The Medicaid Institute at United Hospital Fund

An initiative of United Hospital Fund

Providing More Effective Long-Term Care

One of Medicaid’s biggest responsibilities is providing long-term care services to elderly and disabled beneficiaries who require care over a period of months or years.  While many of these patients also have significant acute care needs, their dependence on long-term care is related to conditions that are generally ongoing and often deteriorate over time.  This central truth holds for a diverse group of Medicaid beneficiaries that includes, for example, seniors with dementia, adults with paralysis, and children with developmental disabilities.

Each month an estimated 240,000 frail elderly and physically disabled Medicaid beneficiaries receive long-term care services like nursing home care, home health services, and personal care.  This figure accounts for less than one-fourth of all elderly and disabled beneficiaries.  An additional 70,000 beneficiaries with developmental disabilities, mental retardation, or long-term mental illness are treated each year in community-based settings or residential facilities.  Because those receiving long-term care are among Medicaid’s most vulnerable and complex beneficiaries—and despite the fact that most have Medicare coverage—their costs (including acute care services) account for more than half of all Medicaid spending. 

Related Publications

Presentation of "Managing Care for High-Cost Elderly Duals: A Challenge for Medicaid"      

Published: 2009

Delivered at the Fourth National Medicaid Congress in Washington, DC, this presentation reviews the findings and policy implications from the Medicaid Institute™ report of the same title.

An Overview of Medicaid Long-Term Care Programs in New York      

Published: 2009

This Medicaid Institute™ report is the first and only data compilation of its kind, aiming to inform current policy discussions about how to address challenges associated with New York's Medicaid long-term care programs.

Managing Care for High-Cost Elderly Duals      

Published: 2008

This analysis considers a cohort of about 259,000 elderly individuals enrolled in both Medicare and Medicaid, focusing on the high-cost 20 percent who account for some $3.5 billion in Medicaid spending annually.

Changes in Nursing Home Care, 1996-2005      

Published: 2008

This report documents a ten-year trend among New York's nursing homes, marking their growing role as providers of short-term care for people continuing recuperation after a hospital stay.

The Costs and Policy Implications of Covering Dual Enrollees of Medicaid and Medicare      

Published: 2006

This issue brief examines the coverage of “duals”—-individuals enrolled in both the Medicaid and Medicare programs—-focusing on spending associated with acute and long-term care services, as well as on ramifications of possible changes to Medicare coverage.

 

Medicaid Institute at United Hospital Fund
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