Impact of Managed Long-Term Services and Supports on Nursing Home Use
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View abstract on PubMed
Summary
This summary is machine-generated.Managed long-term services and supports (MLTSS) programs reduced the share of older adults in long-stay Medicaid nursing homes by 5.83%. These programs help rebalance care towards home and community settings, though targeting low-care residents may need further design adjustments.
Area Of Science
- Health Services Research
- Public Health Policy
- Gerontology
Background
- States increasingly use managed care organizations for long-term services and supports (LTSS).
- The goal is to shift LTSS utilization from nursing homes to home and community-based settings.
- Managed long-term services and supports (MLTSS) programs are a key strategy in this rebalancing effort.
Purpose Of The Study
- To evaluate the impact of MLTSS programs on long-stay nursing home visits funded by Medicaid.
- To determine if MLTSS facilitates the rebalancing of LTSS away from institutional care.
Main Methods
- Analysis of Minimum Data Set (MDS) 3.0 and Master Beneficiary Summary Files (MBSF) from 2011-2021.
- Inclusion of 3,685,771 older adults (65+) with long-stay nursing home stays.
- Application of a staggered difference-in-differences (DiD) regression design comparing states with and without MLTSS.
Main Results
- A 5.83% decrease in the proportion of older adults in long-stay nursing homes in states with MLTSS compared to those without.
- Overall Medicaid nursing home enrollment for older adults declined between 2011 and 2021.
- No significant change observed in the proportion of low-care needs residents due to MLTSS implementation.
Conclusions
- MLTSS programs show potential in achieving state objectives for rebalancing Medicaid LTSS.
- Findings suggest a successful shift from nursing home utilization towards community-based settings.
- Further program design modifications may be needed to specifically address nursing home residents with lower care requirements.
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