Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Brown University School of Public Health, Providence, RI, USA.
Med Care Res Rev. 2022 Feb;79(1):69-77. doi: 10.1177/1077558720987666. Epub 2021 Jan 19.
Assisted living has become more widely used by dual-eligible Medicare beneficiaries as states try to rebalance their long-term services and supports away from institutional (nursing home) care. In an analysis of 2014 Medicare data for 506,193 adults who live in large (25+ beds) assisted living communities, we found wide variability among states in the share of assisted living residents who were dual-eligible, ranging from 6% in New Hampshire to over 40% in New York. This variation is strongly correlated with the Medicaid support for assisted living care: In states with a Medicaid state plan option covering services in assisted living or both a state plan and waiver, the percent of assisted living residents with dual-eligibility was more than 10 percentage points higher than in states with neither a state plan nor waiver. Findings provide a basis for understanding the role of Medicaid financing in access to assisted living for duals.
随着各州试图将其长期服务和支持从机构（疗养院）护理转向平衡，双重资格的医疗保险受益人越来越多地使用辅助生活。在对居住在大型（25 张以上床位）辅助生活社区的 506,193 名成年人的 2014 年医疗保险数据进行分析后，我们发现各州辅助生活居民中双重资格的比例存在很大差异，从新罕布什尔州的 6%到纽约州的 40%以上。这种差异与医疗补助对辅助生活护理的支持密切相关：在有覆盖辅助生活服务的医疗补助州计划选项或既有州计划又有豁免的州，有双重资格的辅助生活居民的比例比既没有州计划也没有豁免的州高出 10 多个百分点。这些发现为了解医疗补助融资在双重资格人群获得辅助生活方面的作用提供了依据。
