Medicaid Community-Based Programs: A Longitudinal Analysis of State Variation in Expenditures and Utilization
(2004). Medicaid Community-Based Programs: A Longitudinal Analysis of State Variation in Expenditures and Utilization. Inquiry, 40, pp.375-389.
Abstract
This paper reports inter-state variation in expenditures and participation in Medicaid home and community based services programs and also uses time series progression models to identify factors that may influence such variations.
As states face the challenges posed by budget crises and pressures to develop Medicaid home and community based services (HCBS), this paper provide a longitudinal analysis of state variation in expenditures and utilization for three HCBS programs (waivers, home health and personal care), and for total Medicaid PAS. The first part of the analysis describes the nature and scope of state variation for each program in 1999 using measures including participants per 1,000 population and expenditures per capita.
The second part of the analysis presents time series regression models that estimate socio-demographic, state policy, and market factors associated with inter-state variation in waiver participants and expenditures and home health, personal care and total HCBS expenditures for the period 1992-1999. Among the results, positive state-level factors related to HCBS participants and expenditures include: higher percentages of aged persons, greater incomes per capita, and a larger supply of home health agencies.
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