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AHR: Medicaid & Deficit Reduction Briefing November 10, 2011

AHR: Medicaid & Deficit Reduction Briefing November 10, 2011. Medicaid Coverage: Long-Term Care & Dual Eligibles Bruce A. Chernof, M.D. President & CEO. 40% of long-term care is financed by Medicaid. * Numbers do not sum to 100% due to rounding.

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AHR: Medicaid & Deficit Reduction Briefing November 10, 2011

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  1. AHR: Medicaid & Deficit Reduction Briefing November 10, 2011 Medicaid Coverage: Long-Term Care & Dual Eligibles Bruce A. Chernof, M.D. President & CEO

  2. 40% of long-term care is financed by Medicaid * Numbers do not sum to 100% due to rounding. ** Private insurance payments include Medigap insurance as well as long-term care insurance. ***Other sources include the Veterans’ Administration, individual state programs and private philanthropy.

  3. Trend toward HCBS over institutional care for Medicaid LTC expenditures Source: Burwell, B., Sredl, K., and Eiken, S. Medicaid expenditures for LTC services, 1995-2007. HCBS.org. *HCBS = home and community-based services; ICF-MR = intermediate care facilities for the mentally retarded

  4. HCBS spending as % of Medicaidlong-term care spending by state WA ME VT MT ND NH MN OR MA WI NY ID CT RI SD MI WY PA NJ IA NE DE OH NV IL IN MD WV UT VA D.C. CA CO MO KY KS NC TN OK SC AZ AR NM MS AL GA LA TX AK FL HI 50%+ 40% to 49.9% 30% to 39.9% <30% Source: Analysis of data from the CMS Form 64 performed by Eiken, S., Sredl, K., Burwell, B., Gold, L. “Medicaid Long-Term Care Expenditures, FY 2009.” HCBS ClearingHouse, August 2010. http://hcbs.org/moreInfo.php/nb/doc/3325/Medicaid_Long_Term_Care_Expenditures_FY_2009

  5. Duals are 17% of Medicare population, but 28% of those with 5+ chronic conditions Percent of Total Medicare Population (N=45 million) Percent of Medicare Population with 5 or More Chronic Conditions (N=585,740)

  6. Duals are more likely to use health services than Medicare-only beneficiaries

  7. Older Duals have more chronic conditions and functional impairment than Medicare-only beneficiaries 1 N = 3,800,892 dual eligibles and 23,913,710 Medicare-only beneficiaries. Excludes beneficiaries who died during the year.

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