A comparative analysis of Medicaid long-term care policies and their effects on elderly dual enrollees. Health Econ 2009 Mar;18(3):275-90
Date
05/09/2008Pubmed ID
18464296DOI
10.1002/hec.1367Scopus ID
2-s2.0-65349134762 (requires institutional sign-in at Scopus site) 14 CitationsAbstract
Individuals with dual enrollment in Medicare and Medicaid have become the focus of heightened US federal and state policy interest in recent years. These beneficiaries are among the most vulnerable and costly persons served by either program. This analysis uses a reduced-form econometric model and a unique survey of community-resident dual enrollees to take a critical step toward understanding the relationships and combinations of state long-term care (LTC) policies and their relative effectiveness in achieving their intended effects: increasing access to care, improving activities of daily living/instrumental activities of daily living (ADL/IADL) assistance, and reducing unmet needs. We then simulate the effects of alternative policies to determine the most effective combination.The combination of policies that was most effective in reducing the percentage of individuals receiving low levels of assistance was high spending in the community relative to nursing home and low community LTC spending per recipient; that is, spending more on community care and spreading it across more people. Overall, this analysis confirms that Medicaid LTC policy decisions by states, and the combinations of policies that are implemented, result in important variations in levels of assistance to elderly persons with disabilities.
Author List
Rice JB, Kasper JD, Pezzin LEAuthor
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Activities of Daily LivingAged
Aged, 80 and over
Disabled Persons
Eligibility Determination
Female
Health Policy
Health Services Accessibility
Health Services for the Aged
Humans
Long-Term Care
Male
Medicaid
Medicare
Models, Economic
Needs Assessment
Program Evaluation
State Health Plans
United States
Vulnerable Populations
