Excess mortality for this disability group was found to be 7.4 times higher than age-matched community-dwelling Medicaid recipients not receiving home-based and community-based services, and 26.6 times higher than the general population.
Mortality appeared to be higher among beneficiaries receiving Medicaid home and community-based services (HCBS) compared to beneficiaries not receiving these services during the COVID-19 pandemic.
Data shared in a recent analysis published in Health Affairs were collected from 14 private health plans in 12 US states during the first months of the pandemic, from March 2020 to December 2020. Data were collected to examine excess mortality in recipients younger than 65 years. The year he received Medicaid Long Term Service and Support (LTSS) in the form of HCBS.
The authors of the analysis shared that over 23% of all COVID-19-related deaths in the United States are associated with long-term care facilities. However, little is known about her impact of COVID-19 on people in need of long-term services and support with disabilities who do not live in these facilities. People with disabilities typically receive care through Medicaid HCBS.
Excess mortality for this disability group was found to be 7.4 times higher than age-matched community-dwelling Medicaid recipients not receiving home-based and community-based services, and 26.6 times higher than the general population. As a percentage of expected mortality, excess mortality among her HCBS recipients aged 65 years and older was slightly higher, but comparable to nursing home residents.
The monthly sample for analysis consisted of approximately 55,000 adults under age 65 and 90,000 adults age 65 and older receiving Medicaid HCBS.
These groups of HCBS recipients suffer from high mortality due to social barriers, individual risk factors, and likely indirect effects. People receiving Medicaid HCBS have a higher proportion of secondary health conditions that contribute to an increased risk of contracting COVID-19 and experiencing worse outcomes. Living in a group setting or participating in a gathering day program puts you at higher risk of exposure. Additionally, people are typically dependent on daily face-to-face services provided by caregivers who enter their homes on a regular basis, further increasing their risk of exposure to COVID-19.
Additionally, with the spread of COVID-19, persons with disabilities, family caregivers, and direct care workers in the community faced significant barriers in obtaining and testing PPE. Staffing was also an issue with the availability of these caregivers, preventing patients from receiving the daily support and services they needed. Although more research is needed, people with the disorder report delaying or not receiving regular preventative or special care during that period. analysis said it could give
The authors say the study will help shed light on a largely invisible population in public discourse and the response to COVID-19. Their findings highlight the vulnerability of the HCBS population during the pandemic. It highlights sexuality.
For example, early in the pandemic, Congress called for timely federal reports on nursing home mortality. Research has linked these reports to nursing home staffing, media attention, and helped engage policy discussions and responses.
However, similar reporting was not required for those receiving Medicaid HCBS. Of the approximately 14 million people in the United States who need LTSS, only a minority live in nursing homes.
About 7.5 million Medicaid recipients received HCBS in 2019, and 1.6 million lived in nursing homes and other facilities, according to the analysis.
More conversations are being held about expanding access to HCBS and LTSS systems, but gaps in access and availability to these services remain.
The authors hope that as the aging and disabled community and policy makers work to reform the system, their findings will be useful for timely and publicly available data on people undergoing HCBS across age groups. and access to high-quality reports also need to be addressed.
