There has been a noticeable shift in the distribution of expenditures among Medicaid long-term care services over the past three decades. In 1990, home- and community-based care accounted for 13 percent of the program’s long-term care costs, but this had risen to a majority share of approximately 64 percent by 2021.
Institutional care rates continue to fall
Medicaid spent approximately 32 billion U.S. dollars on long-term care services in 1990, and close to 90 percent of that went towards institutional care, such as nursing homes and other residential facilities. The decrease over recent years in the proportion of spending devoted to institutional care can be partly attributed to a push towards home- and community-based care. This expansion of services is growing in popularity because individuals can receive treatment in familiar surroundings and benefit from increased levels of comfort.
State variations in long-term care costs
Medicaid expenditures for long-term care services vary significantly from state to state, which is primarily due to each state being able to administer its Medicaid program differently. New York and Pennsylvania were among the states that spent the most on Medicaid long-term care expenditures in 2019.
Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service
This statistic was assembled from several of KFF's publications and data tables. All years are Federal Fiscal Years, which run from October 1 through September 30.
This statistic shows fee-for-service LTC spending only. States with noticeably small spending may have sizeable portions of their Medicaid population enrolled in managed care. All spending includes state and federal expenditures. Expenditures do not include administrative costs, accounting adjustments, or expenditures in the U.S. territories.
All figures are rounded.
* Home health and personal care includes standard home health services, personal care, home and community-based care for the functionally disabled elderly, and services provided under home and community-based services waivers.
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Kaiser Family Foundation. (September 22, 2022). Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service [Graph]. In Statista. Retrieved July 03, 2024, from https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e
Kaiser Family Foundation. "Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service ." Chart. September 22, 2022. Statista. Accessed July 03, 2024. https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e
Kaiser Family Foundation. (2022). Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service . Statista. Statista Inc.. Accessed: July 03, 2024. https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e
Kaiser Family Foundation. "Distribution of Medicaid Long-term Care Services Expenditures from Fy 1990 to Fy 2021, by Type of Service ." Statista, Statista Inc., 22 Sep 2022, https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e
Kaiser Family Foundation, Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service Statista, https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e (last visited July 03, 2024)
Distribution of Medicaid long-term care services expenditures from FY 1990 to FY 2021, by type of service [Graph], Kaiser Family Foundation, September 22, 2022. [Online]. Available: https://www.statista.com/statistics/245439/distribution-of-medicaid-long-term-care-services-expenditures-by-type/?session=8d455a866d47478eb86f6cae5b60de6e