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Research on Aging
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Medicaid Nursing Facility Utilization

Martin Kitchener

University of California, San Francisco

James H. Swan

University of North Texas

Charlene Harrington

University of California, San Francisco

This study uses a longitudinal California data set (1995 to 2000) to address two concerns about Medicaid nursing facility (NF) utilization. First, to consider the impact of national cost-control policies, the authors analyze data trends in Medicaid NF participants, days of care, and expenditures. Second, the authors investigate the percentage of Medicaid days of care (%MDOC) using a panel regression model to consider resident, facility, and county market predictors. The findings show that although statewide Medicaid NF participants, expenditures, and%MDOC remain stable, Medicaid market segmentation persistes, with program participants distributed unevenly among facilities. Factors associated positively with facility%MDOC are the proportion of minority residents, a larger facility size, for-profit status, the percentage of aged Black persons in the county, and market concentration. The factors associated negatively with%MDOC are the percentages of resident men, residents aged 85 or older, residents with Alzheimer’s disease, Medicaid reimbursement rates, and county wealth.

Key Words: nursing homes • access • Medicaid • policy

Research on Aging, Vol. 28, No. 4, 493-514 (2006)
DOI: 10.1177/0164027506287790


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