Affordable Access

deepdyve-link
Publisher Website

Medicaid Contributes Substantial Costs to Dementia Care in an Ethnically Diverse Community.

Authors
  • Zhu, Carolyn W1, 2
  • Ornstein, Katherine A1
  • Cosentino, Stephanie3
  • Gu, Yian3
  • Andrews, Howard4
  • Stern, Yaakov3
  • 1 Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • 2 James J Peters VA Medical Center, Bronx, New York.
  • 3 Cognitive Neuroscience Division of the Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, New York.
  • 4 Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York.
Type
Published Article
Journal
The journals of gerontology. Series B, Psychological sciences and social sciences
Publication Date
Aug 13, 2020
Volume
75
Issue
7
Pages
1527–1537
Identifiers
DOI: 10.1093/geronb/gbz108
PMID: 31425587
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The main objective of this study was to estimate effects of dementia on Medicaid expenditures in an ethnically diverse community. The sample included 1,211 Medicare beneficiaries who did not have any Medicaid coverage and 568 who additionally had full Medicaid coverage enrolled in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multiethnic, population-based, prospective study of cognitive aging in northern Manhattan (1999-2010). Individuals' dementia status was determined using a rigorous clinical protocol. Relationship between dementia and Medicaid coverage and expenditures were estimated using a two-part model. In participants who had full Medicaid coverage, average annual Medicaid expenditures were substantially higher for those with dementia than those without dementia ($50,270 vs. $21,966, p < .001), but Medicare expenditures did not differ by dementia status ($8,458 vs. $9,324, p = .19). In participants who did not have any Medicaid coverage, average annual Medicare expenditures were substantially higher for those with dementia than those without dementia ($12,408 vs. $8,113, p = .02). In adjusted models, dementia was associated with a $6,278 increase in annual Medicaid spending per person after controlling for other characteristics. Results highlight Medicaid's contribution to covering the cost of dementia care in addition to Medicare. Studies that do not include Medicaid are unlikely to accurately reflect the true cost of dementia. Published by Oxford University Press on behalf of The Gerontological Society of America 2019.

Report this publication

Statistics

Seen <100 times