In the News

What is the marginal benefit of payment‐induced family care? Impact on Medicaid spending and health of care recipients

Author: Coe, NB, J Guo, RT Konetzka, CH Van Houtven
Research on home‐based long‐term care has centered almost solely on the costs; there has been very little, if any, attention paid to the relative benefits. This study exploits the randomization built into the Cash and Counseling Demonstration and Evaluation program that directly impacted the likelihood of having family involved in home care delivery. They find that some family involvement in home‐based care significantly decreases health‐care utilization: lower likelihood of emergency room use, Medicaid‐financed inpatient days, any Medicaid hospital expenditures, and fewer months with
Type: Long-term care, Informal Care

Five-Year Cost of Dementia to Medicare

Author: Lindsay White, Paul Fishman, Anirban Basu, Paul K. Crane, Eric B. Larson, Norma B. Coe
About 5.5 million older adults are living with dementia, a chronic, progressive disease characterized by severe cognitive decline. This number will likely grow significantly as the U.S. population ages, which has cost implications for the Medicare program. A full accounting of these additional expenses will help policymakers plan for them in their Medicare budgets. This study examined survival and Medicare expenditures in older adults with and without dementia to estimate dementia’s incremental costs to Medicare in the five years after diagnosis. Patients with dementia had significantly
Type: ADRD, Aging, Medicare

Medicare expenditures attributable to dementia

Author: White, L, P Fishman, A Basu , EB Larson, NB Coe
This article estimates dementia's incremental cost to the traditional Medicare program. The authors compared Medicare expenditures for 60 months following a claims-based dementia diagnosis to those for a randomly selected, matched comparison group.   Dementia's five-year incremental cost to the traditional Medicare program is approximately $15 700 per patient, nearly half of which is incurred in the first year after diagnosis. Increased costs for individuals with dementia were driven by more intensive use of Medicare part A covered services.
Type: ADRD

Patient Outcomes After Hospital Discharge to Home With Home Health Care vs to a Skilled Nursing Facility

Author: Werner, R.M., NB Coe, M. Qi, and R.T. Konetzka
This article examines how patient outcomes and Medicare spending are affected by the decision to discharge patients to home with home health care vs to a skilled nursing facility for postacute care. The authors find that among Medicare beneficiaries eligible for postacute care at home or in a skilled nursing facility, discharge to home with home health care was associated with higher rates of readmission, no detectable differences in mortality or functional outcomes, and lower Medicare payments.
Type: Aging, Post-Acute Care

A Comprehensive Measure of the Costs of Caring For a Parent: Differences According to Functional Status

Author: Norma B. Coe, Meghan M. Skira, Eric B. Larson
Providing unpaid care for an older parent has costs that go well beyond a caregiver’s lost wages. A new estimate suggests that the median direct and indirect costs of caregiving are $180,000 over two years, about the same as full-time institutional care. This estimate accounts for lost earnings as well as non-tangible factors, such as lost leisure time and changes to the caregiver’s well-being. It suggests that informal care cost caregivers at least $277 billion in 2011, which is 20 percent higher than estimates that only consider lost wages.
Type: Aging, Labor Market/Retirement, Long-term care, Caregiving, Informal Care