Dual Eligibles Are More Likely to Be: Female, Live in a Nursing Home, Have a Serious Disease

Statistics and Facts

· When developing programs for dual eligibles, it is important to be aware that dual eligibles are more likely to be: female, live in a nursing home, have a serious disease or chronic condition (stroke, diabetes, mental disorder), suffer from serious functional limitations (cognitive and physical), have less access to a regular source of care or preventive services, and make greater use of emergency room services.[1]

· New York accounts for 20% of national Medicaid spending for long-term care services for the elderly, but represents only about 10% of national elderly Medicaid beneficiaries.[2]

· In 1995, New York spent $5.7 billion on Medicaid long-term care for the elderly, which represented 24.2% of all non-DSH Medicaid spending in the state.[3]

· In 1995, expenditures per elderly resident were $2,444, which was more than twice the national average expenditure of $967 per resident.[4]

· In 1995, New York was one of the states most heavily oriented toward home and community based care, spending 23.1% of Medicaid long-term care spending. In fact, New York’s expenditures for the elderly represented over 40% of national spending for home and community based services.[5]

· Medicaid long-term care spending for the elderly in New York grew moderately from 1990 to 1995 at a rate of 5.5%, compared with a national average of 10.7%.[6]

· From 2000 to 2030, the projected increase in the number of individuals aged 65 and older in New York State is 1,468,539, which represents 60% increase.[7]

· In 2000, New York ranked 24th in the nation for percent of population aged 65 and older, with only 12.9% of the population fitting that description. New York is projected to be ranked 28th in the nation by 2030 for percent of population aged 65 and older, with a projected 20.1% of the population fitting that description in 2030.[8]

· As of 2005, New York had 3,132,974 individual over the age of 60. This number is projected to grow to over 4,400,000 by 2025.[9]

· Estimated Average Nursing Home Rates for the different regions of New York in 2004 were as follows:[10]

-  Western Region/ Buffalo: $215/day or $78,475/year

-  Western Region/ Rochester: $243/day or $88,695/year

-  Central Region: $205/day or $74,825/year

-  Northeastern Region $226/day or $82,490/year

-  Northern Metropolitan Region: $287/day or $104,755/year

-  New York City: $300/day or $109,500/year

-  Long Island $324/day or $118,260/year

· The number of households in New York with individuals aged 65 and older living alone was 715,550 in 2000.[11]

· The number of individuals in New York aged 85 and older increased by 63,315 from 1990 to 2000, representing a 25.5% change.[12]

· Following are some tables taken from New York State Office for the Aging—Expore Aging—Population Demographic Projections to 2025 that give insight into the projected population of New York over the next two decades.

Table 1[13]

Table 2[14]

Table 3[15]

Table 4[16]

Table 5[17]

© 2005-2006 CDHS/Research Foundation of SUNY/BSC College Relations Group

[1] United States General Accounting Office, “Medicare and Medicaid: Implementing State Demonstrations for Dual Eligibles Haw Proven Challenging,” a report to the Special Committee on Aging, U.S. Senate, GAO/HEHS-00-94, (August 2000).

[2] Wiener, Joshua M. and David G. Stevenson, “Long-Term Care for the Elderly: Profiles of Thirteen States,” an occasional paper for the Urban Instituted (August 1, 1998) available at http://www.urban.org/urlprint.cfm?ID=5976 last accessed March 30, 2005.

[3] Id.

[4] Id.

[5] Id.

[6] Id.

[7] U.S. Census Bureau, Population Division, Interim State Population Projections, “Table 4: Interim Projections: Change in Total Population and Population 65 and Older, by State: 2000 to 2030,” (April 21, 2005).

[8] U.S. Census Bureau, Population Division, Interim State Population Projections, “Table 3: Interim Projections: Ranking of States by Projected Percent of Population Age 65 and Older: 2000, 2010, and 2030,” (April 21, 2005).

[9] New York State Office for the Aging—Explore Aging—Population Demographic Projections to 2025, “Table 3: Selected New York State Population Projection Trends 1995 to 2025,” available at http://aging.state.ny.us/explore/projections/page12.htm last accessed January 3, 2006.

[10] New York State Partnership for Long Term Care, “Estimated Average NYS Nursing Home Rates,” available at http://www.nyspltc.org/rates.html last accessed January 3, 2006.

[11] U.S. Bureau of the Census, prepared by Empire State Development, State Data Center, “Households by Household Type, Presence of Children and County, 2000,” (October 30, 2002).

[12] U.S. Census Bureau, Census 2000 Summary File 1; 1990 Census of Population, “Table 10: States and Puerto Rico Ranked by Percent Change of Population 85 Years and Over: 1990 to 2000,” (October 3, 2001).

[13] New York State Office for the Aging—Exploring Aging—Population Demographic Projections to 2025, available at http://aging.state.ny.us/explore/projections/page6.htm last accessed January 3, 2006.

[14] New York State Office for the Aging—Exploring Aging—Population Demographic Projections to 2025, available at http://aging.state.ny.us/explore/projections/page4.htm last accessed January 3, 2006.

[15] Id.

[16] New York State Office for the Aging—Exploring Aging—Population Demographic Projections to 2025, available at http://aging.state.ny.us/explore/projections/page5.htm last accessed January 3, 2006.

[17] Id.