Expenditures and use of wraparound health insurance for employed people with disabilities

Gettens, John; Hoffman, Denise; Henry, Alexis D.

doi:10.1016/j.dhjo.2015.12.001

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…While the lack of data at the state or national level on Medicaid Buy-In program participation limits what analysis is possible on program trends and connections between MBI, earnings and assets, and health outcomes, notable work has been done that looks at service utilization or barriers by individuals participating in a buy-in program. For example, Gettens, Hoffman, & Henry (2016) found that the average wraparound expenditures were $427 per member per month for individuals enrolled in the Medicaid buy-in program.…”

Section: Discussionmentioning

confidence: 99%

“…Article focus varied across a number of topics relevant to MBI programs: six (n=6, 40%) focused on participant characteristics, including types of daily limitation activities, service utilization and costs of coverage (Hall, Kurth, & Moore, 2007;Hall, Fox, & Fall, 2010;Gettens, Hoffman, & Henry, 2016;Henry, Banks, Clark, & Himmelstein, 2007;Neri, Wong & Harrington, 2013), followed by five (n=5, 33%) which focused on employment decisions and outcomes as well as barriers to MBI program participation (Hall & Fox, 2004;Henry et al, 2006;Liu, Ireys, & Thornton, 2008;Schimmel, Liu, & Croake, 2012;Shah, Mancuso, He, & Kozak, 2012). Two (n=2, 13%) articles centered on the implementation and administration of Medicaid Buy-In across states (Ireys, Gimm, & Gilbert, 2009;Sulewski, Gilmore, & Foley, 2006).…”

Section: Focus Areasmentioning

confidence: 99%

“…Six (n=6, 40%) studies presented opportunities for improvement in efficiency, typically around increasing access, availability of services, and improved communication and information sharing between agencies and potentially eligible individuals. Studies looked at health conditions and needs for services beyond typical access to LTSS in support of employment and found demand for wraparound programs (Gettens, Hoffman, & Henry, 2016), dental care access and oral health , or personal assistant services in the workplace (WPAS), which are available but used by less than one percent of California MBI participants (Neri, Wong, & Harrington, 2013). Additionally, Hall, Kurth, and Moore (2007) looked at Medicare Part D access for MBI participants and identified gaps in participant knowledge regarding plan options and difficulty obtaining medication.…”

Section: Study Outcomesmentioning

confidence: 99%

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All over the Map: A Systematic Literature Review and State Policy Scan of Medicaid Buy-In Programs for Working Individuals with Disabilities

et al. 2021

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While supports for people with disabilities have increased, significant healthcare and financial barriers persist. State-administered Medicaid Buy-In programs for working people with disabilities, distinct from broader buy-in discussions that have emerged as some states consider expanding access to health insurance, are intended to incentivize employment and protect against a loss of Long-Term Services and Supports. Loss of these services would be detrimental to a person's ability to access daily living and workforce participation supporting services. This paper explores identified drivers of and barriers to participation, outcomes, and the current state of programs that are currently in place. Authors conducted a systematic literature search to identify evidence published in peer-review journals. Additionally, a policy scan using information from government sources for the 45 state-administered buy-in programs was completed. The results indicate that state Medicaid Buy-In programs vary dramatically in their construction and presentation, with eligibility and administration information or lack thereof having the potential to significantly affect a person's decision making around benefit enrollment and employment. Findings are discussed in the context of additional recent state and federal policy efforts to improve outcomes around employment, income, and asset generation for people with disabilities.

