Journal article
Medicaid Cost Savings of a Preventive Home Visit Program for Disabled Older Adults
Journal of the American Geriatrics Society (JAGS), v 66(3), pp 614-620
01 Mar 2018
PMID: 29165789
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background/ObjectivesLittle is known about cost savings of programs that reduce disability in older adults. The objective was to determine whether the Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program saves Medicaid more money than it costs to provide.
DesignSingle-arm clinical trial (N = 204) with a comparison group of individuals (N = 2,013) dually eligible for Medicaid and Medicare matched on baseline geographic and demographic characteristics, chronic conditions, and healthcare use. We used finite mixture model regression estimates in a Markov model.
SettingBaltimore, MD
ParticipantsIndividuals aged 65 and older with reported difficulty with at least one activity of daily living.
InterventionCAPABLE is a 5-month program to reduce the health effects of impaired physical function in low-income older adults by addressing individual capacity and the home environment. CAPABLE uses an interprofessional team (occupational therapist, registered nurse, handyman) to help older adults attain self-identified functional goals.
MeasurementsMonthly average Medicaid expenditure and likelihood of high- or low-cost use of eight healthcare service categories.
ResultsAverage Medicaid spending per CAPABLE participant was $867 less per month than that of their matched comparison counterparts (observation period average 17 months, range 1-31 months). The largest differential reduction in expenditures were for inpatient care and long-term services and supports.
ConclusionCAPABLE is associated with lower likelihood of inpatient and long-term service use and lower overall Medicaid spending. The magnitude of reduced Medicaid spending could pay for CAPABLE delivery and provide further Medicaid program savings due to averted services use.
Clinical trial registrationCAPABLE for Frail dually eligible older adults NCT01743495
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Details
- Title
- Medicaid Cost Savings of a Preventive Home Visit Program for Disabled Older Adults
- Creators
- Sarah L. Szanton - University of BaltimoreY. Natalia Alfonso - Bloomberg (United States)Bruce Leff - University of BaltimoreJack Guralnik - University of Maryland, BaltimoreJennifer L. Wolff - Bloomberg (United States)Ian Stockwell - University of Maryland, Baltimore CountyLaura N. Gitlin - University of BaltimoreDavid Bishai - Bloomberg (United States)
- Publication Details
- Journal of the American Geriatrics Society (JAGS), v 66(3), pp 614-620
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- 1C1CMS330970-01 / CMS Innovation Award
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University
- Web of Science ID
- WOS:000427256700031
- Scopus ID
- 2-s2.0-85034732500
- Other Identifier
- 991020112082304721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology