An Investigation of Interstate Variation in Medicaid Long-Term Care Use and Expenditures Across 40 States in 2006. Appendix D. Supplementary Data Tables

07/01/2013

TABLE D.1. Number of Enrollees Who Were Aged or Had Disabilities and Used Medicaid FFS LTC Services Compared with the Total Number of Full-Benefit Enrollees in 2006
State All Full-Benefit
  Medicaid Enrollees  
Non-LTC
  Enrolleesa  
Total LTC
  Enrolleesb  
Total HCBS
  Enrolleesb  
Aged or Disabled
Enrollees Using LTC Services
Any
  FFS LTC  
  HCBS     ILTC  
All 40 states 40,394,079 37,435,165 2,958,914 1,927,667 2,904,883 1,852,525 1,231,914
Alabama 689,473 629,693 59,780 36,962 59,526 36,684 25,556
Alaska 130,355 122,690 7,665 6,692 7,591 6,604 1,390
Arkansas 638,964 596,067 42,897 23,182 40,947 21,059 21,719
California 7,068,123 6,486,076 582,047 480,990 578,611 477,381 123,151
Colorado 541,752 498,348 43,404 30,745 42,632 29,777 14,857
Connecticut 513,481 456,396 57,085 30,695 56,805 30,178 31,561
Delaware 162,643 155,891 6,752 3,291 6,662 3,188 3,758
District of Columbia 163,015 155,031 7,984 3,707 7,841 3,550 4,676
Florida 2,724,350 2,561,456 162,894 88,817 153,416 78,044 79,921
Georgia 1,632,879 1,565,354 67,525 30,142 66,667 28,945 39,258
Hawaii 229,335 219,277 10,058 5,852 9,711 5,467 4,638
Idaho 206,105 188,561 17,544 13,059 17,227 12,554 5,874
Illinois 2,287,016 2,115,107 171,909 106,463 153,120 79,894 84,694
Indiana 962,569 903,159 59,410 19,472 59,185 19,215 41,684
Iowa 433,477 381,850 51,627 35,546 51,128 34,839 21,379
Kansas 343,606 302,038 41,568 27,711 40,507 26,508 15,464
Kentucky 806,882 755,944 50,938 39,692 50,373 39,046 28,422
Louisiana 1,091,896 1,029,936 61,960 24,711 60,275 22,982 39,062
Maryland 756,640 704,002 52,638 30,162 52,081 29,509 23,766
Mississippi 629,430 589,898 39,532 16,377 39,336 16,147 24,701
Missouri 1,083,126 990,564 92,562 62,587 90,743 60,263 38,822
Nebraska 257,558 236,216 21,342 11,162 21,186 10,836 11,769
Nevada 230,084 217,836 12,248 7,919 12,164 7,811 4,836
New Jersey 1,029,982 930,092 99,890 57,910 99,441 57,366 45,339
New Mexico 455,289 430,562 24,727 18,953 24,595 18,782 6,561
New York 4,921,559 4,531,537 390,022 267,714 385,991 263,323 158,227
North Carolina 1,529,497 1,383,698 145,799 105,398 145,432 104,945 46,332
North Dakota 71,001 61,594 9,407 4,186 9,380 4,156 5,723
Ohio 2,081,906 1,915,229 166,677 101,594 163,699 90,590 89,608
Oklahoma 711,203 659,625 51,578 30,435 50,793 29,450 23,878
South Carolina 839,652 796,237 43,415 26,351 43,085 25,946 18,386
South Dakota 119,472 109,090 10,382 4,845 10,327 4,767 6,019
Tennessee 1,419,091 1,366,613 52,478 19,023 51,989 18,314 34,610
Utah 292,771 281,421 11,350 5,709 11,264 5,612 6,058
Vermont 147,968 138,471 9,497 6,485 9,493 6,478 3,619
Virginia 843,228 790,354 52,874 34,915 52,361 34,360 27,275
Washington 1,046,139 970,445 75,694 59,455 75,694 59,455 20,425
West Virginia 366,042 340,145 25,897 14,899 25,825 14,741 11,901
Wisconsin 863,939 802,218 61,721 29,903 61,721 29,903 34,557
Wyoming 72,581 66,444 6,137 3,956 6,059 3,856 2,438
SOURCE: Mathematica analysis of 2006 MAX data for 39 states and the District of Columbia with representative FFS LTC data (excludes data from Arizona, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, and Texas).
