Document Detail

Variation by disability in state predictors of Medicaid 1915c waiver use and expenditures.
MedLine Citation:
PMID:  16326658     Owner:  NLM     Status:  MEDLINE    
PURPOSE: States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care. A substantially greater share of long-term-care dollars supports community-based care for individuals with intellectual and developmental disabilities, relative to older and working-age persons with primarily physical disabilities. DESIGN AND METHODS: We used state-level data for the period from 1992 to 2001 to estimate fixed-effects panel models. We compared state predictors of waiver utilization and expenditures for waivers serving both older and working-age individuals (O/WAIs) relative to waivers serving individuals with intellectual and developmental disabilities (IDDs). RESULTS: We found community-based-care capacity to predict use and expenditures for both target groups. Although regulation of institutional supply was positively related to expenditure measures for IDDs, it was not related to use or expenditures for O/WAIs. Demand variables (e.g., the size of a state's African American population) predicted use and expenditures for IDD waivers, but they were less consistent for O/WAI waivers. State resources were a robust predictor of use and expenditures for both groups. IMPLICATIONS: Increased community-based-care capacity appears to be an important factor in efforts to expand the availability of Medicaid community-based care. Federal policies that address state resource issues may also spur growth in community-based long-term care.
Nancy A Miller; Martin Kitchener; Keith T Elder; Yu Kang; Andrea Rubin; Charlene Harrington
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Gerontologist     Volume:  45     ISSN:  0016-9013     ISO Abbreviation:  Gerontologist     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-04-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375327     Medline TA:  Gerontologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  764-72     Citation Subset:  IM    
Department of Public Policy, University of Maryland, Baltimore County, Public Policy Building, 21250, USA.
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MeSH Terms
Community Health Services / economics,  utilization*
Disabled Persons*
Health Expenditures*
Health Services Needs and Demand
Long-Term Care
Medicaid / legislation & jurisprudence*
State Government*
United States
Grant Support
H133G010023//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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