Medicaid Managed Care - U.S. Senate Special Committee on Aging

270
drugs, ICF services, and optometrists' services. States must offer services uniformly throughout the
state, providing comparable coverage to all categorically needy beneficiaries and allowing beneficiaries
to obtain services from any qualified provider.
Figure 20-2. <strong>Medicaid</strong> Expenditures per Beneficiary, 1995 (dollars)
$2,118
$1,3 ($35)
($91)
$8,654
($3,610)
$10,129
($1445) ($2,083) 4(62.496)
Low-income Children Low-income Adults Blind and Disabled Elderly
* Long-Term <strong>Care</strong> :] Acute <strong>Care</strong>
SOURCE: Kaiser Commission on the Future of <strong>Medicaid</strong> 1997b.
($7,633)
NOTE: Expenditures exclude disproportionate share hospital payments, adjustments, and administrative
costs.
Several federal requirements establish <strong>Medicaid</strong> coverage for poor Medicare beneficiaries. Under these
arrangements, beneficiaries typically receive help meeting Medicare cost sharing and may also be
eligible for other benefits not covered by Medicare. Chapter 19 of this report provides a detailed
examination of dually eligible beneficiaries.
It is not surprising, given the types of beneficiaries eligible for the program, that <strong>Medicaid</strong> spends large
proportions of its budget on both acute and long-term care services (Figure 20-3). Overall, nursing
facility care (for both mentally retarded and other beneficiaries) and inpatient hospital services
accounted for the largest shares of <strong>Medicaid</strong> payments, about 26 percent and 17 percent of payments,
respectively, in 1995 (Kaiser Commission 1996c; 1997a). <strong>Medicaid</strong> spends over one-third of its funds
on long-term care services, a much higher share than for Medicare or national health spending as a
419 Physician Payment Review Commission