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Non-LTC Enrollees include all full-benefit enrollees eligible as children and non-disabled adults. Only aged and disabled enrollees are included in counts of LTC enrollees and users.
  2. Individuals who are enrolled in 1915(c) waivers but do not receive HCBS are included in counts of LTC and HCBS enrollees but excluded from counts of LTC and HCBS users.

TABLE D.2. Medicaid LTC System Performance Indicators for Enrollees Who Were Aged or Had Disabilities and Were Eligible for Full Medicaid Benefits in 2006
State Total
LTC $
Total
  LTC Users  
  Percentage of Medicaid  
LTC $ Allocated
to HCBS
Percentage of Total
Medicaid $ for
  LTC Users Allocated  
to HCBS
  Percentage of LTC  
Users Receiving HCBS
  Percentage of Potential  
LTC Users
Receiving HCBSa
  Per-User Spending  
on HCBS
  Per-User Spending  
on ILTC
  Ratio of Per-User  
$ on HCBS
Relative to ILTC
All 40 states   76,879,134,892   2,904,883 40.8 52.9 63.8 17.8 16,914 36,971 0.458
Alabama 1,130,404,702 59,526 27.2 39.9 61.6 11.9 8,385 32,196 0.260
Alaska 284,916,040 7,591 72.7 79.3 87.0 24.5 31,371 55,930 0.561
Arkansas 858,715,978 40,947 24.9 39.6 51.4 11.0 10,165 29,682 0.342
California 9,878,514,101 578,611 54.7 65.9 82.5 32.9 11,325 36,316 0.312
Colorado 1,019,876,958 42,632 50.7 58.7 69.8 18.9 17,375 33,822 0.514
Connecticut 2,238,931,231 56,805 31.6 41.3 53.1 22.8 23,454 48,513 0.483
Delaware 301,695,573 6,662 34.0 40.3 47.9 9.2 32,215 52,952 0.608
District of Columbia 315,228,327 7,841 23.2 34.8 45.3 11.8 20,620 51,760 0.398
Florida 3,747,337,138 153,416 31.1 38.7 50.9 9.8 14,924 32,314 0.462
Georgia 1,493,201,190 66,667 28.4 40.2 43.4 6.9 14,636 27,245 0.537
Hawaii 329,343,209 9,711 38.5 45.3 56.3 13.4 23,187 43,678 0.531
Idaho 371,132,820 17,227 42.6 60.4 72.9 21.2 12,601 36,252 0.348
Illinois 3,176,627,446 153,120 30.8 45.3 52.2 16.4 12,256 25,946 0.472
Indiana 1,828,498,633 59,185 27.3 34.4 32.5 6.3 25,979 31,890 0.815
Iowa 1,157,728,242 51,128 37.2 53.6 68.1 25.9 12,375 33,987 0.364
Kansas 840,599,103 40,507 52.5 61.9 65.4 22.7 16,645 25,826 0.644
Kentucky 1,209,161,974 50,373 25.8 81.8 77.5 13.3 7,991 31,565 0.253
Louisiana 1,525,871,254 60,275 27.5 36.2 38.1 9.0 18,253 28,324 0.644
Maryland 1,768,700,598 52,081 42.8 49.7 56.7 14.8 25,675 42,542 0.604
Mississippi 1,037,298,529 39,336 11.1 21.5 41.0 7.5 7,115 37,343 0.191
Missouri 1,466,773,653 90,743 40.7 57.6 66.4 18.7 9,908 22,403 0.442
Nebraska 562,110,501 21,186 37.4 45.9 51.1 16.4 19,410 29,890 0.649
Nevada 306,338,277 12,164 43.3 52.0 64.2 10.5 16,978 35,923 0.473
New Jersey 3,447,275,904 99,441 31.2 38.9 57.7 19.4 18,755 52,304 0.359
New Mexico 687,375,842 24,595 70.3 74.1 76.4 18.5 25,725 31,124 0.827
New York 17,776,758,555 385,991 45.3 58.6 68.2 29.2 30,580 61,458 0.498
North Carolina 2,701,905,573 145,432 43.3 57.6 72.2 23.0 11,151 33,058 0.337
North Dakota 305,327,011 9,380 25.8 32.0 44.3 14.8 18,943 39,595 0.478
Ohio 4,884,852,294 163,699 33.5 45.8 55.3 15.3 18,044 36,271 0.497
