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A Descriptive Profile of Medicaid Buy-In Participants from Linked Multi-Agency Data. Su Liu Henry T. Ireys Craig Thornton AcademyHealth Annual Research Meeting Seattle, WA June 25 2006. Overview of Presentation. Description of Medicaid Buy-In program Data construction
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A Descriptive Profile of Medicaid Buy-In Participants from Linked Multi-Agency Data Su Liu Henry T. Ireys Craig Thornton AcademyHealth Annual Research Meeting Seattle, WA June 25 2006
Overview of Presentation • Description of Medicaid Buy-In program • Data construction • Highlights from descriptive profile of participants • Concluding comments NOTE: research is conducted under a contract from the Centers for Medicare and Medicaid Services (CMS) (Contract no. 500-00-0047 05)
The Medicaid Buy-In Program • Encourages work by allowing individuals with disabilities to “buy into” Medicaid without giving up higher earnings or assets • Optional state program under Medicaid • Currently offered by 31 states • More than 120,000 individuals enrolled
Medicaid Buy-In: State Variation • Enacting legislation give states flexibility to • Set income and asset limitations • Establish premium rate structure • Require income verifications • Conduct outreach programs
Study Purpose • To develop quantitative measures of participation in the Buy-In program • Enrollment • Expenditures • Earnings
Data Integration Process MBI participants finder files from states CMS data systems SSA data systems Medicaid eligibility and claims Social security disability Medicare eligibility and claims Annual reported earnings Integrated Individual-Level Analytical File
Number of States and Participantsin Medicaid Buy-In Program, 1999-2005 NOTE: Enrollment as of 12/31/05 includes estimated number of participants in AZ, IN and MS, because of missing data. DATA SOURCE: Quarterly Medicaid Infrastructure Grant (MIG) reports from states
Distribution of Impairments Among Buy-In Participants, 27 States, 2000-2004 DATA SOURCE: Buy-In finder files from 27 states and SSA’s Ticket Research File
Distribution of Prior SSI and SSDI Status Among Buy-In Participants, 27 States, 2000-2004 DATA SOURCE: Buy-In finder files from 27 states and SSA’s Ticket Research File
Medicaid and Medicare Combined PMPM Expenditures ($) Among Buy-In Participants in 2002, by States DATA SOURCE: Buy-In finder files from 22 states, MSIS claims files, and Medicare enrollment database and claims files
Percent of Buy-In Participants with Reported EarningsEarning Above 100% FPL, by States, 2004 DATA SOURCE: Buy-In finder files from 27 states and SSA’s Master Earnings File
Demographic Distribution: High Earners vs. All Participants, 27 States, 2004 DATA SOURCE: Buy-In finder files from 27 states and SSA’s Master Earnings File
Concluding Comments • Many factors will shape future enrollment in Medicaid Buy-In program • Fiscal status of state Medicaid programs • Medicare Part D • Other public and private insurance initiatives • Support and advocacy from disability community • Changes in definition of disability • Statutory changes • Broad employment trends
Future Direction • State-Based Research Resource Center • Identify states’ research interests and needs • Facilitate access to resources and coordinate research activities • Enhance states’ research capacity and quality
Questions/Comments?SLiu@Mathematica-mpr.com Sign up to receive email updates on future Medicaid Buy-In and disability research issue briefs