Assessing the Health and Welfare of the HCBS Population

Table 13B: Dually Eligible HCBS Participants

Table 13: Outcome Indicators by Key Attributes of State Medicaid and Long-Term Care Environment, 2005a

Select for:

Outcome Indicator No Medically Needy Program More Restrictive Eligibility Criteria Less Restrictive Eligibility Criteria Nursing Home Level of Care Eligibility Criteria for HCBS Percentage of State LTC Funds Spent on HCBS
High Mid Low >Median ≤Median
Short-Term Complications of Diabetes 279 265 177 407 233 158 203 272
Asthma or Chronic Obstructive Pulmonary Disease 5,334 4,324 3,261 4,552 4,259 3,156 3,574 4,841
Congestive Heart Failure 6,786 6,610 4,812 6,648 6,377 4,821 5,103 7,074
Composite: Potentially Preventable Infection 11,104 10,143 7,164 10,514 9,962 7,357 8,053 10,649
    Bacterial Pneumonia 6,877 6,029 4,467 6,080 6,019 4,631 5,025 6,331
    Urinary Tract Infection 4,227 4,114 2,697 4,434 3,942 2,726 3,028 4,318
Infection Due to Device or Implant 873 807 600 902 785 618 661 844
Dehydration 2,577 2,499 1,623 2,804 2,389 1,547 1,836 2,616
Composite: ACSC Chronic Conditions 15,269 14,041 10,715 14,679 13,644 10,260 11,421 15,100
Composite: ACSC Acute Conditions 10,364 9,276 6,559 9,357 9,284 6,680 7,431 9,753
Composite: ACSC Overall 25,630 23,315 17,273 24,034 22,926 16,939 18,851 24,850
Pressure Ulcer 4,306 4,221 3,413 4,523 4,155 3,058 3,454 4,564
Injurious Falls 479 395 313 320 460 331 310 477

Notes: 

ACSC = ambulatory care-sensitive condition; HCBS = home and community-based services; I/DD = intellectual and development disabilities; SMI = serious mental illness; LTC = long-term care.

a. All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS population. HCBS population for outcome indicators excludes: individuals under age 18; people with only institutional use in a given quarter; people on managed care plans; and persons in the States of Arizona, Maine, Washington, and Wisconsin.

Dually eligible = dually eligible for Medicaid and Medicare. Eligibility for Medicare defined as inclusion in Medicare denominator file.

Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

HCBS subpopulations of I/DD, SMI, Under 65 Without I/DD or SMI, and 65+ are defined as in the Appendix.

Median is defined as the value at which half of States are below and half of States are above.

Source for Outcome Indicators: Agency for Healthcare Research and Quality (AHRQ), Medicaid Analytic eXtract (MAX) data, and Medicare Provider Analysis and Review (MedPAR) data.

Sources for column heading data are described in the Appendix.

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Page last reviewed December 2012
Internet Citation: Table 13B: Dually Eligible HCBS Participants. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/hcbs/hcbsfindings/hcbsfindtab13b.html