Medicaid statistics : program and financial statistics

200 Pages·1991·10.8 MB·English

by  United States. Medicaid Bureau

PUBS
US DEPARTMENT OF
RA
412 HEALTH AND HUMAN SERVICES
A Health Care Financing Administration
M4229 Medicaid Bureau
1994 HCFA Pub. No. 10129
A
February 1996
U.S. Department of Health and Human Services
Donna E. Shalala, Secretary
Health Care Financing Administration
Bruce C. Vladeck, Administrator
Medicaid Bureau
Sally K. Richardson, Director
This report was prepared by the
Office ofInformation Systems and Data Analysis
Health Care Financing Administration
Medicaid Bureau
7500 Security Boulevard
MD
Baltimore, 21244
c-3
MEDICAID
STATISTICS
Program and
Financial Statistics
Year 994
Fiscal
1
US DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Medicaid Bureau
HCFAPub. No. 10129
February 1996

FOREWORD
Medicaid Statistics: Program and Financial Statistics, Fiscal Year 1994 is the annual
compilation ofnational Medicaid summary statistical data. Medicaid Statistics is published
in response to the need for a consolidated source ofcurrent statistical data on a variety of
Medicaid program and financial characteristics. This publication offers a compilation of
available Medicaid summary statistics for Fiscal Year 1994 (October 1993 - September
1994).
Medicaid Statistics provides selected summary statistical data generated from a variety of
Medicaid data sources. Using information obtained from State Medicaid agencies, the
Health Care Financing Administration (HCFA) central and regional offices, and the Bureau
ofthe Census, this publication compiles national Medicaid State program and expenditure
data. The tables and graphs include profile data on the Medicaid population and Medicaid
expenditures by region, State and nationwide. This publication makes such data available to
interested parties for informational purposes and purposes ofprogram analysis.
Medicaid Statistics is the result ofthe combined efforts ofstaffofthe Medicaid Bureau,
HCFA regional offices, Bureau ofData Management and Strategy, the Office ofthe
Actuary, the Bureau ofthe Census, and States. I want to personally commend and thank
everyone involved for their dedicated efforts to compile this information into a useful
resource document. Previous editions ofMedicaid Statistics have been helpful to HCFA
and others in making policy and management decisions, responding to inquiries, and
improving agency effectiveness in ensuring that Medicaid beneficiaries have access to
mandated services and benefits. I believe this book will increase the usefulness ofthe other
Medicaid Statistics books by enabling readers to collect historic data for analyses.
Sally K. Richardson
Director
Medicaid Bureau
PREFACE
Since its inception in July 1965, the Medicaid program has grown from a basic source of
health care for the poor to a complex program designed to address the health care needs of
a large and diverse population. The increased State and Federal Medicaid expenditures in
recent years have created the need for prudent fiscal and program management by both the
Federal and State governments. To that extent, HCFA, the States and the health care
community require statistical data on services and expenditure patterns in order to develop
policy which results in the provision ofcost-effective quality health care to the needy.
The importance ofthe Medicaid program as a major funding source ofhealth care and the
rapid increase in Medicaid expenditures has focused attention on the need for a compiled
publication ofMedicaid statistics. The Health Care Financing Administration (HCFA)
published Medicaid Statistics: Fiscal Year 1991 in direct response to the increasing demand
for a consolidated source ofMedicaid data on a variety ofprogram areas.
The Medicaid Statistics: Fiscal Year 1994 publication offers profile data on the Medicaid
population and Medicaid expenditures by region, State and nationwide similar to its
predecessors from fiscal years 1991 through 1993. This compilation ofState program and
financial statistics (October 1993 through September 1994) is intended to provide to
Medicaid program administrators and other interested parties a timely release ofdata
summaries available from HCFA. Also, this publication offers a reference directory of
contact persons for additional information.
