State variations in home health expenditures and utilization under Medicare and Medicaid

Expenditures for home health services provided under Medicare and Medicaid nearly tripled between 1977 and 1982. Utilization and expenditures for home health services vary widely across the states for both programs, and this article examines in some detail the nature and extent of these variations. States vary considerably with respect to relative utilization, visits, and visit-expenditures under Medicare; and states vary in terms the role visits versus visit-reimbursements play in shaping overall costs. The Medicaid program is effectively two programs: New York; and the other states, with eight accounting for half of Medicaid expenditures outside New York.