States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.
States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.
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DOI：
10.1177/1077558717737152
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发表时间：
2019-12
期刊：
影响因子：
--
通讯作者：
Mor V
中科院分区：
文献类型：
--
作者：
Keohane LM;Trivedi A;Mor V
医疗需要的途径可以为低收入医疗保险受益人提供临时的灾难性保险，否则他们没有资格获得全部医疗补助。在2009年1月至2010年6月期间，有医疗需要的州的低收入受益人加入医疗补助计划的比例高于没有此类计划的州（7.5%对4.1%，p < .01）。然而，在新的完全医疗补助参与者中，生活在一个有医疗需求的州与3.8个百分点相关。（调整后的95%置信区间[1.8，5.8]）切换到部分医疗补助的概率增加4.5个百分点（调整后的95%置信区间[2.9，6.2]）12个月内退出Medicaid的概率增加。当新的医疗补助参与者在医疗补助福利的第一个月只使用医院服务而不是养老院服务时，离开医疗补助的预测风险最大。保护低收入医疗保险受益人获得医疗服务的替代战略可以提供更稳定的覆盖面。
Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries’ access to care could provide more stable coverage.
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