Due to the latitude States have in administering Medicaid, there is considerable interstate
Medicaid program variation. This variation has become more diverse as States adopt new
eligibility groups, services, reimbursement and administrative policies. In light ofthis
variation, this publication does not attempt to provide the wide range ofanalysis ofthe data
needed for a complete and comprehensive view ofthe national Medicaid program. By
compiling the array ofavailable Medicaid statistics into one publication, Medicaid Statistics
is intended to make timely summary data available for the analyses needed to assist health
care administrators in their efforts to provide affordable quality care.
TABLE OF CONTENTS
FOREWORD
PREFACE
LIST OF TABLES AND GRAPHS
iv
INTRODUCTION
1
OVERVIEW OF THE MEDICAID PROGRAM
I. 2
H. MEDICAID DATA SOURCES 11
NATIONAL SUMMARIES
HI. 12
A. National Graphics 13
B. National Summary Tables 28
IV. PROGRAM STATISTICS 38
A. HCFA-2082 Tables 39
B. Managed Care Table 125
C. Census Tables 127
V. FINANCIAL STATISTICS 131
A. HCFA-64 Tables 132
B. TPL Tables 173
VL REFERENCE DIRECTORY 176
in
LIST OF TABLES AND GRAPHS
NATIONAL SUMMARY
HI.
A. National Graphics
Figure 1. Medicaid Recipient Trends 14
Figure 2. Medicaid Vendor Payment Trends 15
Figure 3. Medicaid Recipients and Vendor Payments
by Maintenance Assistance Status - FY 1994 16
Figure 4 Percent Distribution ofMedicaid Recipients
and Vendor Payments by Maintenance Assistance
Status - FY 1994 17
Figure 5. Medicaid Recipients and Vendor Payments by
Basis ofEligibility - FY 1994 18
Figure 6. Percent Distribution ofMedicaid Recipients and
Vendor Payments by Basis ofEligibility - FY 1994 19
Figure 7. Medicaid Recipients by Type ofService - FYs 1993 - 1994 20
Figure 8. Medicaid Vendor Payments by Type ofService -
FYs 1993 - 1994 21
Figure 9. Medicaid Recipients and Vendor Payments by Age -
FY 1994 22
Figure 10. Medicaid Recipients and Vendor Payments by Sex -
FY 1994 23
Figure 1 1. Medicaid Recipients and Vendor Payments by Race -
FY 1994 24
Figure 12. Medicaid Medical Assistance Payment Trends 25
Figure 13. Medicaid Medical Assistance Payments - FY 1994 26
Figure 14. Medicaid Vendor Payments vs Expenditures 27
B. National Summary Tables
Table 1. Medicaid Recipients, Vendor, Medical Assistance,
and Administrative Payments 29
Table 2. Medicaid Recipients and Vendor Payments by
Maintenance Assistance Status 30
Table 3 Medicaid Recipients and Vendor Payments by
.
