Content by Keyword: Nursing Home

Data reported by PHA staff to TAC on voucher issue and lease numbers, supplemented by data obtained during Mathematica discussions with PHAs during summer 2012, provided a snapshot at each of four points in time (June 2011, September 2011, December 2011, and summer 2012) of each PHA's progress in issuing and leasing the NED2 vouchers. These data p

Although 28 PHAs were awarded NED2 vouchers, for the purpose of this analysis we focused on the 13 that received at least 35 vouchers each, since those receiving fewer had less experience by which to judge their success in implementation. The 13 PHAs in eight states that met this threshold are listed in Table II.1 . 10 Collectively, they recei

Prior to the release of the HUD NOFA for the NED program, it was widely believed that demand for housing vouchers among low-income, non-elderly individuals admitted to institutions would be high, and that such vouchers could be issued and leased with relative ease. This belief was fueled by state MFP staff, who identified lack of affordable housin

In 2009, the U.S. Department of Housing and Urban Development (HUD), in partnership with the Centers for Medicare and Medicaid Services (CMS), announced the availability of nearly 1,000 housing choice vouchers (HCVs) to low-income, non-elderly individuals with disabilities who were residing in institutions, with the intention of making rental cost

The Housing Choice Voucher (HCV) program for institutionalized, non-elderly disabled (NED) people stems from the 1999 case Olmstead v. L.C. (527 U.S. 581), in which the U.S. Supreme Court declared that people with disabilities are entitled to receive services in "the most integrated setting appropriate." This ruling required states to expand optio

The following acronyms are mentioned in this report and/or appendices.

Background : The U.S. Department of Housing and Urban Development (HUD), in collaboration with the Centers for Medicare and Medicaid Services, allocated Housing Choice Vouchers to 28 public housing authorities (PHAs) in January 2011. PHAs were required to partner with the state Money Follows the Person program, or the relevant health and human se

The authors acknowledge the efforts of the many people who helped produce this report. First, thanks to Hakan Aykan, Alison Cuellar and Gavin Kennedy in the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, for providing overall direction and support for this study.

These beneficiaries are also commonly called dual eligible. See Borck et al. (2013) or Kaiser Family Foundation (2010) for additional information about Medicaid-eligibility for individuals who are aged or have a disability.

The following tables contain the set of coefficient estimates and odds ratios from the regression models. To get predicted rates for Table 2 and Table 3 , we retained the estimated coefficients. Then for "No ER Visit Resulting in IP Stay, SNF Stay, or Other NH Stay", we computed the predicted transition rate by setting the indicator variables f

Bharucha, A., R. Pandav, C. Shen, H.H. Dodge, and M. Ganguli. "Predictors of Nursing Facility Admission: A 12-Year Epidemiological Study in the United States." Journal of the American Geriatrics Society , 52(3): 434-439, March 2004.

This analysis identified nursing home use and ER visits leading to an inpatient stay as significant predictors of the transition from Medicare-only eligibility to MME status. Moreover, these predictors were particularly strong among younger Medicare beneficiaries (under 65) compared to older (65 and above) beneficiaries.

Some limitations of this study should be noted in considering our results. First, our analysis was restricted to those not in managed care, and understanding how transition rates differ for those in managed care may be informative and policy relevant. Second, our results are informative of factors that predict MME status and nursing home entry, bu

This analysis identified nursing home use (SNF or other nursing home) as an important predictor of MME status, particularly among younger Medicare beneficiaries. Additionally, having both a Medicare-financed SNF stay and a non-SNF stay is an even stronger predictor of MME status. Chronic conditions, particularly related to Alzheimer's or dementia,

In addition to service utilization, chronic conditions were also associated with the rate of transition to MME status, as well as non-SNF nursing home entry.

The results in the previous section highlight that a nursing home stay, particularly a non-SNF stay, is strongly predictive of transition to MME status. The analysis indicates that acute care services and SNF use are associated with having a non-SNF nursing home stay ( Table 3 ). For those under 65 with "no prior ER visit resulting in an inpatient

The analysis indicates that the likelihood that Medicare beneficiaries transition to MME status is associated with the types of services they use, particularly nursing home care ( Table 2 ). For example, among younger Medicare-only beneficiaries with no service utilization--"no ER visit leading to an inpatient admission, no SNF stay, and no non-SN

We combined data from multiple sources to examine beneficiary characteristics and service utilization patterns that predict transitions from Medicare-only eligibility to MME status on a monthly basis. We also examined beneficiary characteristics and service utilization patterns that predict entry into nursing home care not covered by the Medicare

MMEs must meet the eligibility requirements of both Medicare and Medicaid. At a high level, Medicare beneficiaries become eligible for Medicaid through one of three ways: having low income and few resources, incurring high medical expenses, or requiring institutional level of care (for a more complete description, see the companion study by Borck