Oklahoma 1,012,058,004 50,793 40.5 51.2 58.0 14.8 13,902 25,239 0.551
South Carolina 909,136,545 43,085 34.6 45.8 60.2 11.2 12,107 32,363 0.374
South Dakota 251,692,447 10,327 35.9 41.9 46.2 12.6 18,956 26,803 0.707
Tennessee 1,854,934,959 51,989 37.0 44.4 35.2 4.9 37,521 33,741 1.112
Utah 334,796,035 11,264 38.9 45.4 49.8 7.1 23,234 33,742 0.689
Vermont 257,050,002 9,493 57.8 70.2 68.2 23.4 22,928 29,987 0.765
Virginia 1,421,468,659 52,361 42.6 66.6 65.6 11.8 17,618 29,922 0.589
Washington 1,510,683,980 75,694 65.2 70.1 78.5 20.9 16,570 25,730 0.644
West Virginia 734,425,562 25,825 38.0 47.2 57.1 10.4 18,914 38,284 0.494
Wisconsin 1,764,144,875 61,721 44.5 50.2 48.4 13.2 26,260 28,326 0.927
Wyoming 176,243,168 6,059 57.0 63.1 63.6 16.8 26,045 31,097 0.838
SOURCE: Mathematica analysis of 2006 MAX data for 39 states and the District of Columbia with representative FFS LTC data (excludes data from Arizona, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, and Texas). Potential LTC Users are based on data from the ACS 2007 Public Use Microdata Sample.
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Potential LTC users include SSI recipients and individuals with income up to 300% of the SSI limit who have a physical, mental, or emotional condition lasting 6 months or more resulting either in difficulties conducting ADLs (dressing, bathing, or getting around inside the home) or difficulties in learning, remembering or concentrating.

TABLE D.3. Medicaid LTC System Performance Indicators for Aged Enrollees Eligible for Full Medicaid Benefits in 2006
State Total
LTC $
Total
LTC Users
  Percentage of Medicaid  
LTC $ Allocated
to HCBS
  Percentage of Total  
Medicaid $ for
LTC Users Allocated
to HCBS Users
Percentage of LTC
  Users Receiving HCBS  
  Percentage of Potential  
LTC Users
Receiving HCBSa
Percentage of New
  Nursing Home Spells  
in 2007 Preceded
by HCBS
Use in 2006
Per-User
  Spending on HCBS  
Per-User
  Spending on ILTC  
  Ratio of Per-User  
$ on HCBS
Relative to ILTC
All 40 states   38,970,178,862     1,648,932   25.8 34.7 51.4 21.7 22.6b 11,875 31,422 0.378
Alabama 727,083,255 32,141 8.9 16.7 40.1 11.6 20.8 5,003 31,302 0.160
Alaska 128,395,747 3,507 59.0 65.9 82.2 43.0 33.3 26,260 60,771 0.432
Arkansas 487,483,212 26,288 17.1 27.5 45.7 16.8 24.9 6,937 25,706 0.270
California 5,037,150,509 332,832 46.7 54.1 77.5 47.1 33.6 9,123 29,849 0.306
Colorado 504,301,801 22,023 22.3 28.9 51.6 22.6 29.0 9,914 32,464 0.305
Connecticut 1,297,631,176 35,589 15.6 21.8 39.9 26.2 29.4 14,255 44,657 0.319
Delaware 155,128,400 3,837 10.2 13.0 26.3 7.7 16.7 15,734 46,304 0.340
District of Columbia 180,684,788 4,650 25.9 30.7 42.5 17.2 16.9 23,720 46,167 0.514
Florida 2,109,846,021 91,269 9.7 13.1 33.6 8.8 10.8 6,688 29,628 0.226
Georgia 893,273,614 41,087 10.0 13.2 24.9 6.6 10.8 8,744 25,232 0.347
Hawaii 194,837,917 5,758 14.1 18.7 38.2 11.9 13.2 12,525 44,431 0.282
Idaho 170,029,106 8,017 27.1 38.4 61.4 24.1 35.8 9,375 33,104 0.283
