Medicaid enrollment among elderly medicare beneficiaries: individual determinants, effects of state policy, and impact on service use. Health Serv Res 2002 Aug;37(4):827-47
Date
09/19/2002Pubmed ID
12236387Pubmed Central ID
PMC1464012DOI
10.1034/j.1600-0560.2002.55.xScopus ID
2-s2.0-0036706166 (requires institutional sign-in at Scopus site) 51 CitationsAbstract
OBJECTIVE: To better understand factors associated with Medicaid enrollment among low-income, community-dwelling elderly persons and to examine the effect of Medicaid enrollment on the use of health care services by elderly persons, taking into account selection in program participation.
DATA SOURCES: 1996 Medicare Current Beneficiary Survey (MCBS) Access to Care and Cost and Use files.
METHODS: Individual-level predictions of the probability of dual enrollment are obtained from equations that estimate jointly the residential status of Medicare beneficiaries (community versus institution) and the probability of Medicaid enrollment among community-dwelling eligible beneficiaries. Predicted values are then substituted into the service use equations, which are estimated via two-part models.
PRINCIPAL FINDINGS: Less than half of all community-dwelling elderly persons with incomes at or below 100 percent of the Federal Poverty Level (FPL) were enrolled in Medicaid in 1996. Once selective enrollment was accounted for, there was limited evidence of a dual enrollment effect on service use. Although there were no effects of state Medicaid policy variables on the probability that beneficiaries lived in the community (as opposed to nursing homes), the effects of state's Medicaid generosity in home and community-based services had a sizeable and statistically significant effect on influencing the likelihood that eligible elderly persons enrolled in Medicaid.
CONCLUSIONS: Our results provide compelling evidence that Medicaid participation can be influenced by state policy. The observation that "policy matters" provides new insights into how existing programs might reach a larger proportion of potentially eligible beneficiaries.
Author List
Pezzin LE, Kasper JDAuthor
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
AgedFemale
Health Care Surveys
Health Policy
Health Services Accessibility
Health Services Needs and Demand
Health Services for the Aged
Humans
Male
Medicaid
Medicare
Poverty
Socioeconomic Factors
United States
