An Investigation of Interstate Variation in Medicaid Long-Term Care Use and Expenditures Across 40 States in 2006

This report explores interstate variations in long-term care (LTC) expenditure and service use patterns, not only in terms of institutional and non-institutional services, but also by Medicaid LTC users’ age and type of disability (for example, intellectual and developmental disabilities [ID/DD] or other adult-onset disabilities). Some states have reoriented more toward home and community-based services (HCBS) than others. It also well known that greater progress has been made in serving certain subgroups within the LTC population in the community (those with ID/DD) compared to others and that reliance on institutional care remains greatest among older adults, although interstate variations exist. This report seeks to quantify the magnitude of such differences.