What is the relationship between Maryland demographic trends and the increase in the Medicaid under-65 nursing facility population?

Purpose: Maryland Medicaid beneficiaries under 65 in nursing facilities (NF) have increased 34% from Calendar Year (CY) 2000 to 2005. The under-65 NF population is primarily comprised of persons age 50-64 with multiple diagnoses and functional impairments, which may reflect the beginning of a demographic bulge associated with the “baby boomers”. There is also speculation that the under-65 NF population is characterized by chronic diseases more commonly associated with adults 65 years and older. This study explores the relationship between Maryland's population trends and the growth in the Medicaid under-65 NF population. This study is limited to Medicaid-only beneficiaries. Data: The data sources include: 2000 Decennial Census, American Community Survey (CY 2001-2005), Maryland's Medicaid Decision Support System (FY 2000-2005), and Maryland's Behavioral Risk Factor Surveillance System (BRFSS) (CY 2000-2005). Methods: Descriptive data analyses were used to examine the relationship between Maryland's population and the increase in the Medicaid under-65 NF population. The increase in the under-65 NF population was also compared to a subpopulation of likely Medicaid-eligible persons, based on income and disability status. Percent comparisons were used to relate the growth trends in the under-65 NF populations, Maryland's population and likely Medicaid-eligible subpopulation. Results: The increase in both the Medicaid under-65 NF population and the likely Medicaid-eligible subpopulation reflect Maryland's population trends. Conclusions: The findings suggest that the growth in Maryland's under-65 NF population is likely the result of the “baby boom” generation entering older adulthood; not the increased prevalence of chronic disease among younger adults.