title: Factors associated with expenditures for medicaid home and community based services (HCBS) and intermediate care facilities for persons with mental retardation (ICF/MR) services for persons with intellectual and developmental disabilities.
abstract: This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual characteristics, by residential setting type, Medicaid program (ICF/MR or HCBS), and state. Annual average per-person Medicaid expenditures for HCBS recipients were less than those of ICF/MR residents ($61,770 and $128,275, respectively). HCBS recipients had less severe disability (intellectual, physical, health service needs) than ICF/MR residents. Controlling these differences, and for congregate settings, HCBS were less costly than ICFs/MR, but this distinction accounted for only 3.3% of variation in expenditures. Persons living with families receiving HCBS ($25,072) and in host families (including foster, companion, or shared living arrangements; $44,112) had the lowest Medicaid expenditures.
authors.affiliation: Research and Training Center on Community Living, University of Minnesota, Minneapolis, MN 55455, USA. lakin001@umn.edu
authors.forename: K Charlie
authors.initials: KC
authors.lastname: Lakin
authors.forename: Robert
authors.initials: R
authors.lastname: Doljanac
authors.forename: Soo-Yong
authors.initials: SY
authors.lastname: Byun
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Stancliffe
authors.forename: Sarah
authors.initials: S
authors.lastname: Taub
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Chiri
mesh_terms: D000328:Adult; D002648:Child; D003153:Community Health Services / Q000191:economics* / Q000706:statistics & numerical data; D002658:Developmental Disabilities / Q000191:economics / Q000628:therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008607:Intellectual Disability / Q000191:economics / Q000628:therapy*; D007380:Intermediate Care Facilities / Q000191:economics*; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States