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

Table 13G: HCBS Population Age 65+

Select for:

• Table 13A: National HCBS Population.
• 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.

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	150	158	109	177	152	77	114	169
Asthma or Chronic Obstructive Pulmonary Disease	6,648	5,474	3,596	5,270	5,576	3,280	4,002	6,249
Congestive Heart Failure	9,587	9,531	6,045	9,070	9,568	5,569	6,504	10,408
Composite: Potentially Preventable Infection	14,434	13,125	8,228	13,974	13,096	8,011	9,475	13,962
Bacterial Pneumonia	9,058	7,835	5,064	8,064	7,936	5,075	5,899	8,331
Urinary Tract Infection	5,376	5,290	3,165	5,910	5,160	2,936	3,576	5,630
Infection Due to Device or Implant	608	599	407	590	603	396	432	651
Dehydration	3,424	3,340	1,856	3,756	3,244	1,628	2,183	3,524
Composite: ACSC Chronic Conditions	19,478	18,495	12,326	17,796	18,594	10,894	13,266	20,272
Composite: ACSC Acute Conditions	13,786	12,476	7,767	12,667	12,688	7,427	8,999	13,250
Composite: ACSC Overall	33,261	30,970	20,092	30,462	31,280	18,320	22,265	33,519
Pressure Ulcer	4,497	4,649	3,696	5,077	4,632	2,818	3,647	5,097
Injurious Falls	708	596	386	463	713	390	404	719

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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