Scripps report finds more Ohioans being served for less

The proportion of Ohioans receiving long-term care Medicaid services in their own homes and communities to those receiving care in nursing homes has increased from less than ten percent in 1993 to 42 percent in 2009, according to a new Scripps Gerontology Center report.

The report, "Coming of Age: Tracking the Progress and Challenges of Delivering Long-Term Services and Supports in Ohio," emphasizes the shift to home and community services has lowered Ohio’s long-term care Medicaid spending on older people (when adjusted for inflation) over the past 12 years, while raising the average number of persons served each day by nearly 10,000.

The increase in non-institutional Medicaid services, the report observes, is due, in part, to the expansion of the state’s PASSPORT home-care program (from 15,000 to 30,000 participants) in roughly the same time period, coupled with the state’s recent provision of Medicaid-funded assisted living units and other home-care alternatives.

According to the report, Ohio’s average monthly Medicaid reimbursement for a PASSPORT client was $1,067, compared to $4,281 for a nursing home resident in the 2009 fiscal year. The report specifies a 14.5 percent decrease in Medicaid-funded nursing home use by Ohioans age 60 and older between 1997 and 2009, despite a 15 percent increase in Ohio’s overall 60 and older population, findings that are especially significant as Ohio’s severely disabled older population is expected to double by the year 2040.

The report, authored by Scripps researchers Shahla Mehdizadeh, Robert Applebaum, Ian Nelson and Jane Straker – and funded by the Ohio Department of Aging and the Ohio Long-Term Care Research Project – notes that, despite considerable gains over the past decade, Ohio still is below the national average in the proportion of Medicaid funds allocated to home and community-based services.

The report recommends that Ohio policy makers consider expanding preventive services for older persons; continue the successful measures of its newly implemented nursing home diversion and transition program; respond to the growing number of individuals under age 60 using nursing homes; and pay increasing attention to the high nursing home bed supply.

The full report is available online.