To understand the extent of home-based medical care (HBMC) utilization for Medicaid beneficiaries and the composition of the workforce providing these services.
Approach:
Study Design: Cross-sectional study using the Transformed Medicaid Statistical Information System Analytical Files from 2018 to 2022.
Data Collection: Identified HBMC visits using specific Current Procedural Terminology codes and excluded telehealth visits.
Population: Focused on non-dual-eligible Medicaid beneficiaries and categorized them into four eligibility groups.
Key Findings:
The number of clinicians providing HBMC increased by 32.5% from 2018 to 2022.
APRNs accounted for 62% of HBMC visits by 2022, up from 48.7% in 2018.
The number of beneficiaries receiving HBMC rose by 26.8% during the study period.
Beneficiaries with disabilities represented the largest group receiving HBMC but decreased slightly from 49.9% to 45.1%.
Fee-for-service beneficiaries had higher per capita HBMC visits compared to managed care beneficiaries.
Interpretation:
Limitations:
Administrative data may not capture all services provided.
Findings are not generalizable to excluded states.
Incident-to billing may misattribute services provided by APRNs and PAs to physicians.
Nearly 90% of patients who met algorithmic criteria for postacute sequelae of SARS-CoV-2 infection had at least 1 chronic or potentially chronic condition requiring ongoing clinical management.
