State Spending for Medicare and Medicaid Home Care Programs

Health Affairs

Volumn 17, Issue 1, 1998, Pages 201-212

  Kenney, Genevieve ^a   Rajan, Shruti ^a   Soscia, Stephanie ^b  

^a URBAN INSTITUTE   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLINICAL TRIAL; COST; ECONOMICS; HEALTH CARE COST; HOME CARE; HUMAN; INFORMATION PROCESSING; MEDICAID; MEDICARE; MULTICENTER STUDY; STATISTICS; UNITED STATES;

COSTS AND COST ANALYSIS; DATA COLLECTION; HEALTH EXPENDITURES; HOME CARE SERVICES; HUMANS; MEDICAID; MEDICARE; UNITED STATES;

EID: 0031601575     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.1.201     Document Type: Article

References (14)

1. M.A. Cohen and A. Tumlinson, "Understanding the State Variation in Medicare Home Health Care: The Impact of Medicaid Program Characteristics, State Policy, and Provider Attributes," Medical Care 35, no. 6 (1997): 618-633.
2. Health Care Financing Administration, A Profile of Dually Eligible Beneficiaries (Baltimore: HCFA, March 1997).
3. G. Kenney and S. Rajan, "Understanding Dual Eligibles' Use of Medicare Home Health Services: The Effects of Differences in Medicaid Home Care Programs" (Working paper, Urban Institute, Washington, D.C., November 1997).
4. HCFA, A Profile of Dually Eligible Beneficiaries.
5. Ibid.
6. B. Burwell, "Medicaid Long-Term Care Expenditures in Fiscal Year 1995" (Memorandum, Medstat Group, Cambridge, Massachusetts, January 1996).
7. Ibid.
8. G. Kenney and M. Moon, Reining in the Growth in Home Health Services under Medicare (New York: Commonwealth Fund, May 1997); and C. Bishop and K.C. Skwara, "Recent Growth of Medicare Home Health," Health Affairs (Fall 1993): 95-110.
9. G. Kenney and M. Moon, Reining in the Growth in Home Health Services under Medicare (New York: Commonwealth Fund, May 1997); and C. Bishop and K.C. Skwara, "Recent Growth of Medicare Home Health," Health Affairs (Fall 1993): 95-110.
10. We examined the correlation between Medicare and Medicaid home care expenditures in 1993 as well as the correlation between the changes in Medicare and Medicaid expenditures between 1987 and 1993. In both cases, the correlation coefficient was negative, significant, and close to .25.
11. The state operates a program for elderly persons ineligible for Medicaid and at risk of institutionalization. This program mirrors Medicaid's waiver program for the elderly. Medicaid spending for Minnesota for 1995 is projected based on Medicaid home care expenditure growth between 1993 and 1994.
12. Connecticut has established a parallel state-funded program for elderly persons who do not qualify for Medicaid but are at risk of institutionalization.
13. A reclassification of states based on their 1995 expenditures moves New Mexico into the group of states with low Medicare and high Medicaid spending relative to median expenditures per enrollee in each program. Nonetheless, its Medicaid home care expenditure per enrollee is still below the national mean spending per enrollee in each program.
14. Without surveying more states, it is difficult to assess the extent to which the findings from interviews in five states can be generalized. However, after completing this paper, we interviewed persons in twelve more states and findings from our continuing work generally support the major themes identified here.