Picture of Housing and Health: Medicare and Medicaid Use Among Older Adults in HUD-Assisted Housing. Picture of Housing and Health: Medicare and Medicaid Use Among Older Adults in HUD-Assisted Housing : Table 2

03/01/2014

: Table 2

ObjectivesResults
Match Rate between HUD and CMS dataAmong HUD-assisted individuals age 65 or older in 2008, 93% matched to Medicare based on Social Security number (SSN) only; 85% matched to Medicare when requiring a match on SSN, gender, and date of birth.
Estimate HUD-assisted Medicare beneficiaries enrollment in Part D subsidy assistance programs or MedicaidHealth insurance assistance programs for Medicare beneficiaries reduce out-of-pocket health care expenses, which result in savings for HUD. Among HUD-assisted Medicare beneficiaries age 65 years or older:Approximately 68% of HUD-assisted Medicare beneficiaries were dually enrolled in Medicare and Medicaid.Approximately 90% of the Medicare beneficiaries had Part D (drug coverage) coverage. Among those with Part D coverage, 80% received premium and out-of-pocket assistance through the Low Income Subsidy Program.While we would not expect the proportion to be 100%, as not all HUD-assisted Medicare beneficiaries meet the eligibility requirements for these programs because the income criteria for HUD-assisted housing can be higher than that for health insurance assistance, there may be room for improvement in the enrollment rates.
Compare Medicare and Medicaid payment and utilization among Medicare and Medicaid enrollees (MMEs)Most of our analyses to compare HUD-assisted individuals to unassisted individuals focused on Medicare beneficiaries dually enrolled in Medicaid (MMEs), age 65+ with fee-for-service (FFS) coverage compared to unassisted MME beneficiaries in the community in order to examine comparable groups in terms of economic status because this factor drives social determinants of health, use of services, and resulting payment.Health conditions:HUD-assisted MMEs had more chronic conditions (55% of HUD-assisted MMEs had 5 or more compared to 43% of unassisted MME), which translated into higher health care utilization and costs than unassisted MMEs in the community.Medicare payments and utilization:HUD-assisted MME beneficiaries' average Medicare FFS per member per month (PMPM) payment was 16% higher than unassisted MMEs in the community ($1,222 compared to $1,054).Higher utilization by HUD-assisted MMEs for home health visits (31% higher), ambulatory surgery center visits (45% higher), physician office visits (26%), and emergency department visits (13%) drove the higher payments.Medicaid payments and utilization:HUD-assisted MMEs Medicaid FFS PMPM payment was 32% higher than unassisted MMEs ($1,180 vs. $895).HUD-assisted MMEs used over 100% more Personal Care services, 80% more "other HCBS", and over 67% more durable medical equipment services covered by Medicaid unassisted MMEs in the community.