An Approach to Estimating State-Level Medicaid Nursing Home Spending.

Area of Science:

• Health Economics
• Public Health Policy
• Long-Term Care Research

Background:

• Medicaid nursing home spending is a significant component of healthcare expenditure.
• Accurate and comparable state-level data on nursing home payment rates are crucial for policy analysis.
• Existing data sources may have limitations in terms of accessibility or timeliness.

Purpose of the Study:

• To develop and validate a novel measure of state-level, average daily Medicaid nursing home spending rates.
• To utilize publicly available data for creating this new measure.
• To enable transparent and timely cross-state comparisons of Medicaid nursing home payment rates.

Main Methods:

• A new measure was calculated by dividing average daily Medicaid spending by estimated Medicaid days in nursing homes.
• Data were sourced from Brown University's Long-Term Care Focus and the Medicaid Long-Term Services and Supports Annual Expenditure Report.
• The new measure was validated by comparing it to existing benchmarks from 2004 and 2019 using Pearson and Spearman rank correlation coefficients.

Main Results:

• The developed measure showed strong positive correlations with historical data (Pearson r=0.70, Spearman ρ=0.80).
• Correlations with government-published estimates were also strong (Pearson r=0.68, Spearman ρ=0.63).
• These findings indicate the reliability and validity of the new measure.

Conclusions:

• A validated, reliable, and transparent measure for comparing state-level Medicaid nursing home payment rates has been established.
• This measure exclusively uses publicly available data, removing barriers associated with restricted or proprietary information.
• The approach facilitates timely policy evaluation and enhances transparency in long-term care spending analysis.