Medicaid HCBS Caregiver Payment Policy and Post-Discharge Visits Among Dual-Eligible Older Adults With ADRD
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View abstract on PubMed
Summary
This summary is machine-generated.State policies offering Home- and Community-Based Services (HCBS) caregiver payments increase timely post-discharge visits for dementia patients. Payments to two caregiver types particularly boosted in-person follow-up care.
Area Of Science
- Gerontology
- Health Services Research
- Public Health Policy
Background
- Older adults with dementia often require post-hospitalization care.
- Timely follow-up visits are crucial for managing dementia patients' health after discharge.
- Home- and Community-Based Services (HCBS) play a vital role in supporting these individuals.
Purpose Of The Study
- To investigate the link between state HCBS caregiver payment policies and timely follow-up visits for dementia patients.
- To analyze the impact of different caregiver payment structures on in-person versus telehealth visits within 14 days of discharge.
Main Methods
- Analysis of 2021 Medicare claims data for 51,633 dual-eligible beneficiaries with dementia.
- Categorization of state HCBS caregiver payment policies into three groups: no payment, payment for friends/family, and payment for two caregiver types.
- Multinomial logistic regression with hospital random effects to assess associations with follow-up visit modes (in-person, telehealth, no visit).
Main Results
- State HCBS caregiver payment policies significantly influenced the mode of timely follow-up visits.
- States with payments for two caregiver types showed a 6.8% higher probability of timely in-person visits but a 3.2% lower probability of timely telehealth visits compared to states with no payments.
- Other HCBS generosity measures and demographic factors were also associated with post-discharge visit patterns.
Conclusions
- Financial support for family caregivers via state HCBS policies can enhance timely post-discharge visits, especially in-person visits.
- Policies allowing payments to multiple caregiver types demonstrated the most significant impact.
- These findings highlight the importance of caregiver payment policies in improving post-discharge care for dementia patients.
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