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

Table 13B: Dually Eligible HCBS Participants

Select for:

• Table 13A: National HCBS Population.
• 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	279	265	177	407	233	158	203	272
Asthma or Chronic Obstructive Pulmonary Disease	5,334	4,324	3,261	4,552	4,259	3,156	3,574	4,841
Congestive Heart Failure	6,786	6,610	4,812	6,648	6,377	4,821	5,103	7,074
Composite: Potentially Preventable Infection	11,104	10,143	7,164	10,514	9,962	7,357	8,053	10,649
Bacterial Pneumonia	6,877	6,029	4,467	6,080	6,019	4,631	5,025	6,331
Urinary Tract Infection	4,227	4,114	2,697	4,434	3,942	2,726	3,028	4,318
Infection Due to Device or Implant	873	807	600	902	785	618	661	844
Dehydration	2,577	2,499	1,623	2,804	2,389	1,547	1,836	2,616
Composite: ACSC Chronic Conditions	15,269	14,041	10,715	14,679	13,644	10,260	11,421	15,100
Composite: ACSC Acute Conditions	10,364	9,276	6,559	9,357	9,284	6,680	7,431	9,753
Composite: ACSC Overall	25,630	23,315	17,273	24,034	22,926	16,939	18,851	24,850
Pressure Ulcer	4,306	4,221	3,413	4,523	4,155	3,058	3,454	4,564
Injurious Falls	479	395	313	320	460	331	310	477

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.

Return to Contents
Return to Document