Lobat Hashemi, MS¹, Frederick H. Hooven, MMHS¹, Raymond E Glazier, PhD², and Jay Himmelstein, MD MPH¹. (1) UMass Medical School, Center for Health Policy and Research, 222 Maple Ave, Shrewsbury, MA 01545, 508-856-8525, lobat.hashemi@umassmed.edu, (2) Center for the Advancement of Rehabilitation & Disability Services, Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138

Massachusetts has one of the first Medicaid programs in the country to fund PAS services for both working and non-working persons with disabilities. This study is designed to assess differences in Medicaid payments per member per month (PMPM), among users of PAS who are working and those who are not. Our sample consisted of individuals between the ages of 18-64 who received at least one hour of PAS services between July 2001 and June 2002. We excluded anyone with a claim for long-term care or rehabilitation in the sixth months prior to the study period. In fiscal year 2002, 198 individuals (2.2%) of the working population and 4,624 individuals (2.5%) in the standard disabled (non-working) population used PAS services. Working members used an average of 41 PAS direct service hours per week, compared with 31 hours per week for the non-working population. Medicaid payments for PAS were $2,149 (PMPM) for workers and $1,398 PMPM for those not working. However, payments for all other categories of Medicaid services were significantly lower in the working population ($565) than for those who were not working, ($1,425). We also present results controlling for functional status and other insurance coverage. States planning buy-in programs with PAS coverage could vastly over-estimate program expenditures if budget projections assume that payments for non-PAS care are the same for working members and non-working members. A better understanding of differences between these populations is essential for the design and implementation of policies that promote employment for people with disabilities.

Learning Objectives: After this session, participants will be able to

• Learn about one of the first Medicaid programs in the country to fund Personal Assistance Services (PAS) for both working and non-working persons with disabilities.
• Understand the characteristics and healthcare utilization of the members who use PAS services.
• Learn about the costs of providing PAS services to the Medicaid working and non-working disabled population.

Keywords: Disability, Disability

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.