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Section: Discussionmentioning

confidence: 99%

Section: Focus Areasmentioning

confidence: 99%

Section: Study Outcomesmentioning

confidence: 99%

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All over the Map: A Systematic Literature Review and State Policy Scan of Medicaid Buy-In Programs for Working Individuals with Disabilities

et al. 2021

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“…Primary insurance should be able to reduce out-of-pocket spending for healthcare services that are provided (Gettens et al, 2015). Insurance scheme acting as one of the alternative source of financing for healthcare, should be able to act as household prevention of impoverishment as a result of high out-of-pocket healthcare expenditure (Molla et al, 2017).…”

Section: Prepayment Programmementioning

confidence: 99%

Rising Healthcare Expenditure – Demand Side: A Systematic Review

2019

IJPHCS

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Background: Globally, total health expenditure is rising including in Malaysia. Healthcare demand is the decision that is made based on variety of choices that is available for utilising healthcare, consequently stimulating productivity. Among others, healthcare demand can be represented by healthcare expenditure. The concept of estimation of health production function provides derivative of utility/satisfaction. Elasticity is the responsiveness of quantity demanded that alters with respect to for example, income. Healthcare is generally inelastic; therefore there is increment of expenditure on healthcare despite price increment for healthcare utilisationreflecting quantity demanded for healthcare. The aim of this manuscript is to critically analyse demand-side of rising healthcare expenditure. Materials and Methods: A systematic review was conducted using the PRISMA 2009 flow. Public domains used were PubMed, Medline, CINAHL and Scopus. Keywords used were health OR health care OR medical care AND expenditure OR household expenditure OR spending AND demand OR demand side OR demand-side. Inclusion criteria included publications in English and were published within 15 years. Reviews and commentaries were excluded. Finally, 30 articles were included in the review. Result and Discussion: The chosen articles are divided into sections on healthcare demand and expenditure and also health insurance. Based on the review, rising healthcare expenditure can be as a result of the demand for healthcare according to healthcare expenditure and financial hardship, prepayment programme and also demand-side policies, Conclusion: This review showed that the rise of healthcare expenditure could be resulted from healthcare demand based on healthcare expenditure and financial hardship, prepayment programme and also demand-side policies. The rise would not be solved with just the exchange of private sector's third-party payment to public domain system. Third-party payers and consumers should implement cost-sharing and more importantly a cost effective national health policy be present without the compromise of a good quality healthcare service.

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“…For the majority of states (39 states), Medicaid enrollment occurs upon receipt of SSI benefits. Medicaid may be available to SSDI recipients and additional SSI recipients depending on income and state eligibility requirements (Centers for Medicare and Medicaid Services, 2019a) and may provide additional community-based and personal assistance services that are particularly beneficial for individuals with disabilities (Gettens et al, 2016; Kim et al, 2006).…”

mentioning

confidence: 99%

Disability, Federal Disability Benefits, and Health Care Access After the Affordable Care Act

Pellegrini

Geissler

2020

Journal of Disability Policy Studies

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Limited research considers whether differences in health care access and utilization exist for individuals with a disability with and without receipt of federal disability benefits in the Affordable Care Act (ACA) era. National Health Interview Survey (NHIS) data (2014–2016) are used to estimate the relationship between federal disability benefit receipt and health care access and utilization for individuals with a disability, controlling for disability benefit application, and predisposing, enabling, and need characteristics. Study results show that individuals with a disability receiving federal disability benefits have increased odds of seeing any provider (odds ratio [OR]: 1.50; 95% confidence interval [CI] = [1.12, 2.01]) and decreased odds of worrying about the costs of health care (OR: 0.68; 95% CI = [0.57, 0.80]) and delaying needed medical care due to costs (OR: 0.50; 95% CI = [0.42, 0.61]) versus nonrecipients with a disability. Findings highlight the continued importance to address disabled nonrecipients’ health care access and utilization barriers in the post-ACA period.

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Expenditures and use of wraparound health insurance for employed people with disabilities

Cited by 5 publications

References 12 publications

All over the Map: A Systematic Literature Review and State Policy Scan of Medicaid Buy-In Programs for Working Individuals with Disabilities

All over the Map: A Systematic Literature Review and State Policy Scan of Medicaid Buy-In Programs for Working Individuals with Disabilities

Rising Healthcare Expenditure – Demand Side: A Systematic Review

Disability, Federal Disability Benefits, and Health Care Access After the Affordable Care Act

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