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Related Experiment Videos

State Medicaid programs offering personal care services.

A J LeBlanc1, M C Tonner, C Harrington

  • 1University of California, San Francisco, USA. aleblanc@mdrcsf.org

Health Care Financing Review
|October 16, 2002
PubMed
Summary
This summary is machine-generated.

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Medicaid offers personal care services through Title XIX (PCS) and 1915(c) waivers. Waivers are more popular for controlling costs, but PCS programs serve more people nationwide, with significant state variations in participation and spending.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Medicaid Program Analysis

Background:

  • Medicaid provides essential personal care services (PCS) through two main avenues: the optional Title XIX State plan benefit and 1915(c) home and community-based services (HCBS) waivers.
  • By 1998-1999, a significant number of states utilized both programs, with 26 offering PCS State plan benefits and 45 employing HCBS waivers for personal care services.

Purpose of the Study:

  • To analyze the landscape of Medicaid personal care services in the United States by 1998-1999.
  • To compare the utilization and administrative mechanisms of the Title XIX PCS benefit versus 1915(c) HCBS waivers.
  • To highlight the substantial state-level variations in Medicaid personal care program reach and expenditure.

Main Methods:

  • Comparative analysis of state-level data on Medicaid personal care services.

Related Experiment Videos

  • Examination of program enrollment and administrative structures for Title XIX PCS and 1915(c) HCBS waivers.
  • Statistical review of participant numbers per capita and per capita expenditures across states.

    • Main Results:

    • Nationwide, the Title XIX Personal Care Services (PCS) program served a larger participant base compared to services offered through 1915(c) waivers.
    • Home and community-based services (HCBS) waivers were a more frequently adopted administrative mechanism, potentially due to better control over program growth.
    • Significant disparities were observed across states in Medicaid personal care: participant rates varied from 7.33 to 0.04 per 1,000 population, and per capita expenditures ranged from $91.21 to $0.02.

    Conclusions:

    • Medicaid personal care services exhibit considerable heterogeneity in program structure and delivery across states.
    • While Title XIX PCS reaches more individuals, 1915(c) waivers are favored for administrative control, indicating different strategic uses of these programs.
    • The wide range in participation and spending underscores the need for further investigation into factors driving these state-level differences in Medicaid personal care access and investment.