Study Suggests Medicaid-Sponsored Home Care Reduces Nursing Home Use

A recently released study of Medicaid-financed nursing home use over 18 months in 2001 and 2002 finds that in states such as Oregon that have extensive community based long-term care services, Medicaid-covered nursing home stays were shorter than the national average. The numbers suggest that where seniors have alternatives, their nursing home stays are more likely to be for acute care following a hospitalization or for a shorter period at the end of life.

The study, "Medicaid-Financed Nursing Home Services: Characteristics of People Served and Their Patters of Care, 2001-2002," conducted by Mathematica Policy Research for the Office of Disability, Aging and Long-Term Care Policy for the U.S. Department of Health and Human Services, reports that over half of enrollees beginning Medicaid-financed nursing home spells were already residing in nursing homes when Medicaid began financing part of their stay, with 29 percent obtaining coverage within six months, 5 percent between six and 12 months, 7 percent between one and two years, and 9 percent after more than two years.

In 2002, more than 45 percent of nursing home costs nationally were paid by Medicaid, but a larger proportion of nursing home residents were Medicaid beneficiaries since even on Medicaid, some of the cost of their care is covered by Medicare, their own contributions from income, and other sources. In terms of all Medicaid expenditures, while aged and disabled enrollees make up about 25 percent of Medicaid beneficiaries, they account for 80 percent of Medicaid expenditures.

The report confirms the continuing trend that most nursing home residents are among the older old. The average of nursing home resident who entered in 2002 was 76 years of age, with 32 percent each being between the ages 75 and 84 and 85 and older. Twenty percent were under age 65 and 16 percent between ages 65 and 74.

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