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

Table 13A: National Home and Community-Based Services Population

Select for:

• Table 13B: Dually Eligible HCBS Participants.
• Table 13C: Medicaid-Only HCBS Participants.
• Table 13D: I/DD Subpopulation.
• Table 13E: SMI Subpopulation.
• Table 13F: HCBS Population Ages 18-64 Without I/DD or SMI.
• Table 13G: HCBS Population Age 65+.

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	376	319	222	534	271	215	251	344
Asthma or Chronic Obstructive Pulmonary Disease	5,029	4,037	3,180	4,196	3,954	3,070	3,401	4,560
Congestive Heart Failure	5,931	5,724	4,236	5,807	5,514	4,275	4,408	6,215
Composite: Potentially Preventable Infection	9,912	8,973	6,332	9,402	8,769	6,562	7,060	9,488
Bacterial Pneumonia	6,141	5,349	4,001	5,448	5,307	4,181	4,457	5,636
Urinary Tract Infection	3,771	3,624	2,331	3,953	3,462	2,381	2,602	3,851
Infection Due to Device or Implant	925	851	594	930	812	652	658	904
Dehydration	2,360	2,241	1,392	2,502	2,140	1,335	1,590	2,372
Composite: ACSC Chronic Conditions	14,225	12,865	9,986	13,648	12,385	9,652	10,489	14,025
Composite: ACSC Acute Conditions	9,217	8,136	5,763	8,316	8,103	5,945	6,476	8,625
Composite: ACSC Overall	23,439	21,000	15,748	21,963	20,486	15,596	16,965	22,647
Pressure Ulcer	4,010	3,925	2,853	4,175	3,854	2,547	2,961	4,271
Injurious Falls	396	318	235	265	370	246	243	380

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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