Medicaid Home and Community Based Services Spending and Nursing Home Use by Individuals Under the Age of 44
Seiyoun Kim, Ziwei Pan, Nurah Koney-Laryea, Hye-Young Jung, Sophia Jan, Kira L. Ryskina
TL;DR
This study examines how state spending on home and community-based services affects nursing home use for individuals under 44, highlighting racial disparities.
Contribution
The study is the first to analyze HCBS spending's impact on nursing home use for younger, medically complex individuals and racial disparities.
Findings
Higher HCBS spending reduced nursing home stays for Non-Hispanic White children.
No significant link was found between HCBS spending and nursing home use for BIPOC children.
HCBS investments may not be enough to address racial disparities in nursing home use.
Abstract
Prior studies of the role of state spending on home and community-based services (HCBS) in nursing home use focused on adults over the age of 65. However, medically complex children and adults under 50 years old represent a small (about 5%) but highly vulnerable subset of nursing home patients. We measured the impact of HCBS spending on short-term and long-term nursing home stays by children and adults under 44 years old and compared the impact between Non-Hispanic White (NHW) individuals and Black, Indigenous, and People of Color (BIPOC). We used the Minimum Data Set to measure nursing home stays in each state per year in 2012 to 2019. The Medicaid Long Term Services and Supports annual expenditure reports were used to measure HCBS expenditures per state resident with a disability. Our outcome was nursing home use by children (<18 years old) and adults (18-43 years old) associated with…
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Taxonomy
TopicsGeriatric Care and Nursing Homes · Health disparities and outcomes · Migration, Aging, and Tourism Studies