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The purpose of this paper was to provide a synthesis and critique of current research on Medicaid spenddown. The primary goal was to ask what these studies could tell us about the extent to which persons incurred catastrophic expenses in nursing homes. A corollary goal was to examine how the data and research methods used in the various studies af
The Effect of Cash and Counseling on Medicaid and Medicare Costs: Findings for Adults in Three States
Recent research suggests that Florida's Cash and Counseling model-Consumer Directed Care (CDC)-increased the well-being of children with disabilities and their parents in Florida and that the Cash and Counseling programs in Arkansas, Florida, and New Jersey similarly increased the well-being of adults. The program also increased the likelihood th
The Outcome-Based Quality Improvement (OBQI) program provides reports to all Medicare-certified home health agencies so that they can identify potential quality problems and devise appropriate strategies to address them. There are 41 OBQI quality measures. A data-driven "stepwise" approach currently is used to risk adjust the OBQI indicators wit
Effect of Consumer Direction on Adults' Personal Care and Well-Being in Arkansas, New Jersey, and Florida
This report examines the effects of the Cash and Counseling program in three states Arkansas, Florida, and New Jersey regarding how consumer direction affects the use and quality of both paid and unpaid personal care assistance received by consumers, as measured by consumers' satisfaction with care, the frequency of unmet needs, and the in
This project examines the Medicare Advantage (MA) products available in 2006, how they compare to past offerings when only local MA options were authorized, initial plan decisions and experiences under the new competitive bidding process, and how well available offers and enrollment meet Congress's overall objectives in enacting the Medicare Presc
This study uses the 1985 National Nursing Home Survey to examine the use and cost of nursing home care among the elderly population of the United States. The following questions are addressed: How many persons aged 65+ use nursing homes in a given year? How do they stay and what are their annual charges? How often, and to what extent, do residents
This report describes the implementation of consumer directed care by synthesizing information from in-person discussions with program staff, a mail survey of program consultants, telephone interviews with consumers in the treatment group, and program records. It discusses the program's goals and features, the ways beneficiaries managed their pro
U.S. Department of Health and Human Services Federal Programs for Persons with Disabilities Brian O. Burwell, Bonnie Preston, and Sarah Bailey Mathematica Policy Research, Inc. January 1990 PDF Version: http://aspe.hhs.gov/daltcp/reports/task2es.pdf (143 PDF pages)
This study describes community and institutional service use patterns over a five year period (1982-1987), based on secondary analyses of longitudinal data for over 4,000 Massachusetts elderly. Emphasis was placed on community service use of persons judged to be at high risk of institutional placement. For nursing home users, the elderly were dist
Many children with special health care needs depend on the health and supportive services provided by Medicaid. It is important that policymakers have a sound understanding of these children's patterns of health care use, especially given the shift to managed care. Previous studies of children on Medicaid with severe disability and/or chronic illn
Report from the Working Group on Improving Public Policies and Programs Affecting Persons with Mental Retardation and Other Developmental Disabilities
This report analyzes the impact of current federal policies and programs on the growth of community living arrangements and supportive services for people with mental retardation and other developmental disabilities (MR/DD).