Do State Medicaid Policies Affect the Risk of Nursing Home Entry among the Elderly?

Abstract

This study investigates the effects of five state Medicaid policies on the risk of nursing home entry among a recent cohort of older persons. Longitudinal data from the first (1993) and second (1995) waves of the Asset and Health Dynamics Among the Oldest Old Survey and continuous-time hazard models are used for the analyses. Separate models are developed for women and men, each controlling for a variety of demographic, socioeconomic, and health-related characteristics of sample persons. Findings suggest that the state Medicaid policies included in the analyses do not significantly affect the risk of nursing home use among women or men and that the strongest predictors of the risk are health-related characteristics. Circumstantial evidence is presented to argue that the lack of policy effects might be due to changes in recent decades in health care policies driven by cost containment efforts.