Risks for Nursing Home Placement and Medicaid Entry Among Older Medicare Beneficiaries with Physical or Cognitive Impairment.
Issue: More than half of individuals who age into Medicare will experience physical and/or cognitive impairment (PCI) at some point that hinders independent living and requires long-term services and supports. As a result of Medicare’s limits on covered services, Medicare beneficiaries with PCI experience financial burdens and reduced ability to live independently. Goal: Describe the characteristics and health spending of Medicare beneficiaries with PCI and estimate the
likelihood of Medicaid entry and long-term nursing home placement. Methods: The Health and Retirement Study 1998–2012 is used to estimate long-term nursing home placement, as well as Medicaid entry. The Medicare Current Beneficiary Survey 2012 provides information on health care spending and utilization. Key findings and conclusions: Almost two-thirds of community-dwelling Medicare beneficiaries with PCI have three or more chronic conditions. More than one-third of those with PCI have incomes less than 200 percent of the federal poverty level but are not covered by Medicaid; almost half spend 10 percent or more of their incomes out-of-pocket on health care. Nineteen percent of individuals with PCI and high out-of-pocket costs entered Medicaid over 14 years, compared to 10 percent without PCI and low out-of-pocket costs.
Department of Health Policy and Management and Roger C. Lipitz Center for Integrated Health Care, Johns Hopkins Bloomber School of Public Health, USA.
Amber
A
Willink
Department of Health Policy and Management and Roger C. Lipitz Center for Integrated Health Care, Johns Hopkins Bloomber School of Public Health, USA.
Karen
K
Davis
The Commonwealth Fund Council of Economic Advisors
Cathy
C
Schoen
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D009735:Nursing Homes; D011203:Poverty; D044469:Racial Groups; D012306:Risk; D014481:United States