Serving low-income seniors where they live: Medicaid's role in providing community-based long-term services and supports
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Garfield, Rachel, author Young, Katherine, author Musumeci, MaryBeth, author Reaves, Erica L., author Kasper, Judy, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body. Kaiser Commission on Medicaid and the Uninsured, issuing body.
- Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, September 2015
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Services for the Aged -- statistics & numerical data Health Services Needs and Demand -- statistics & numerical data Long-Term Care -- statistics & numerical data Medicaid Poverty United States
- Genre(s):
- Technical Report
- Abstract:
- Seniors managing chronic health conditions or experiencing an age-related decline in physical or cognitive functioning may need long-term services and supports (LTSS) to complete daily self-care activities (such as eating, bathing or dressing) or household activities (such as preparing meals or doing laundry). LTSS include a range of services, including adult day health care programs, home health aide services, personal care services, and case management services, among others. LTSS needs may be met through both paid services and unpaid services provided by friends or family members. While some people who need LTSS choose or require care based in nursing facilities, most people with LTSS needs live in the community. Medicare is the primary source of health insurance for nearly all seniors, but the program does not cover LTSS, and few Medicare beneficiaries have private insurance that covers these services. For some low-income Medicare beneficiaries (called “dual eligible beneficiaries”), Medicaid fills this gap by providing wraparound coverage for a range of services, including LTSS. Helping these individuals remain in the community rather than reside in a nursing facility is a goal of both beneficiaries and states, in part due to the Americans with Disabilities Act’s community integration mandate. Understanding the community-based LTSS population served by Medicaid is important for designing effective care delivery systems, particularly as states are increasingly developing new systems of integrated and managed care for this population, and because Medicaid is the nation’s primary payer for LTSS. In addition, other low-income seniors may have LTSS needs but may not meet Medicaid eligibility criteria or be enrolled in the program. Some Medicaid waiver programs that provide home and community-based LTSS have waiting lists for coverage. Since many of these people may become eligible for Medicaid should they ever need institutional-based LTSS, it is important to understand the needs and characteristics of this population as well as that already served by Medicaid. To better understand the low-income population with LTSS needs, including those covered by Medicaid and those who are not, this issue brief examines the need for LTSS among seniors who live in the community5 and need LTSS. We use the 2011 National Health and Aging Trends Study (NHATS) to examine rates of need for LTSS and detail the characteristics of seniors who need these services. Throughout the brief, we compare dual eligible beneficiaries to low-income seniors without Medicaid. We also examine a third group, higher income seniors without Medicaid, to understand the role of income. Because LTSS needs increase with age, we also Serving Low-Income Seniors Where They Live: Medicaid's Role in Providing Community-Based Long-Term Services and Supports 2 examine differences by age. A full description of the NHATS data and the analytical approach are included in the methods section at the end of this issue brief.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (13 pages, 2 unnumbered pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101670666 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101670666