Home- and Community-Based Service Use Among Medicare-Medicaid Enrollees with Functional Limitations, 2007–2008

The MAX Medicaid policy issue brief series highlights the essential role MAX data can play in analyzing the Medicaid program. MAX is a set of annual, person-level data files on Medicaid eligibility, service utilization, and payments that are derived from state reporting of Medicaid eligibility and claims data into the Medicaid Statistical Information System (MSIS). MAX is an enhanced, researchfriendly version of MSIS that includes final adjudicated claims based on the date of service, and data that have undergone additional quality checks and corrections. CMS produces MAX specifically for research purposes. For more information about MAX, please visit: http://www. cms.gov/Research-Statistics-Data-and-Systems/ComputerData-and-Systems/MedicaidDataSourcesGenInfo/MAXGeneralInformation.html. Over the past three decades, Medicaid programs have expanded the provision of long-term services and supports (LTSS) through homeand community-based services (HCBS). As states have sought to make these services more accessible to a wider population, understanding the characteristics of the Medicare-Medicaid enrollees who use them has become increasingly important. However, Medicaid claims data alone yield little insight into the functional limitations of enrollees receiving HCBS. This issue brief draws on newly merged data from the Medicaid Analytic eXtract (MAX) and Medicare Current Beneficiary Survey (MCBS) from 2007–2008 to provide insight into enrollees’ functional limitations, as measured by limitations in activities of daily living (ADL) and associated HCBS use. These limitations appear to be common among Medicare-Medicaid enrollees and affect both the percentage of enrollees who use HCBS and the cost associated with that care.