Performance Improvement 2009. What Medicaid Services Do Beneficiaries Use, At What Cost, and How Does This Vary Across States?


This study examined how successfully States have rebalanced their long-term care systems and how Medicaid enrollees who utilize community-based long-term care services differ from people in institutions.

The study found that only 34% of Medicaid long-term care expenditures paid for persons served were for community-based services in 2002, while almost 59% of long-term care users used community-based services. National estimates mask significant variation across states. While the use-based measure was larger than the expenditure measure in every state, there was significant variation across states in how the two measures compared. Institutional and community long-term care expenditures were much more balanced among young disabled Medicaid enrollees than their aged counterparts in 2002. Over half of long-term care expenditures were for community-based services among disabled enrollees but less than 20% were for community-based care among those over 65. The primary distinguishing factor between people using community-based and those using institutional long-term care was age. Compared with people using community-based services, a higher percentage of people in institutions were non-Hispanic White, female, dual Medicare and Medicaid enrollees, and enrolled in Medicaid for only part of the year--all factors associated with age.

Report Title: A Profile of Medicaid Institutional and Community-Based Long-Term Care Service Use and Expenditures Among the Aged and Disabled Using MAX 2002: Final Report
Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy
Federal Contact: John Drabek, 202-690-6443
Performer: Mathematica Policy Research, Inc.
PIC ID: 8900

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"PerformanceImprovement2009.pdf" (pdf, 1.26Mb)

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