Table 8B: Dually Eligible HCBS Participants

Assessing the Health and Welfare of the HCBS Population

Table 8: Outcome Indicators for the Home and Community-Based Services Population by Participant Attributes, 2005^a

• Table 8A: National HCBS Population.
• Table 8C: Medicaid-Only HCBS Participants.
• Table 8D: I/DD Subpopulation.
• Table 8E: SMI Subpopulation.
• Table 8F: HCBS Population Ages 18-64 Without I/DD or SMI.
• Table 8G: HCBS Population Age 65+.

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Outcome Indicator	White Only, Non-Hispanic	Black Only, Non-Hispanic	Hispanic	Other Race or Multiple Races, Non-Hispanic	Unknown Race	Male	Female	Ages 18-64	Ages 65-84	Age 85+	MSA	Non-MSA
Short-Term Complications of Diabetes	195	451	208	92	151	266	213	378	153	74	225	261
Min	s	s	s	s	s	s	121	s	s	s	s	s
Max	706	1,662	6,316	4,771	s	1,345	619	1,490	1,021	235	821	831
Asthma or Chronic Obstructive Pulmonary Disease	4,646	3,708	3,149	1,802	3,865	3,400	4,458	2,791	5,510	3,041	3,677	5,585
Min	1,063	s	s	s	s	633	1,369	325	2,362	1,288	905	s
Max	9,973	8,539	8,955	30,000	s	8,334	11,696	6,435	14,482	7,905	8,571	11,072
Congestive Heart Failure	5,565	8,374	5,800	2,891	5,656	4,390	6,715	2,546	7,529	10,071	5,534	7,348
Min	1,796	s	s	s	s	1,420	1,666	312	3,747	3,374	1,398	2,664
Max	10,692	14,644	25,397	14,035	s	9,970	12,890	10,816	13,739	18,767	11,524	12,232
Composite: Potentially Preventable Infection	10,053	8,542	7,726	5,095	8,349	8,545	9,410	5,631	9,983	16,128	8,468	11,256
Min	5,974	s	s	s	s	6,011	5,558	3,271	5,193	8,896	5,646	6,681
Max	17,151	35,556	36,364	27,038	s	17,470	16,542	9,978	20,951	31,034	15,497	18,170
Bacterial Pneumonia	6,373	4,362	4,539	3,426	5,113	5,811	5,419	3,435	6,126	9,714	5,025	7,278
Min	3,964	s	s	s	s	3,975	3,284	2,238	3,279	5,215	3,582	4,186
Max	10,817	22,222	9,185	14,517	s	11,941	9,382	5,891	13,104	21,944	8,391	11,300
Urinary Tract Infection	3,680	4,180	3,187	1,669	3,236	2,734	3,991	2,196	3,857	6,414	3,443	3,978
Min	s	s	s	s	s	1,242	2,017	751	1,914	2,824	1,850	1,446
Max	7,713	13,333	36,364	13,519	s	6,665	8,493	4,848	9,597	15,214	7,876	7,645
Infection Due to Device or Implant	572	1,401	882	362	601	743	731	1,066	605	225	743	739
Min	s	s	s	s	s	s	224	215	s	s	s	s
Max	1,139	3,558	12,857	2,985	s	1,426	1,460	1,816	2,231	589	1,568	1,488
Dehydration	2,106	3,022	1,691	1,080	2,061	1,737	2,376	1,238	2,403	3,936	2,008	2,683
Min	s	s	s	s	s	475	714	375	1,064	1,007	452	620
Max	4,227	6,171	4,420	5,783	s	3,483	4,796	2,391	5,238	8,114	4,383	4,589
Composite: ACSC Chronic Conditions	12,505	17,164	12,947	6,321	12,111	10,425	14,251	7,962	16,349	15,590	12,062	16,209
Min	3,408	s	s	s	s	3,243	3,452	1,126	7,806	3,988	2,919	4,948
Max	23,903	29,841	44,444	109,091	s	18,993	26,365	17,105	31,276	26,495	21,492	26,641
Composite: ACSC Acute Conditions	9,218	7,983	7,030	4,579	7,775	7,149	9,031	4,652	9,483	15,315	7,608	11,006
Min	s	s	s	s	s	4,430	5,247	2,335	4,848	7,669	5,016	6,250
Max	16,012	26,667	43,750	24,652	s	15,066	15,687	8,565	19,300	26,941	13,115	17,587
Composite: ACSC Overall	21,723	25,144	19,975	10,900	19,884	17,572	23,281	12,613	25,831	30,902	19,668	27,213
Min	8,723	s	s	s	s	7,673	9,820	3,754	12,971	11,656	7,935	10,256
Max	39,914	44,860	74,074	109,091	s	34,059	41,284	22,863	50,576	50,856	32,463	44,228
Pressure Ulcer	3,472	6,789	3,352	1,525	3,397	4,095	3,804	3,300	3,854	5,806	3,982	3,777
Min	1,663	s	s	s	s	1,775	1,548	1,208	1,220	1,064	1,625	918
Max	7,916	20,000	16,970	11,285	s	11,025	10,192	7,947	11,816	13,629	9,756	9,500
Injurious Falls	455	223	286	233	382	193	477	129	454	836	328	556
Min	s	s	s	s	s	s	s	s	s	s	s	s
Max	2,128	841	562	6,579	s	1,066	2,181	340	2,539	5,521	2,275	2,762

Notes: 

ACSC = ambulatory care-sensitive condition; I/DD = intellectual and development disabilities; MSA = metropolitan statistical area; SMI = serious mental illness.

^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 people in the States of Arizona, Maine, Washington, and Wisconsin.

Minimum (min) and maximum (max) defined as lowest rate and highest rate among States.

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.

s = Suppressed due to small cell size.

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

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