Kentucky’s medicaid eligibility requirements contain a series of medical needs, which must be met in a combination of at least two in order for a recipient to be eligible. The eligibility is for either services in a nursing facility or home and community based waiver services; that is, health care services provided in the home. Such home based services are cheaper than a nursing facility, and for those with less substantial medical needs, the patient can stay in their own home for longer periods of time.
No one disputes the above facts. The puzzling part is what organic structure pushes more of the spending into nursing facilities, when home care is more desirable and less expensive. Kentucky health care advocates pointed that out earlier this week:
Advocates Tuesday urged a panel of lawmakers studying ways to better manage the state’s Medicaid program to consider more creative ways to serve the roughly 800,000 Kentuckians who depend on it for health care.
Jim Kimbrough, a volunteer with AARP of Kentucky, said most elderly and disabled people would rather stay in their homes and communities than move to an institution, such as a nursing home.
Services to help people stay at home — including personal care and housekeeping help — are much cheaper, Kimbrough told members of the Medicaid Cost Containment Task Force.
Yet in 2008 the Kentucky Medicaid program spent about $806 million to pay for the care of elderly and disabled individuals in institutions, compared to only $182 million on home and community services, he said.
“We can provide quality services to more people at the same amount,” Kimbrough said.
Sheila Schuster, executive director of the Kentucky Mental Health Coalition, asked lawmakers to consider Medicaid services as an investment. Access to mental health care and medication, for example, helps keep people out of costly psychiatric hospitals and allows many to work and pay taxes, Schuster said.
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