Illinois 1,301,097,539 80,876 18.9 26.4 40.8 16.8 14.8 7,454 20,469 0.364
Indiana 886,974,760 34,198 5.9 7.6 10.9 3.3 N/A 14,215 26,796 0.530
Iowa 502,596,147 27,483 21.0 37.7 54.7 29.7 30.2 7,021 23,870 0.294
Kansas 381,859,547 20,601 22.7 28.6 42.4 20.1 22.0 9,931 22,897 0.434
Kentucky 662,878,165 27,858 8.0 76.9 73.5 21.0 24.6 2,599 29,838 0.087
Louisiana 627,400,315 29,365 15.6 16.6 20.2 6.4 5.2 16,431 22,283 0.737
Maryland 876,247,758 24,857 16.0 19.7 29.7 10.5 9.1 18,972 40,716 0.466
Mississippi 616,636,525 24,700 7.1 12.1 33.3 10.2 15.7 5,329 32,674 0.163
Missouri 763,286,271 52,382 19.3 38.4 55.3 24.8 30.5 5,097 20,559 0.248
Nebraska 275,941,618 12,463 16.6 23.0 35.6 15.7 24.4 10,346 25,533 0.405
Nevada 153,086,456 6,952 27.0 32.0 55.3 14.5 16.9 10,745 32,695 0.329
New Jersey 1,883,875,180 64,057 21.4 26.8 48.1 23.9 19.6 13,072 41,737 0.313
New Mexico 289,303,163 13,160 48.0 52.5 63.5 22.5 25.0 16,609 28,018 0.593
New York 8,670,454,546 215,851 36.3 46.4 55.5 32.1 31.0 26,246 46,502 0.564
North Carolina 1,409,902,537 80,627 32.0 38.4 61.1 28.8 30.1 9,170 26,996 0.340
North Dakota 166,576,261 5,751 7.6 12.0 26.0 11.1 19.2 8,461 33,452 0.253
Ohio 2,571,660,709 94,670 19.0 29.4 45.4 21.0 21.1 11,370 32,798 0.347
Oklahoma 480,456,706 30,023 20.9 28.4 47.6 21.9 27.5 7,039 21,694 0.324
South Carolina 462,115,519 23,702 14.9 19.2 42.1 11.7 17.3 6,912 26,918 0.257
South Dakota 127,027,358 6,175 8.7 12.8 24.9 11.4 15.7 7,145 23,414 0.305
Tennessee 890,405,688 30,416 12.5 13.5 10.7 2.5 3.8 34,375 28,169 1.220
Utah 106,803,128 4,558 8.6 11.5 22.2 4.7 N/A 9,076 26,134 0.347
Vermont 121,855,143 4,889 20.3 36.8 46.3 24.4 30.6 10,942 31,360 0.349
Virginia 734,087,006 31,989 19.4 42.2 50.6 14.4 20.3 8,824 26,999 0.327
Washington 779,745,608 41,395 46.4 53.4 69.9 35.1 33.0 12,512 27,264 0.459
West Virginia 391,330,106 13,616 13.6 16.6 36.4 10.5 16.2 10,718 37,167 0.288
Wisconsin 882,718,934 36,521 17.0 19.9 26.5 11.8 14.4 15,512 25,775 0.602
Wyoming 68,010,623 2,799 14.8 22.4 33.5 10.5 23.9 10,719 28,725 0.373
SOURCE: Mathematica analysis of 2006 MAX data for 39 states and the District of Columbia with representative FFS LTC data (excludes data from Arizona, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, and Texas). Potential LTC Users are based on data from the ACS 2007 Public Use Microdata Sample. Percentage of new nursing home spells preceded by HCBS are from Ballou et al. (2011).
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Potential LTC users include SSI recipients and individuals with income up to 300% of the SSI limit who are 65 or older and have a physical, mental, or emotional condition lasting 6 months or more resulting either in difficulties conducting ADLs (dressing, bathing, or getting around inside the home) or difficulties in learning, remembering or concentrating.
  2. National figure includes 38 states (excludes data for Indiana and Utah).

N/A = not available (first new spells data were unavailable or unreliable for Indiana and Utah).

