| NIH project number | 1RF1AG094518-01A1 |
| Project ID | NIH-11444909 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with disabilities enrolled in Medicaid waiver programs who have intensive home care needs in North Carolina.
✕Less likely to help
Beneficiaries whose needs are not primarily met by home caregiving arrangements or whose conditions make home care unsafe may not benefit.
What this research studies
If funded, researchers will study adults with disabilities in North Carolina to see how switching to paid family care affects staying at home and overall healthcare spending in real-world Medicaid programs. The study builds on past findings that paying family members can reduce hospital use in some demonstrations, but it’s unclear how it impacts day-to-day safety and home life across a broader population. Using administrative data and real-world program information, the team will compare outcomes where family care is used to outcomes with traditional aides, while accounting for differences in health status and preferences. The goal is to provide evidence that could inform policy decisions about waiver design and caregiver payment decisions.
Why it matters
Potential benefit: If successful, the findings could help shape policies to support safer home care and potentially reduce expensive hospital care for people with disabilities.
How similar studies have gone: Previous demonstrations suggested paid family care can reduce acute care use, but real-world effects on staying at home and costs are not well established.
Where this research is happening
-
Duke University
Durham, United States Active
Researchers
- Principal investigator: Van Houtven, Courtney Harold — Duke University
- Study coordinator: Van Houtven, Courtney Harold
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About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.