Basis ofEligibility 31
Table 4. Medicaid Recipients by Type ofService 32
Table 5. Medicaid Vendor Payments by Type ofService 32
Table 6. Medicaid Recipients and Vendor Payments by Age 33
Table 7. Medicaid Recipients and Vendor Payments by Sex 34
Table 8. Medicaid Recipients and Vendor Payments by Race 35
Table 9. Medicaid Recipients as a Percentage ofPopulation by Age 36
Table 10. Medicaid Recipients as a Percentage ofPopulation by Sex 36
Table 1 1. National Summary ofMedicaid Managed Care Programs and Enrollment ... 37
IV
IV. PROGRAM STATISTICS TABLES
A. HCFA-2082 Tables by Region and State - FY 1994
Table 1. Medicaid Recipients by Maintenance Assistance Status 43
Table 2. Medicaid Recipients by Basis ofEligibility 45
Table 3. Medicaid Recipients by Type ofService 47
fable 4. Categorically Needy Medicaid Recipients Who
Receive Cash Payments by Basis ofEligibility 52
Table 5. Categorically Needy Medicaid Recipients Who Do
Not Receive Cash Payments by Basis ofEligibility 54
Table 6. Medically Needy Medicaid Recipients Who Do Not
Receive Cash Payments by Basis ofEligibility 56
Table 7. Medicaid Recipients ofOther Coverage Groups from
Pre 1988 Legislation by Basis ofEligibility 58
MCCA
Table 8. Medicaid Recipients ofCoverage Groups from
of 1988 and Later Legislation by Basis ofEligibility 60
Table 9. Medicaid Medical Vendor Payments by Maintenance
Assistance Status ofRecipients 62
Table 10 Medicaid Medical Vendor Payments by Basis of
Eligibility ofRecipients 64
Table 11 Medicaid Medical Vendor Payments by Type ofService 66
Table 12 Medicaid Medical Vendor Payments for Categorically
Needy Recipients Who Receive Cash Payments by
Basis ofEligibility 71
Table 13. Medicaid Medical Vendor Payments for Categorically
Needy Recipients Who Do Not Receive Cash Payments
by Basis ofEligibility 73
Table 14 Medicaid Medical Vendor Payments for Medically
Needy Recipients by Basis ofEligibility 75
Table 15 Medicaid Medical Vendor Payments for Other Coverage
Groups from Pre 1988 Legislation by Basis ofEligibility 77
Table 16 Medicaid Medical Vendor Payments for Coverage Groups
MCCA &
from of 1988 Later Legislation by Basis ofEligibility 79
Table 17 Medicaid Eligibles by Full-Year, Partial Year and
Months Covered 81
Table 18 Medicaid Eligibles by Maintenance Assistance Status 82
Table 19 Medicaid Eligibles by Basis ofEligibility 84
Table 20 Categorically Needy Medicaid Eligibles Who Receive
Cash Payments by Basis ofEligibility 86
Table 21 CategoricallyNeedy Medicaid Eligibles Who
Do Not Receive Cash Payments by Basis ofEligibility 88
Table 22 Medically Needy Medicaid Eligibles Who Do
Not Receive Cash Payments by Basis ofEligibility 90
Table 23. Medicaid Eligibles ofOther Coverage Groups from
Pre 1988 Legislation by Basis ofEligibility 92
Table 24. Medicaid Eligibles ofOther Coverage Groups from
MCCA &
of 1988 Later Legislation by Basis ofEligibility 94
Table 25. Medicaid Recipients ofMedical Care by Age 96
Table 26. Medicaid Recipients ofMedical Care by Sex 99
Table 27. Medicaid Recipients ofMedical Care by Race/Ethnicity 100
Table 28. Medicaid Vendor Payments ofMedical Care by Age 102
Table 29. Medicaid Vendor Payments ofMedical Care by Sex 105
Table 30. Medicaid Vendor Payments ofMedical Care by
Race/Ethnicity 106
Table 31. Medicaid Eligibles ofMedical Care by Age 108
Table 32. Medicaid Eligibles ofMedical Care by Sex Ill
Table 33. Medicaid Eligibles ofMedical Care by Race/Ethnicity 112
Table 34. Medicaid Inpatient Hospital Recipients, Discharges
and Days ofCare 114
Table 35. Medicaid Long-Term Care Recipients and
Days ofCare 115
Table 36. Medicaid Eligibles and Payments ofMedicare
Premiums for Aged and Disabled 117
Table 37. Medicaid Eligibles and Premium Payments for
Health Insurance Plans and Capitation Plans 119
Table 38. Medicaid Eligibles and Premium Payments for
Qualified and Provisional Health Maintenance Organizations 120
Table 39. Medicare Deductible and Coinsurance Payments for Aged 121
Table 40. Medicare Deductible and Coinsurance Payments for Disabled 123
B. Managed Care Enrollment Table by Region and State - June 30, 1994
Table Managed Care Enrollment 126
1.
C. Census Statistics Tables by Region and State - July 1, 1994
Table Population Estimates by Age 128
1.
Table 2. Population Estimates by Sex 130
VI