An Analysis of the Impact of Spend-down on Medicaid Expenditures

This study analyzes Connecticut nursing home data on a current resident cohort, with particular attention to how many residents began their stays as private pay, but eventually spent down to Medicaid eligibility. It also estimates how many residents were Medicaid eligible prior to admission or became eligible at admission. Using data on the amount of income that nursing home residents on Medicaid applied to their bills, the authors were able estimate the amounts of Medicaid funds provided for the care of various types of nursing residents. Those who spenddown received nearly 38% of Medicaid expenditures. [36 PDF pages]