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Are coresidence and nursing homes substitutes? Evidence from Medicaid spend-down provisions

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  • Mommaerts, Corina

Abstract

This paper measures the extent to which the price of nursing home care affects a potential substitute living arrangement: coresidence with adult children. Exploiting variation in state Medicaid income “spend-down” provisions over time, I find that living in a state with a spend-down provision decreases the prevalence of coresidence with adult children by 1–4 percentage points for single elderly individuals, with a corresponding increase in the use of nursing home care. These findings suggest that changes in Medicaid eligibility for long-term care benefits could have large impacts on living arrangements, care utilization patterns, and Medicaid expenditures.

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  • Mommaerts, Corina, 2018. "Are coresidence and nursing homes substitutes? Evidence from Medicaid spend-down provisions," Journal of Health Economics, Elsevier, vol. 59(C), pages 125-138.
    • Handle: RePEc:eee:jhecon:v:59:y:2018:i:c:p:125-138
    DOI: 10.1016/j.jhealeco.2018.04.003
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    2. Julien Bergeot & Roméo Fontaine, 2020. "The heterogeneous effect of retirement on informal care behavior," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1101-1116, October.
    3. Bergeot, Julien & Tenand, Marianne, 2021. "Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data," CEPREMAP Working Papers (Docweb) 2105, CEPREMAP.
    4. David Bardey & Luigi Siciliani, 2021. "Nursing‐homes' competition and distributional implications when the market is two‐sided," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 30(2), pages 472-500, May.
    5. Kristin F. Butcher & Kelsey Moran & Tara Watson, 2022. "Immigrant labor and the institutionalization of the U.S.‐born elderly," Review of International Economics, Wiley Blackwell, vol. 30(5), pages 1375-1413, November.
    6. Amitabh Chandra & Courtney Coile & Corina Mommaerts, 2023. "What Can Economics Say about Alzheimer's Disease?," Journal of Economic Literature, American Economic Association, vol. 61(2), pages 428-470, June.
    7. Tatyana Koreshkova & Minjoon Lee, 2020. "Nursing Homes in Equilibrium: Implications for Long-term Care Policies," Working Papers wp414, University of Michigan, Michigan Retirement Research Center.
    8. Iegor Rudnytskyi & Joël Wagner, 2019. "Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach," Risks, MDPI, vol. 7(3), pages 1-20, August.
    9. Theis Theisen, 2020. "Municipalities’ Decision to Care: At Home or in a Nursing Home," International Advances in Economic Research, Springer;International Atlantic Economic Society, vol. 26(4), pages 327-342, November.
    10. Yi Chen & Hanming Fang, 2018. "The Long-Term Consequences of Having Fewer Children in Old Age: Evidence from China’s “Later, Longer, Fewer” Campaign," NBER Working Papers 25041, National Bureau of Economic Research, Inc.
    11. Bram Wouterse & Arjen Hussem & Albert Wong, 2022. "The risk protection and redistribution effects of long‐term care co‐payments," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(1), pages 161-186, March.
    12. Liu, Yinan & Zai, Xianhua, 2022. "The Unintended Effect of Medicaid Aging Waivers on Informal Caregiving," EconStor Preprints 249566, ZBW - Leibniz Information Centre for Economics.
    13. Mommaerts, Corina & Truskinovsky, Yulya, 2020. "The cyclicality of informal care," Journal of Health Economics, Elsevier, vol. 71(C).
    14. Yinan Liu & Emma Zai, 2023. "The unintended effect of Medicaid aging waivers on informal caregiving," MPIDR Working Papers WP-2023-006, Max Planck Institute for Demographic Research, Rostock, Germany.
    15. Cristina Giudici & Silvia Polettini & Alessandra Rose & Nicolas Brouard, 2019. "Which Aspects of Elderly Living Conditions are Important to Predict Mortality? The Complex Role of Family Ties at Home and in Institutions," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 142(3), pages 1255-1283, April.

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