Research Methods: Statistical Analysis

Profile of Rural Residential Care Facilities: A Chartbook

Abstract: 

As federal and state policymakers consider their most cost-effective options for strengthening rural long-term services and supports (LTSS), more information is needed about the current system of care. Using data from the 2010 National Survey of Residential Care Facilities, this chartbook from the Maine Rural Health Research Center presents information on a slice of the rural LTSS continuum—the rural residential care facility (RCF).  Survey results identify important national and regional differences between rural and urban RCFs, focusing on the facility, resident and service characteristics of RCFs and their ability to meet the LTSS needs of residents.  Rural RCFs are more likely to have private pay patients compared to urban facilities and their residents have fewer disabilities as measured by their functional assistance needs.  Compared to urban facilities, the policies of rural RCFs appear less likely to support aging in place.

Suggested Citation: Lenardson JD, Griffin E, Croll Z, Ziller EC, Coburn AF. Profile of Rural Residential Care Facilities: A Chartbook. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2014.

Publication Type: 
Report
Publish Date: 
May 20, 2014
URL: 
http://muskie.usm.maine.edu/Publications/rural/Chartbook-Rural-Res-Care-Facilities.pdf

Rural Residents More Likely to be Enrolled in High Deductible Health Plans

Abstract: 

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance Marketplaces.

Rural residents with private insurance are more likely to have an HDHP than are urban, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents, suggesting that it will be important to monitor HDHP enrollment, plan affordability, and health plan literacy among plans available through the Health Insurance Marketplaces.

Full report (Working Paper): High Deductible Health Insurance Plans in Rural Areas

Suggested Citation: Lenardson JD, Ziller EC, Coburn AF. Rural Residents More Likely to Be Enrolled in High Deductible Health Plans. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2014. Research & Policy Brief PB-55.

Publication Type: 
Research and Policy Brief
Publish Date: 
May 13, 2014
URL: 
http://muskie.usm.maine.edu/Publications/rural/PB55-High-Deductible-Health-Plans-Rural.pdf

High Deductible Health Insurance Plans in Rural Areas

Abstract: 

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance Marketplaces.

Rural residents with private insurance are more likely to have an HDHP than are urban, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents, suggesting that it will be important to monitor HDHP enrollment, plan affordability, and health plan literacy among plans available through the Health Insurance Marketplaces.

Associated Research & Policy Brief: Rural Residents More Likely to be Enrolled in High Deductible Health Plans

Suggested Citation: Lenardson JD, Ziller EC, Coburn AF. High Deductible Health Insurance Plans in Rural Areas. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2014. Working Paper #55.

Publication Type: 
Report
Publish Date: 
May 13, 2014
URL: 
http://muskie.usm.maine.edu/Publications/rural/High-Deductible-Insurance-Plans-Rural.pdf

Dementia in Maine: Characteristics, Care, and Cost Across Settings [CHARTBOOK]

Abstract: 

The World Health Organization and Alzheimer’s Disease International have recommended that dementia be considered a public health priority for all nations. The number of people with Alzheimer’s disease in Maine is expected to nearly double from about 26,000 persons in 2010 to nearly 50,000 by 2030. As the oldest state in the nation, Maine faces the impending impact of this disease on its social systems, community resources and its health and long term care systems.  In particular, service and use patterns highlighted in this report indicate that Maine’s long term care system is increasingly becoming a system of care for people with dementia.

This report provides a baseline picture of the current use of services by people with and without dementia in Maine. While this provides a comprehensive view of those accessing services through state funded home care programs or other MaineCare funded long term care services, it does not include the costs of informal care by caregivers, friends and family members. Nor does it include the out-of-pocket costs that many incur with private resources to care for a family member. We hope, however, that this information will be useful to those who are planning for the future of Maine’s long term care system and the needs of people with dementia and their families and caregivers.

Suggested Citation: Fralich J, Bratesman S, Olsen L, et al. Dementia in Maine: Characteristics, Care, and Cost Across Settings. Portland, ME: University of Southern Maine, Muskie School of Public Service; December, 2013.

For more information contact: Julie Fralich Julief@usm.maine.edu; 207-780-4848; Stuart Bratesman sbrates@usm.maine.edu; or  Louise Olsen louiseo@usm.maine.edu

This report was prepared under a Cooperative Agreement between the Muskie School of Public Service, University of Southern Maine and the Maine Department of Health and Human Services, Office of Aging and Disability Services.  This work was funded under Cooperative Agreement number CA-ES-13-251.

