Chart: RI elders cost Medicaid 7 times more than kids, families
March 1st, 2012 at 6:00 am by Ted Nesi under Nesi's Notes, On the Main Site
In 2010, 25 cents of every $1 spent by Rhode Island’s government went toward Medicaid.
The $2 billion Rhode Island spent on Medicaid, half of which is paid for with federal money, subsidizes health care for low-income people through multiple departments, agencies and programs. Now that pension costs have been reined in, Medicaid is also the fastest-growing part of the state budget.
The state says 190,823 residents used Medicaid in some form or fashion in January. Children and families made up two-thirds of those people (68%) and adults with disabilities made up another 16%. Elders (9%) and children with special needs (7%) make up the rest.
Common sense would imply, then, that the bulk of Medicaid spending is also on children and families. But that’s not true at all. Average Medicaid spending among children and families was roughly $3,727 per enrollee in 2010, compared with roughly $26,009 each among the elderly – nearly seven times more per person.
Here’s a chart from Elena Nicolella, Rhode Island’s Medicaid director, showing the disparity:
“As you can see, the amount we spent per blind or disabled person, or per elderly person, is much, much more than the amount we spend per child or adult,” health economist Aaron Carroll wrote recently. “This means that if we really want to cut Medicaid spending, and we want to do it on the backs of adults or children, we will have to drop many, many more of them to make a real impact on spending.”
(chart via Economic Progress Institute)
Nesi's Notes covers politics and the economy in and around Rhode Island for WPRI.com. (Twitter: 
What impact does or shouldMedicare have on these numbers?
This article gives some sense of why low-income seniors wind up using both Medicare and Medicaid:
“While Medicaid was created mostly to provide medical care to low-income moms and their kids, two out of every three Medicaid dollars is spent on the elderly and disabled. Last year, the program spent one-third of its budget — more than $100 billion federal dollars — on long-term care, either in nursing facilities or in the community. States, which share the program’s cost, spent tens of billions more.
Overall, Medicaid pays more than 40 percent of all long-term care costs. The advocacy group FamiliesUSA estimates that more than 6 million seniors and nearly 10 million younger people with disabilities rely on the program for assistance.”
http://www.kaiserhealthnews.org/Columns/2011/May/051811gleckman.aspx
Isn’t it a shame that 1 of every 5 Rhode Islanders qualifies for Medicaid?
Bill,
How often do you see an elder transfer the house to the family trust to get on these benefits? That is a scam and most realize it even with the statutory wait period.
It’s state supported welfare even for the well off.
Bill what this tells me is that 20% of the Rhode Island population never planned on retirement or in this case old age. Many of these people need to be given comfort care until they die. They have no redeeming value to society.
Ted,
Is there any estimate of how much fraud or mismanagement is buried in these numbers.
And any insurance company providing health benefits will tell the same story of where the bulk of costs are: The final years of life when elders (or their family members) would prefer keeping the patient alive any way they can.
It is easy to explain why Medicaid costs are so much higher for our elders. RI has a high percent of its population who are age 65 and over. In fact, the 2010 Census found we have the highest percent of persons age 85 and over. The fact is that the older one gets the more likely one will need some long term care either at home or in a nursing facility. In 2010 median daily costs for a nursing home in RI were about $250. Even if one has saved substantially, not too many older folks have that kind of savings to pay for this type of care for long periods of time. The situation is particularly difficult for older women who comprise 60% of our elder population and more than 3/4ths of nursing home residents. These residents are likely to be widowed, in their late 80′s or 90′s and have very low income. Although most do not have a choice about being in a nursing home as their care needs demand it and family is not able to provide the extensive care needed, the state is making attempts to provide less costly but safe alternatives to nursing home care. These efforts have been supported by advocates for seniors.
Ted did you see the chart showing the drop in average incomes in RI?
So why is the Government sector fully employed? We have less students in schools because there are less children yet the schools aren’t laying off teachers? Oh that’s right those are taboo subjects by the media like the East Bay tolls that will pay for bridge repairs in the rest of the state.
I’m not sure I trust these stats anyway (the ones you are pointing to) because they were created with a goal which obviously was to show that RIteCare is not costing taxpayers much money as opposed to peoples parents and grand parents.
Its the same type of sympathy game played for years by Governors and the GA. When something has to be cut they choose the most controversial cuts in order to draw debate about the cuts at all. Then when they raise taxes they say ‘well our only alternative was to cut baby formula for kids on welfare’ or along that line.
This is how Medicaid is working for the younger people on it.
http://bit.ly/wLJI4Z
This is what keeps the Democrats in power by a mile. Add in the state and city gov’t and welfare people and you’ve got probably a third of the population of RI is “taking” from the state.
In reviewing the analyses of the House Fiscal staff, total LTC spending, including nursing home spending, as a percentage of both total Human Services spending and DHS Medicaid spending, has actually declined! In particular, nursing home spending has declined from 22.5% of Medicaid spending in 2010, to 21% in 2011, and down to 20.8% in the Enacted 2012 budget.
Conversely, overall Medicaid spending continues to grow, from $1,487.7 million (or 19.3% of the state budget) to a projected $1,641.4 million (over 21% of the state budget).
Clearly our nursing home residents, or our elderly population overall, are not the driver of spending, including for the reasons Maureen notes about trying to keep more of our disproportionately older population in the community.