TABLE D.4. Medicaid LTC System Performance Indicators for Enrollees Under 65 with Disabilities Eligible for Full Medicaid Benefits in 2006
State Total
LTC $
Total
LTC Users
  Percentage of Medicaid  
LTC $ Allocated
to HCBS
  Percentage of Total  
Medicaid $ for
LTC Users Allocated
to HCBS
  Percentage of LTC  
Users Receiving HCBS
  Percentage of Potential  
LTC Users
Receiving HCBSa
  Per-User Spending  
on HCBS
  Per-User Spending  
on ILTC
  Ratio of Per-User  
$ on HCBS
Relative to ILTC
All 40 states   37,908,956,030     1,255,951   56.1 67.3 80.0 15.4 21,167 53,321 0.397
Alabama 403,321,447 27,385 60.3 71.2 86.9 12.1 10,218 36,506 0.280
Alaska 156,520,293 4,084 84.0 87.7 91.1 18.4 35,331 47,906 0.737
Arkansas 371,232,766 14,659 35.2 51.9 61.8 7.6 14,440 40,112 0.360
California 4,841,363,592 245,779 63.0 75.1 89.2 24.3 13,915 53,784 0.259
Colorado 515,575,157 20,609 78.5 82.2 89.4 17.2 21,977 39,693 0.554
Connecticut 941,300,055 21,216 53.7 62.8 75.2 20.4 31,646 61,942 0.511
Delaware 146,567,173 2,825 59.2 65.0 77.1 10.1 39,858 79,569 0.501
District of Columbia 134,543,539 3,191 19.6 38.2 49.4 8.4 16,731 60,885 0.275
Florida 1,637,491,117 62,147 58.6 63.9 76.3 10.6 20,250 43,369 0.467
Georgia 599,927,576 25,580 55.7 66.7 73.2 7.1 17,855 35,910 0.497
Hawaii 134,505,292 3,953 73.8 74.8 82.6 14.7 30,367 40,433 0.751
Idaho 201,103,714 9,210 55.7 72.1 82.9 19.7 14,681 41,778 0.351
Illinois 1,875,529,907 72,244 39.1 55.2 64.9 16.1 15,633 34,465 0.454
Indiana 941,523,873 24,987 47.4 55.0 62.0 8.0 28,794 46,919 0.614
Iowa 655,132,095 23,645 49.7 63.2 83.8 23.5 16,432 69,493 0.236
Kansas 458,739,556 19,906 77.3 82.4 89.3 24.2 19,945 40,490 0.493
Kentucky 546,283,809 22,515 47.4 85.8 82.5 9.5 13,940 35,980 0.387
Louisiana 898,470,939 30,910 35.8 46.7 55.1 10.6 18,889 37,717 0.501
Maryland 892,452,840 27,224 69.2 71.6 81.3 17.1 27,912 48,351 0.577
Mississippi 420,662,004 14,636 16.9 32.4 54.2 5.9 8,967 48,763 0.184
Missouri 703,487,382 38,361 63.9 73.2 81.6 15.3 14,355 28,625 0.501
Nebraska 286,168,883 8,723 57.5 63.6 73.3 16.9 25,697 44,115 0.583
Nevada 153,251,821 5,212 59.6 65.1 76.1 8.4 23,028 43,703 0.527
New Jersey 1,563,400,724 35,384 43.1 51.2 75.0 15.9 25,349 90,366 0.281
New Mexico 398,072,679 11,435 86.5 88.0 91.1 16.2 33,038 45,129 0.732
New York 9,106,304,009 170,140 53.9 68.1 84.3 27.1 34,200 106,538 0.321
North Carolina 1,292,003,036 64,805 55.6 71.0 86.0 19.5 12,901 52,941 0.244
North Dakota 138,750,750 3,629 47.6 53.1 73.4 18.2 24,820 64,814 0.383
Ohio 2,313,191,585 69,029 49.5 59.0 68.9 12.3 24,075 44,722 0.538
Oklahoma 531,601,298 20,770 58.1 66.6 73.0 11.3 20,374 34,984 0.582
South Carolina 447,021,026 19,383 54.8 66.4 82.4 10.9 15,352 53,402 0.287
South Dakota 124,665,089 4,152 63.7 66.3 77.8 13.2 24,581 42,607 0.577
Tennessee 964,529,271 21,573 59.7 66.7 69.9 6.1 38,198 55,881 0.684
Utah 227,992,907 6,706 53.2 58.3 68.6 8.0 26,341 45,982 0.573
Vermont 135,194,859 4,604 91.5 94.0 91.5 22.9 29,376 21,875 1.343
Virginia 687,381,653 20,372 67.3 88.1 89.3 10.1 25,440 41,837 0.608
Washington 730,938,372 34,299 85.2 83.7 89.0 15.1 20,418 21,125 0.967
West Virginia 343,095,456 12,209 65.8 72.4 80.1 10.3 23,073 41,908 0.551
Wisconsin 881,425,941 25,200 72.0 75.4 80.2 14.0 31,413 40,135 0.783
Wyoming 108,232,545 3,260 83.5 85.7 89.5 20.8 30,965 42,493 0.729
SOURCE: Mathematica analysis of 2006 MAX data for 39 states and the District of Columbia with representative FFS LTC data (excludes data from Arizona, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, and Texas). Potential LTC Users are based on data from the ACS 2007 Public Use Microdata Sample.
