Transition Rates from the Community to Nursing Home Care among Older Adult Medicaid Enrollees, 2006-2009

This study is a follow-up to earlier research conducted with 2006 and 2009 Medicaid (MAX) data on interstate variations on the extent of the "re-balancing" of Medicaid long-term services and supports (LTSS) from nursing home care toward greater reliance on home and community-based services (HCBS). The present study reports interstate variations in transition rates of older adult Medicaid enrollees from the community in 2006 to Medicaid-funded nursing home care over the three-year period from 2007 through 2009. Transition rates by state were measured for older Medicaid enrollees residing in the community in 2006 who were receiving HCBS waiver services, those receiving only state plan personal care services, and those receiving no community LTSS. The study also looked for statistically significant correlations between lower transition rates to nursing home care and variations in state Medicaid LTSS program design.