Medicaid Spenddown in Nursing Homes and the Community

摘要

The paper employs information from nationally representative surveys to examine the incidence and causes of Medicaid spenddown among disabled elderly persons. About 10 percent of nursing home discharges experience 'asset spenddown,' the process of converting from private pay to Medicaid. In contrast, over 50 percent of nursing home patients remain private pay throughout their stays. The incidence of spenddown to Medicaid in the community is greater than the incidence of spenddown in nursing homes, and appears to be more strongly related to medical care costs than community-based long-term care costs. Implications of findings for health care policies are discussed.