Assessing the Health and Welfare of the HCBS Population

Table 13C: Medicaid-Only 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 697 487 337 934 388 364 385 567
Asthma or Chronic Obstructive Pulmonary Disease 4,020 3,143 2,971 3,070 3,003 2,848 2,922 3,696
Congestive Heart Failure 3,103 2,960 2,759 3,142 2,828 2,849 2,478 3,563
Composite: Potentially Preventable Infection 5,970 5,322 4,199 5,881 5,055 4,485 4,303 5,905
    Bacterial Pneumonia 3,705 3,228 2,805 3,449 3,089 3,005 2,882 3,494
    Urinary Tract Infection 2,265 2,094 1,394 2,432 1,967 1,480 1,420 2,411
Infection Due to Device or Implant 1,098 988 578 1,019 897 742 650 1,088
Dehydration 1,643 1,437 799 1,548 1,364 783 905 1,617
Composite: ACSC Chronic Conditions 10,770 9,196 8,117 10,385 8,465 8,064 7,902 10,707
Composite: ACSC Acute Conditions 5,422 4,581 3,720 5,021 4,427 4,025 3,826 5,144
Composite: ACSC Overall 16,190 13,777 11,837 15,406 12,890 12,089 11,728 15,849
Pressure Ulcer 3,031 3,001 1,416 3,073 2,914 1,211 1,591 3,369
Injurious Falls 122 77 35 90 89 25 55 82

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 13C: Medicaid-Only HCBS Participants. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/hcbs/hcbsfindings/hcbsfindtab13c.html