Beyond Spend-down: The Prevalence and Process of Transitions to Medicaid. Study limitations


  • We cannot observe changes over time in baseline characteristics
    • Functional status
    • Living arrangement, home ownership, informal supports may occur in response to functional changes
  • Financial information is limited to baseline income and home ownership and value at baseline
    • Home ownership, value correlated with other wealth accumulations, and may capture baseline economic status relative to others
    • Cannot capture “spenddown” and other changes in wealth, income
  • We do not account for potential endogeneity of the nursing home entry decision

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