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Potential LTC users include SSI recipients and individuals with income up to 300% of the SSI limit who are under 65 and have a physical, mental, or emotional condition lasting 6 months or more resulting either in difficulties conducting ADLs (dressing, bathing, or getting around inside the home) or difficulties in learning, remembering or concentrating.

TABLE D.5. Medicaid LTC System Performance Indicators for Enrollees Under 65 with Physical Disabilities Eligible for Full Medicaid Benefits in 2006 (excludes enrollees with ID/DD)a
State Total
LTC $
Total
LTC Users
  Percentage of Medicaid  
LTC $ Allocated
to HCBS
  Percentage of Total  
Medicaid $ for
LTC Users Allocated
to HCBS
  Percentage of LTC  
Users Receiving HCBS
  Percentage of Potential  
LTC Users
Receiving HCBSb
  Per-User Spending  
on HCBS
  Per-User Spending  
on ILTC
  Ratio of Per-User  
$ on HCBS
Relative to ILTC
All 40 states   13,754,095,189     802,200   46.2 65.7 77.2 27.1 10,262 32,933 0.312
Alabama 181,990,489 22,444 25.8 57.2 84.9 25.7 2,461 32,829 0.075
Alaska 86,936,952 3,109 71.8 81.3 88.4 47.0 22,704 48,320 0.470
Arkansas 142,401,849 9,748 19.9 51.9 59.0 11.7 4,923 26,682 0.185
California 2,358,684,297 172,874 56.3 75.6 89.0 44.5 8,628 41,965 0.206
Colorado 228,371,585 13,314 60.4 71.9 84.3 29.2 12,293 34,563 0.356
Connecticut 311,098,146 13,669 26.5 55.0 69.0 37.6 8,757 39,482 0.222
Delaware 59,857,799 1,965 35.5 52.3 73.4 19.6 14,724 62,987 0.234
District of Columbia N/A N/A N/A N/A N/A N/A N/A N/A N/A
Florida 537,910,311 30,356 28.8 49.9 60.7 10.9 8,397 30,640 0.274
Georgia 274,753,803 16,122 36.9 61.7 63.6 10.1 9,870 27,497 0.359
Hawaii 44,878,815 1,856 40.1 56.4 67.5 13.8 14,376 34,710 0.414
Idaho 88,022,709 6,722 62.5 78.1 83.4 39.4 9,811 21,294 0.461
Illinois 808,239,915 51,214 33.0 46.5 56.0 24.6 9,301 22,215 0.419
Indiana 269,654,796 12,563 34.6 51.6 53.5 9.2 13,876 26,641 0.521
Iowa 156,500,371 12,414 53.1 73.9 85.2 35.3 7,857 29,971 0.262
Kansas 175,683,214 12,728 75.6 82.7 87.8 47.1 11,890 22,264 0.534
Kentucky 247,491,130 19,140 33.1 81.4 80.0 23.1 5,345 23,120 0.231
Louisiana 257,024,505 20,498 29.9 53.4 57.0 18.7 6,569 17,998 0.365
Maryland 370,336,438 16,833 41.0 57.0 71.5 27.6 12,621 41,079 0.307
Mississippi 158,717,706 10,232 21.5 46.8 59.4 10.6 5,601 27,430 0.204
Missouri 526,061,747 35,195 68.9 76.8 82.6 39.3 12,461 21,031 0.592
Nebraska 104,497,665 5,012 37.0 54.4 64.5 22.0 11,957 30,871 0.387
Nevada 72,441,250 3,676 44.2 57.8 69.7 15.2 12,497 32,643 0.383
New Jersey 547,362,116 22,977 36.0 52.8 73.2 25.0 11,725 49,842 0.235
New Mexico 138,343,807 7,576 75.2 81.7 89.7 26.6 15,317 36,477 0.420
New York 2,877,342,505 110,197 45.8 67.2 80.2 46.2 14,923 51,541 0.290
North Carolina 551,750,654 51,916 68.5 82.4 89.8 42.1 8,114 25,235 0.322
North Dakota 26,902,338 1,440 24.4 44.2 66.1 21.1 6,904 34,634 0.199
Ohio 918,529,768 45,043 40.6 59.5 66.6 22.4 12,428 28,437 0.437
Oklahoma 175,827,848 14,043 38.2 60.5 71.3 20.1 6,713 23,480 0.286
South Carolina 138,515,344 13,122 49.4 70.8 84.8 17.5 6,148 32,079 0.192
South Dakota 30,293,347 1,393 16.0 33.3 44.2 6.6 7,876 30,616 0.257
Tennessee 389,929,774 15,371 60.1 70.8 65.2 12.3 23,382 27,115 0.862
