Effect of PACE on Costs, Nursing Home Admissions, and Mortality: 2006-2011. 3. Results for NH Use with the Matched Comparison Group of NH Entrants and HCBS Waiver Enrollees

03/01/2015

Compared to the matched comparison group comprised of both NH entrants and HCBS waiver enrollees, PACE enrollees were significantly less likely to be in a NH, had significantly lower proportion of days in the NH, and were significantly less likely to experience NH stays of at least 30 or 90 days. These findings are along expected lines, since NH use is expected to be high when a large fraction of the matched comparison sample is made up of NH entrants.

Compared to matched NH entrants and HCBS waiver enrollees, PACE enrollees were significantly less likely to use a NH, with the rate of NH use under PACE (11-17 percent) substantially below that of their matched counterparts (25-59 percent) in all intervals (Table 18). The difference of 15-47 percentage points was significant at the 1 percent level during all seven intervals. Similarly, proportion of days in the NH was significantly lower for PACE enrollees in all intervals by 11-30 percentage points (p < 0.01).

PACE enrollees had a significantly lower likelihood of being in a NH for at least 30 days during the seven intervals (Table 18, Panel 3) by 16-42 percentage points (p < 0.01), and a significantly lower likelihood of being in a NH for at least 90 days during the seven intervals (Table 18, Panel 4) by 13-33 percentage points (p < 0.01).

Excluding New York from the study sample did not change these findings in any meaningful way (Table 19). For instance, with New York excluded, the proportion of days in the NH remained significantly lower for PACE enrollees in all intervals, but the margin was 14-32 percentage points (p < 0.01), instead of the 11-30 percentage points difference observed when New York was included.

Finally, compared to the matched comparison group comprised of both NH entrants and HCBS waiver enrollees, the cumulative risk of being in a NH for at least 90 days over successive six-month intervals was significantly lower for PACE enrollees by 20-32 percentage points (Table 20). These findings were similar with somewhat larger differences (26-35 percentage points), once New York was dropped from the study sample (results not shown).

View full report

Preview
Download

"PACEeffect.pdf" (pdf, 1.12Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®