DeLiema Marguerite, Gao Siyu, Scattarelli Justine, Moeller Kelly, Olofinboba Olu
School of Social Work, University of Minnesota, 1404 Gortner Ave., Saint Paul, MN, 55455, United States, 1 6126258798.
Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States.
JMIR Aging. 2025 Aug 27;8:e77441. doi: 10.2196/77441.
Most older Americans have not saved enough to cover long-term care costs. Medicaid-a public health care program for low-income individuals-can help Americans with qualifying care needs pay for assistance in a nursing home or for services in the home. Determining financial eligibility for Medicaid is complicated, and the application process is often managed by family caregivers with limited knowledge of Medicaid programs.
A one-stop digital solution is needed to help family caregivers plan for the cost of long-term care services and learn about getting help paying for services through Medicaid. We aimed to develop a web application that (1) educates informal caregivers about Medicaid programs and eligibility criteria, (2) informs them about the cost of home and institutional care in their local area with and without Medicaid coverage, and (3) uses a custom algorithm to provide personalized financial eligibility information based on the care recipient's income, assets, and monthly spending.
We first interviewed aging services providers and informal family caregivers, then developed a web application that was refined based on user experience interviews with English- and Spanish-speaking caregivers. In the final validation phase, asynchronous usability sessions were recorded with 109 informal caregivers who completed a series of tasks. Participants viewed and rated animated Medicaid "explainer" videos, input financial information to enable the custom algorithm to determine the care recipient's eligibility for Medicaid, adjusted settings on a care cost calculator to estimate the regional cost of home and institutional care services, and completed a Medicaid knowledge quiz before and after using the website.
After engaging with the website and watching the videos, scores on a Medicaid knowledge quiz increased by 61.2% (2-tailed t92=12.9, P<.001). Participants found it easy to enter the care recipient's financial information to determine Medicaid eligibility (out of 7; mean 5.9, SD 1.3) and perceived the care cost calculator as very helpful (out of 7; mean 6.3, SD 1.2). The website received a very high System Usability Scale rating of 88.3 out of 100 (SD 13.1). Caregivers verbalized wanting more education on complex financial concepts that impact Medicaid eligibility and asset preservation.
A comprehensive Medicaid planning website can significantly improve caregivers' knowledge of Medicaid and provide them with a personalized roadmap for accessing care services. The custom algorithm powering the Medicaid eligibility determination could be further refined to account for state-based exceptions. This application may reduce caregiver burden and help support the long-term care planning process.
大多数美国老年人没有攒够钱来支付长期护理费用。医疗补助计划——一项针对低收入人群的公共医疗保健计划——可以帮助有符合条件护理需求的美国人支付疗养院护理或居家服务费用。确定医疗补助计划的财务资格很复杂，而且申请过程通常由对该计划了解有限的家庭护理人员负责。
需要一个一站式数字解决方案来帮助家庭护理人员规划长期护理服务费用，并了解如何通过医疗补助计划获得服务费用帮助。我们旨在开发一个网络应用程序，该程序能够（1）向非正式护理人员介绍医疗补助计划及其资格标准，（2）告知他们当地有和没有医疗补助覆盖时居家和机构护理的费用，（3）使用自定义算法根据护理接受者的收入、资产和每月支出提供个性化的财务资格信息。
我们首先采访了老年服务提供者和非正式家庭护理人员，然后开发了一个网络应用程序，并根据对说英语和西班牙语的护理人员的用户体验访谈进行了完善。在最终验证阶段，对109名完成一系列任务的非正式护理人员进行了异步可用性测试。参与者观看并评价了医疗补助计划的动画“解释”视频，输入财务信息以使自定义算法确定护理接受者是否符合医疗补助计划资格，在护理费用计算器上调整设置以估计当地居家和机构护理服务的费用，并在使用该网站前后完成了一项医疗补助计划知识测验。
在使用该网站并观看视频后，医疗补助计划知识测验的分数提高了61.2%（双侧t92 = 12.9，P <.001）。参与者发现很容易输入护理接受者的财务信息来确定是否符合医疗补助计划资格（满分7分；平均5.9分，标准差1.3分），并认为护理费用计算器非常有帮助（满分7分；平均6.3分，标准差1.2分）。该网站在系统可用性量表上获得了非常高的评分，满分为100分，得分为88.3分（标准差13.1分）。护理人员表示希望获得更多关于影响医疗补助计划资格和资产保全的复杂财务概念的教育。
一个全面的医疗补助计划规划网站可以显著提高护理人员对医疗补助计划的了解，并为他们提供获取护理服务的个性化路线图。为确定医疗补助计划资格提供支持的自定义算法可以进一步完善，以考虑基于州的例外情况。该应用程序可能会减轻护理人员的负担，并有助于支持长期护理规划过程。
