Table 1. Distribution of Total Medicaid Payments, by Service: Selected Calendar Years 1967-97.
Home and community-based waivers have had an impact on the distribution of Medicaid payments.
- The use of home and community-based waivers by States has been growing. For Medicaid recipients at risk of needing long-term institutional care, States use these waivers in an attempt to treat this group in less expensive community-based settings. Medicaid spending under home and community-based waivers is included with other personal health care (OPHC) in the NHE. The growth in waivers may explain some of the shift in the distribution of Medicaid program payments from the nursing home category in the NHE to OPHC. OPHC increased from 3.5 percent of Medicaid payments for personal health care in 1987 to 11.8 percent in 1997, offsetting much of the decline in the nursing home share.
| Service Category | 1967 | 1977 | 1987 | 1997 |
|---|---|---|---|---|
|
| ||||
| Percent | ||||
| Personal Health Care | 100.0 | 100.0 | 100.0 | 100.0 |
| Hospital Care | 54.0 | 43.3 | 39.5 | 37.8 |
| Physician Services | 11.5 | 11.4 | 9.4 | 10.3 |
| Dental Services | 4.5 | 2.6 | 1.2 | 1.3 |
| Other Professional Services | 0.9 | 1.0 | 0.7 | 1.1 |
| Home Health Care | 0.1 | 1.0 | 2.5 | 3.1 |
| Non-Durables | 6.7 | 6.2 | 7.1 | 8.7 |
| Nursing Home Care | 20.7 | 32.6 | 36.1 | 25.9 |
| Other Personal Health Care | 1.4 | 2.0 | 3.5 | 11.8 |
SOURCE: Health Care Financing Administration, Office of the Actuary, National Health Statistics Group.