Publication Type: 
Report
Publish Date: 
December 31, 2013
URL: 
http://muskie.usm.maine.edu/Publications/DA/Dementia-Maine-Chartbook-2013.pdf

Improving Health Outcomes for Children (IHOC): Summary of pediatric quality measures for children enrolled in MaineCare FFY 2009 - FFY 2012

Abstract: 

This report, authored by USM Muskie School research staff, presents the results of the 16 CHIPRA Core Measures that were collected using MaineCare claims or Vital Statistics data and reported in the State of Maine’s FFY 2012 CHIP Annual Report to the Centers for Medicare and Medicaid Services (CMS). Also included in this report are an additional three measures from the Improving Health Outcomes for Children (IHOC) project’s Master List of Pediatric Measures. In addition to presenting results in graphs and narrative, this report also provides measure definitions and background information about each measure topic.

The goal of this document is to present the claims- and vital statistics-based CHIPRA and IHOC measure results in a user-friendly format for IHOC project stakeholders. Measures are grouped by topic. For each topic, a Background section provides a brief description and rationale for collection. (The background discussion for CHIPRA Core Measures is drawn from the Background Report for the Initial, Recommended Core Set of Children’s Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs. Available at: http://www.ahrq.gov/chipra/corebackgrnd.htm) Next, we provide a general description of how each measure is defined, followed by the results.

Suggested citation: Anderson N, Meagher T. Improving Health Outcomes for Children (IHOC): Summary of Pediatric Quality Measures for Children Enrolled in MaineCare FFY 2009 - FFY 2012.   Portland, ME: University of Southern Maine, Muskie School of Public Service; April 2013.

Publication Type: 
Report
Publish Date: 
April 30, 2013
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/ihoc/Summary_of_Pediatric_Quality_Measures_2012.pdf

Older Adults and Adults With Disabilities: Population and Service Use Trends in Maine, 2012 Edition. Chartbook.

Abstract: 

This Chartbook is an update to the Chartbook: Older Adults and Adults with Physical Disabilities: Population and Service Use Trends in Maine 2010. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services continues to be a critical public policy issue in the State and nationally. The information in this Chartbook is provided to help inform state policy makers, legislators, providers, advocates and others with an interest in this subject.

Outline of the Chartbook:

  • Sections 1-4 of this Chartbook provide general demographic information on historical and projected change in the population of older adults in Maine, by county and compared with other states. These sections also provide an overview of the number of older adults who live in poverty, have a disability and live in rural areas.
  • Sections 5 and 6 provide comparisons of the characteristics of people who live in nursing facilities, residential care facilities and at home.
  • Sections 7-10 examine the trends in the use and “case mix” of people in nursing facilities and residential care facilities.
  • Section 11 provides an overview of the supply of nursing and residential care facilities and beds.
  • Section 12 includes a summary of selected quality indicators across long term care settings.
  • Section 13 provides a comparison of the use of services across long term care settings and
  • Section 14 provides comparative expenditure data.

When referencing or using any of the charts or other materials in the Chartbook, please use the following recommended citation:

Fralich, J. et al., Older Adults and Adults with Disabilities: Population and Service Use Trends in Maine, 2012 Edition. (Chartbook). Portland, ME: University of Southern Maine, Muskie School of Public Service; 2012. Available at: http://muskie.usm.maine.edu/Publications/DA/Adults-Disabilities-Maine-Se...

Publication Type: 
Report
Publish Date: 
December 30, 2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/Adults-Disabilities-Maine-Service-Use-Trends-chartbook-2012.pdf

Members Dually Eligible for MaineCare and Medicare Benefits: MaineCare and Medicare Expenditures and Utilization, State Fiscal Year 2010. Chartbook.

Abstract: 

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services.  This first report provides a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008-2010.  This report provides baseline data on the characteristics of Medicare-MaineCare members who are dually eligible, the distribution of expenditures across categories of service for MaineCare and Medicare, and the cost of care for people with select chronic conditions. The report includes information on members considered full benefit as well as those who are partial benefit members.  Partial benefit members are also know as Qualified Medicare Beneficiaries, Specified Low Income Medicare Beneficiaries; Qualified Individuals; and Qualified Disabled and Working Individuals.  Individuals who are dually eligible for MaineCare and Medicare typically have multiple chronic conditions, high medical and long term care costs, and low income. Medicare covers hospital, medical, skilled long term care and pharmacy services while Medicaid pays for behavioral health, community based long term services and supports and nursing home services. The integration of services and benefits for people who are dually eligible is a challenge for states and the federal government. As states move to introduce value based purchasing initiatives through health homes, accountable care communities and other managed care efforts, the need to coordinate services and align incentives between the Medicaid and Medicare programs becomes increasingly critical. Many states are involved in dual eligible demonstrations to improve the integration of services, benefits and care.

Suggested Citation:

McGuire C, Gressani T, Bratesman S, Fralich J, Griffin E.  Members Dually Eligible for MaineCare and Medicare Benefits: MaineCare and Medicare Expenditures and Utilization, State Fiscal Year 2010. (Chartbook).  Portland, ME: University of Southern Maine, Muskie School of Public Service; October 2012.


Publication Type: 
Report
Publish Date: 
October 30, 2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/DualEligible-Chartbook-SFY2010.pdf

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