Utah 63,432,654 2,467 15.4 41.1 44.5 6.7 8,891 35,199 0.253
Vermont 34,439,393 2,666 68.6 86.8 85.4 44.5 10,377 21,216 0.489
Virginia 268,316,349 12,927 45.3 84.4 85.6 16.1 10,991 31,691 0.347
Washington N/A N/A N/A N/A N/A N/A N/A N/A N/A
West Virginia 111,857,577 8,147 41.2 63.8 75.7 16.5 7,471 28,679 0.261
Wisconsin N/A N/A N/A N/A N/A N/A N/A N/A N/A
Wyoming 19,696,223 1,231 52.1 71.0 78.3 20.7 10,650 28,316 0.376
SOURCE: Mathematica analysis of 2006 MAX data for 37 states with representative FFS LTC data (excludes data from Arizona, District of Columbia, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, Texas, Washington, and Wisconsin). Potential LTC Users are based on data from the ACS 2007 Public Use Microdata Sample.
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Enrollees with ID/DD include those enrolled in ID/DD waivers or using ICF/IID services.
  2. Potential LTC users include SSI recipients and individuals with income up to 300% of the SSI limit who are under 65 and have a physical, mental, or emotional condition lasting 6 months or more resulting in difficulties conducting ADLs (dressing, bathing, or getting around inside the home).

N/A = not available (ID/DD data were unavailable or unreliable for District of Columbia, Washington, and Wisconsin).

TABLE D.6. Medicaid LTC System Performance Indicators for Enrollees Under 65 with ID/DD and Eligible for Full Medicaid Benefits in 2006a
State Total
LTC $
Total
LTC Users
  Percentage of Medicaid  
LTC $ Allocated
to HCBS
  Percentage of Total  
Medicaid $ for
LTC Users Allocated
to HCBS Users
  Percentage of LTC  
Users Receiving HCBS
  Percentage of Potential  
LTC Users
Receiving HCBSb
  Percentage of New  
Nursing Home Spells
in 2007 Preceded
by HCBS Use
in 2006
  Per-User Spending  
on HCBS
  Per-User Spending  
on ILTC
  Ratio of Per-User  
$ on HCBS
Relative to ILTC
All 40 states   22,407,952,989     391,061   60.8 68.4 85.2 8.7 42.4c 40,895 118,035 0.346
Alabama 221,330,958 4,941 88.7 90.7 96.1 3.9 50.0 41,336 92,155 0.449
Alaska 69,583,341 975 99.3 99.7 99.8 6.7 75.0 70,992 33,871 2.096
Arkansas 228,830,917 4,911 44.8 51.9 67.3 4.7 16.9 30,991 73,541 0.421
California 2,482,679,295 72,905 69.4 74.4 89.7 11.7 39.3 26,361 87,096 0.303
Colorado 287,203,572 7,295 92.9 94.5 98.6 10.5 75.0 37,081 115,938 0.320
Connecticut 630,201,909 7,547 67.1 69.6 86.6 12.3 57.5 64,686 165,688 0.390
Delaware 86,709,374 860 75.6 77.1 85.5 5.1 33.3 89,202 153,229 0.582
District of Columbia N/A N/A N/A N/A N/A N/A 17.6 N/A N/A N/A
Florida 1,099,580,806 31,791 73.2 76.2 91.2 10.4 42.5 27,783 94,414 0.294
Georgia 325,173,773 9,458 71.6 75.1 89.4 5.2 17.6 27,545 84,557 0.326
Hawaii 89,626,477 2,097 90.6 91.5 96.0 15.3 60.0 40,315 85,177 0.473
Idaho 113,081,005 2,488 50.4 64.1 81.3 8.3 48.4 28,184 96,332 0.293
Illinois 1,067,289,992 21,030 43.7 68.8 86.6 10.4 50.4 25,603 68,509 0.374
Indiana 671,869,077 12,424 52.6 57.4 70.7 7.3 N/A 40,216 81,061 0.496
Iowa 498,631,724 11,231 48.7 57.3 82.3 17.1 72.5 26,238 111,758 0.235
Kansas 283,056,342 7,178 78.3 82.1 91.9 13.3 66.7 33,581 94,355 0.356
Kentucky 298,792,679 3,375 59.2 93.7 96.6 2.5 77.6 54,309 147,816 0.367
Louisiana 641,446,434 10,412 38.2 41.2 51.4 5.4 18.8 45,806 75,158 0.609
