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

Table 13F: HCBS Population Ages 18-64 Without I/DD or SMI

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 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	867	659	481	1,192	571	476	522	801
Asthma or Chronic Obstructive Pulmonary Disease	6,088	4,755	4,425	5,268	4,706	3,868	4,255	5,928
Congestive Heart Failure	5,445	5,372	4,663	5,842	5,103	4,405	4,341	6,316
Composite: Potentially Preventable Infection	8,752	7,632	5,695	7,451	7,833	5,797	5,920	8,912
Bacterial Pneumonia	4,899	4,125	3,495	4,116	4,248	3,564	3,543	4,804
Urinary Tract Infection	3,853	3,507	2,199	3,335	3,586	2,233	2,377	4,108
Infection Due to Device or Implant	2,058	1,987	1,367	2,093	1,853	1,407	1,481	2,174
Dehydration	2,170	2,045	1,276	2,050	2,016	1,232	1,376	2,363
Composite: ACSC Chronic Conditions	17,249	15,265	13,118	17,499	14,629	12,006	12,791	18,023
Composite: ACSC Acute Conditions	7,842	6,462	4,916	6,411	6,761	5,053	5,187	7,598
Composite: ACSC Overall	25,088	21,726	18,033	23,910	21,388	17,059	17,977	25,619
Pressure Ulcer	6,180	6,029	3,239	5,537	6,191	3,067	3,636	6,965
Injurious Falls	198	133	110	142	163	103	113	176

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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