ABSTRACT

Medicaid is the largest health insurer in America, comprising one-sixth of the nation’s total healthcare expenditures. Of this, 40% covers long-term care services for older adults and adults with disabilities. Yet, Medicaid does not provide access to all goods and services needed. Pooled special needs trusts (pooled trusts) are a program through which older individuals, requiring long-term care, may set aside assets and remain Medicaid eligible. Pooled trust funds purchase items such as medical devices, telecommunications and funeral services. This article explores the relationship between Medicaid, pooled trusts and their role in nursing home residents’ well-being. To understand this relationship, a descriptive study sorts the disbursements from a pooled trust into the 5 Gallup-Healthways Index well-being domains. The analysis shows that pooled trust funds purchased goods and services related to well-being. Thus, pooled trusts offer a means for states to expand the support they provide individuals in nursing facilities beyond the medical services covered by Medicaid to include goods and services associated with well-being.

摘要

Medicaid 是美国最大的健康保险公司，占全国医疗保健总支出的六分之一。其中，40% 涵盖为老年人和残疾成年人提供的长期护理服务。然而，Medicaid 并未提供获得所需的所有商品和服务的途径。汇集特殊需求信托（汇集信托）是一项计划，需要长期护理的老年人可以通过该计划留出资产并保持 Medicaid 资格。集合信托基金购买医疗设备、电信和殡葬服务等项目。本文探讨了医疗补助、集合信托及其在疗养院居民福祉中的作用之间的关系。为了解这种关系，一项描述性研究将汇总信托中的支出分类到 5 个盖洛普健康之路指数福祉领域。分析表明，集合信托基金购买了与福祉相关的商品和服务。因此，集合信托为各州提供了一种手段，可以扩大他们在护理设施中为个人提供的支持，超出 Medicaid 涵盖的医疗服务范围，包括与福祉相关的商品和服务。