Maryland 522,116,402 10,391 89.2 90.4 97.1 11.8 27.3 46,151 153,701 0.300
Mississippi 261,944,298 4,404 14.1 17.0 42.0 2.4 23.8 20,039 85,713 0.234
Missouri 177,425,635 3,166 49.1 56.7 70.6 1.7 43.9 39,000 82,961 0.470
Nebraska 181,671,218 3,711 69.2 72.6 85.2 13.7 28.0 39,751 89,076 0.446
Nevada 80,810,571 1,536 73.3 78.1 91.2 4.6 8.3 42,293 119,770 0.353
New Jersey 1,016,038,608 12,407 46.9 49.8 78.6 9.7 35.3 48,845 191,215 0.255
New Mexico 259,728,872 3,859 92.5 93.0 94.0 9.4 30.4 66,253 77,366 0.856
New York 6,228,961,504 59,943 57.6 68.8 92.0 16.3 61.0 65,099 287,894 0.226
North Carolina 740,252,382 12,889 46.0 52.9 70.7 5.2 52.7 37,375 101,209 0.369
North Dakota 111,848,412 2,189 53.2 56.3 78.2 16.9 72.4 34,788 97,989 0.355
Ohio 1,394,661,817 23,986 55.4 58.4 73.4 7.0 41.6 43,907 89,976 0.488
Oklahoma 355,773,450 6,727 67.9 72.3 76.4 6.1 21.5 46,985 65,494 0.717
South Carolina 308,505,682 6,261 57.3 62.5 77.4 5.8 70.5 36,478 82,644 0.441
South Dakota 94,371,742 2,759 79.0 83.7 94.7 17.2 34.4 28,520 85,560 0.333
Tennessee 574,599,497 6,202 59.4 61.8 81.4 3.1 13.6 67,596 191,335 0.353
Utah 164,560,253 4,239 67.7 70.0 82.7 8.5 N/A 31,803 66,615 0.477
Vermont 100,755,466 1,938 99.4 99.7 99.9 14.6 100.0 51,711 45,869 1.127
Virginia 419,065,304 7,445 81.4 91.7 95.6 6.4 45.8 47,911 104,948 0.457
Washington N/A N/A N/A N/A N/A N/A 100.0 N/A N/A N/A
West Virginia 231,237,879 4,062 77.6 80.3 88.8 6.3 26.0 49,745 101,386 0.491
Wisconsin N/A N/A N/A N/A N/A N/A 63.0 N/A N/A N/A
Wyoming 88,536,322 2,029 90.5 92.0 96.4 20.8 80.0 40,981 96,755 0.424
SOURCE: Mathematica analysis of 2006 MAX data for 37 states with representative FFS LTC data (excludes data from Arizona, District of Columbia, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Oregon, Pennsylvania, Rhode Island, Texas, Washington, and Wisconsin). Potential LTC Users are based on data from the ACS 2007 Public Use Microdata Sample. Percentage of new ICF/IID spells preceded by HCBS are from Ballou et al. (2011).
NOTES: Enrollees in managed LTC and those eligible for only restricted Medicaid benefits are excluded. HCBS include 1915(c) waiver services and state plan services for personal care, residential care, home health, adult day care, and private duty nursing. ILTC includes services provided in nursing homes, ICFs/IID, mental hospitals for the aged, and inpatient psychiatric facilities for people under age 21.
  1. Enrollees with ID/DD include those enrolled in ID/DD waivers or using ICF/IID services.
  2. Potential LTC users include SSI recipients and individuals with income up to 300% of the SSI limit who are under 65 and have a physical, mental, or emotional condition lasting 6 months or more resulting in difficulties in learning, remembering or concentrating (but no reported difficulties with ADLs).
  3. National figure includes 38 states (includes data for District of Columbia, Washington, and Wisconsin and excludes data for Indiana and Utah).

N/A = not available (ID/DD data were unavailable or unreliable for District of Columbia, Washington, and Wisconsin; first new spells data were unavailable or unreliable for Indiana and Utah).

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