Outcome Indicators | HCBS Subpopulations | Total | |||||
---|---|---|---|---|---|---|---|
Dually Eligible |
Medicaid Only | I/DD | SMI | Ages 18-64 Without I/DD or SMI |
Age 65+ | ||
Eligible Population (n) | 1,198,581 | 427,169 | 392,412 | 237,181 | 356,839 | 776,180 | 1,625,750 |
Short-Term Complications of Diabetes | 231 | 454 | 155 | 506 | 628 | 134 | 288 |
Min | 89 | s | s | s | 74 | s | 68 |
Max | 825 | 2,273 | 776 | 3,129 | 3,229 | 770 | 1,188 |
Asthma or Chronic Obstructive Pulmonary Disease | 4,089 | 3,217 | 726 | 4,987 | 4,892 | 4,843 | 3,865 |
Min | 1,053 | 346 | s | 995 | 941 | 2,097 | 820 |
Max | 9,925 | 7,232 | 1,886 | 13,038 | 10,886 | 12,777 | 9,165 |
Congestive Heart Failure | 5,904 | 2,892 | 656 | 3,396 | 5,093 | 7,965 | 5,131 |
Min | 1,698 | 207 | 152 | 738 | 1,539 | 3,920 | 1,207 |
Max | 12,025 | 8,246 | 1,791 | 10,460 | 22,149 | 14,483 | 10,538 |
Composite: Potentially Preventable Infection | 9,108 | 4,913 | 4,418 | 7,319 | 7,059 | 11,154 | 8,031 |
Min | 5,714 | 3,249 | 2,071 | 4,532 | 3,702 | 6,023 | 5,222 |
Max | 16,350 | 10,214 | 7,406 | 29,707 | 14,693 | 21,969 | 14,313 |
Bacterial Pneumonia | 5,556 | 3,115 | 2,957 | 4,704 | 4,023 | 6,809 | 4,929 |
Min | 3,632 | 1,654 | 1,294 | 2,598 | 1,969 | 3,838 | 3,368 |
Max | 10,243 | 5,815 | 4,873 | 16,876 | 8,135 | 13,021 | 8,903 |
Urinary Tract Infection | 3,552 | 1,798 | 1,461 | 2,615 | 3,036 | 4,345 | 3,102 |
Min | 1,717 | 907 | 378 | 1,133 | 1,733 | 2,184 | 1,668 |
Max | 7,851 | 4,399 | 2,777 | 12,831 | 8,455 | 10,014 | 6,677 |
Infection Due to Device or Implant | 735 | 817 | 306 | 741 | 1,744 | 514 | 756 |
Min | 136 | s | s | 373 | 551 | s | 326 |
Max | 1,403 | 2,460 | 614 | 3,208 | 5,749 | 1,706 | 1,661 |
Dehydration | 2,153 | 1,176 | 699 | 1,983 | 1,751 | 2,685 | 1,903 |
Min | 611 | 230 | s | 554 | 473 | 1,094 | 660 |
Max | 4,360 | 2,851 | 1,391 | 5,528 | 4,316 | 5,489 | 3,825 |
Composite: ACSC Chronic Conditions | 12,917 | 8,971 | 2,094 | 11,657 | 14,782 | 15,888 | 11,903 |
Min | 3,362 | 899 | 261 | 1,990 | 2,127 | 7,201 | 2,551 |
Max | 23,374 | 20,105 | 5,715 | 25,802 | 39,035 | 29,637 | 22,419 |
Composite: ACSC Acute Conditions | 8,375 | 4,328 | 3,390 | 6,998 | 6,105 | 10,591 | 7,336 |
Min | 5,210 | 2,515 | 1,411 | 4,300 | 3,127 | 5,599 | 4,623 |
Max | 15,478 | 9,203 | 5,798 | 22,873 | 12,915 | 19,987 | 13,724 |
Composite: ACSC Overall | 21,290 | 13,299 | 5,484 | 18,655 | 20,885 | 26,477 | 19,238 |
Min | 8,898 | 3,664 | 1,673 | 9,225 | 5,672 | 13,799 | 7,174 |
Max | 38,852 | 29,161 | 10,824 | 48,675 | 50,219 | 49,623 | 36,143 |
Pressure Ulcer | 3,905 | 2,269 | 1,404 | 2,683 | 4,903 | 4,190 | 3,485 |
Min | 1,699 | 551 | 314 | 557 | 2,139 | 1,290 | 1,542 |
Max | 9,705 | 9,543 | 3,880 | 11,437 | 19,518 | 10,881 | 9,572 |
Injurious Falls | 378 | 65 | 73 | 242 | 137 | 522 | 298 |
Min | s | s | s | s | s | s | s |
Max | 1,764 | 621 | 274 | 1,243 | 711 | 3,282 | 1,400 |
Notes:
ACSC = ambulatory care-sensitive condition; I/DD = intellectual and development disabilities; SMI = serious mental illness.
a. All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS population. HCBS population for outcome indicators excludes: individuals under age 18; people with only institutional use in a given quarter; people on managed care plans; and people in the States of Arizona, Maine, Washington, and Wisconsin.
Minimum (min) and maximum (max) defined as lowest rate and highest rate among States.
Dually eligible = dually eligible for Medicaid and Medicare. Eligibility for Medicare defined as inclusion in Medicare Denominator File.
Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.
HCBS subpopulations of I/DD, SMI, Under 65 Without I/DD or SMI, and 65+ are defined as in the Appendix.
s = Suppressed due to small cell size.
Source: Agency for Healthcare Research and Quality (AHRQ), Medicaid Analytic eXtract (MAX) data, and Medicare Provider Analysis and Review (MedPAR) data.