title: Penny wise, pound wise: a comparison of Medicaid expenditures for home and community-based services versus nursing facility care for older adults.
abstract: Kansas Medicaid offers home and community-based services through the Frail and Elderly (FE) program as an alternative for older adults who are eligible for nursing home (NH) care but wish to stay in the community. We determined demographic and clinical characteristics of enrollees receiving FE or NH services, examined their relative health care utilization patterns, and estimated the difference in Medicaid's expenditures for FE versus NH care. After adjusting for key demographic and clinical variables, mean monthly expenditures were $1,281 lower for the FE cohort. Since NH and FE populations are dissimilar, these care options may not be easily interchangeable at the individual level.
authors.affiliation: Center on Aging, University of Kansas, 1251 Wescoe Hall Drive, Room 6050, Lawrence, KS 66045, USA. Shireman@ku.edu
authors.forename: Theresa I
authors.initials: TI
authors.lastname: Shireman
authors.forename: Sally K
authors.initials: SK
authors.lastname: Rigler
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology; D003153:Community Health Services / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007615:Kansas / Q000453:epidemiology; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014600:Utilization Review