A Synthesis and Critique of Studies on Medicaid Asset Spenddown

The purpose of this paper was to provide a synthesis and critique of current research on Medicaid spenddown. The primary goal was to ask what these studies could tell us about the extent to which persons incurred catastrophic expenses in nursing homes. A corollary goal was to examine how the data and research methods used in the various studies affected the "results" reported. The authors believed that results of Medicaid spenddown studies quoted in the media and by policymakers, without an adequate explanation of what these results actually mean. As a consequence, the public may have been influenced that spenddown is alternatively a smaller (or larger) problem than it really was, depending on which study was quoted. [37 PDF pages]