Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #94 

September 2005 

Changes in Home Health Care Use and 

Expenditures between 1998/99 and 2002 Highlights 

Virender Kumar, PhD and Gary Olin, PhD 

¢ Between 1998/99 and 

Introduction 2002, individuals under 65 

years of age increased 

The Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) provides information on health care use, expenditures, 

and sources of payment among the U.S. civilian noninstitutionalized 

population. This Statistical Brief provides an overview of home health 

care use and expenditures for this population in 1998/99 and 2002. 

The data for 1998 and 1999 have been combined to increase the 

precision of estimates for this period. Only differences between 

their use of paid home 

health care. The proportion 

of non-elderly people with 

home health care expenditures rose from 0.7 percent 

to 0.9 percent during this 

period. 

estimates for the selected years that are statistically significant at the 

0.05 level are discussed in the text. ¢ Between 1998/99 and 

Findings 

2002, Medicaid payments 

increased by 75 percent, 

while state and local 

Paid home health care use by age group government payments 

Table 1 contains estimates of the number and percentage of the U.S. declined by more than 50 

civilian noninstitutionalized population, by age group, with home percent. 

health care expenditures in 1998/99 (pooled 1998 and 1999 calendar 

year data) and 2002. Home health care use was relatively stable 

during this period, although the proportion of non-elderly people with 

home health care expenditures did increase by 0.2 percentage 

points between 1998/99 and 2002 (from 0.7 percent to 0.9 percent). 

¢ The Medicaid share of 

home health care expenditures for the non-elderly 

Home health care expenditures by payment source 

Table 2 shows total home health care expenditures and payments by 

source (all in constant 2002 dollars) for the years 1998/99 and 2002. 

Significant changes were observed for Medicaid and state and local 

rose from 34.2 percent in 

1998/99 to 73.4 percent in 

2002. In contrast, the state 

and local government 

share of home health care 

government home health care expenditures, which moved in 

opposite directions. Medicaid expenditures for home health care 

increased by 75 percent, from $8.9 billion in 1998/99 to $15.6 billion 

in 2002, while state and local government expenditures fell more 

expenditures fell for both 

the non-elderly and the 

elderly, with the biggest 

decline seen in the share 

than half, from $6.3 billion in 1998/99 to 2.7 billion in 2002. paid for the non-elderly 

Expenditure distributions by payment source (falling from 31.4 percent 

in 1998/99 to 7.7 percent 

Table 3 presents the share of home health care expenditures (in in 2002). 

constant 2002 dollars) paid by source for non-elderly and elderly 

people in 1998/99 and 2002. The share paid by Medicaid grew from 

30.6 percent in 1998/99 to 44.8 percent in 2002. This growth was 
driven by increased Medicaid expenditures for non-elderly users of home health care, with the Medicaid 

share of their expenditures more than doubling from 34.2 percent in 1998/99 to 73.4 percent in 2002. 

In contrast, the state and local government share of home health care expenditures for both the nonelderly and the elderly fell during this period. For non-elderly persons, the state and local government 

share decreased from 31.4 percent in 1998/99 to 7.7 percent in 2002. State and local government 

funding of home health care expenses for the elderly population decreased from 15.5 percent in 

1998/99 to 7.7 percent in 2002. 

Data Source 

The estimates shown in this Statistical Brief are drawn from analyses of the 1998, 1999, and 2002 Full 

Year Consolidated Data Files (HC-028, HC-038, and HC-070, respectively), which are available on the 

MEPS Web site (www.meps.ahrq.gov). 

Definitions/Methodology

Population 

Estimates presented in this brief are for persons who were living in the community for all or part of the 

year. Persons in the military and those residing in nursing homes or other institutions for the entire year 

are not included in the comparisons. 

Home health care use 

Persons with expenditures for services from home health care agencies and paid independent 

providers are counted as receiving home health care during the reported year. 

Age 

Age is the sampled person’s age as of December 31st of the reported year. 

 

Expenditures 

Home health care expenditures include all direct payments to providers of the services. Sources of the 

payments include individuals, private insurance (including TRICARE), Medicare, Medicaid, and other 

sources such as the Veterans’ Administration, Workers’ Compensation, and miscellaneous public 

sources. Expenditures were adjusted to constant 2002 dollars using the overall consumer price index 

(http://www.bls.gov/cpi/home.htm#data). 

Total private expenditures 

Total private is the sum of out-of-pocket (including family and friends), private insurance, other private, 

and TRICARE expenditures. 

Total government expenditures 

Total government is the sum of Medicare, Medicaid, Department of Veteran's Affairs, Indian Health 

Services, other Federal sources, Worker's compensation, other state and local government, other 

public sources, and unclassified source funds. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of 

social, demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 
References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component.

MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care 

Policy and Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component.

MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care 

Policy and Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Kumar, V. (Westat) and Olin, G. (AHRQ). Changes in Home Health Care Use and Expenditures 

between 1998/99 and 2002. Statistical Brief #94. September 2005. Agency for Healthcare Research 

and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st94/stat94.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD 

Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Table 1. Number and percentage of the U.S. civilian noninstitutionalized population with home 

health care expenditures, by age group, 1998/99 and 2002 

Paid home health care 

1998/99 2002 

Age group 

Users 

(in thousands) 

Percentage of 

age group 

Users 

(in thousands) 

Percentage of 

age group 

All ages 5,243 1.9 5,992 2.1 

Under 65 1,672 0.7 2,229 0.9 

65 and over 3,571 10.4 3,763 10.4 

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Household Component of the 

Medical Expenditure Panel Survey, 1998, 1999, and 2002.

Table 2. Home health care expenditures for the U.S. civilian noninstitutionalized population, by 

payment source, 1998/99 and 2002 

Source Expenditures (in millions of 2002 dollars) 

 1998/99 2002 

All sources $29,135 $34,817 

Total private 5,130 5,507 

Total governmenta 24,005 29,309 

 Medicare 8,485 10,665 

 Medicaid 8,923 15,612 

 State and local government 6,324 2,676 

a

 Total government is the sum of Medicare, Medicaid, Department of Veteran's Affairs, Indian Health Services, other Federal 

sources, Worker's compensation, other state and local government, other public sources, and unclassified source funds. 

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Household Component of the 

Medical Expenditure Panel Survey, 1998, 1999, and 2002. 

Table 3. Distribution of home health care expenditures for the U.S. civilian noninstitutionalized 

population, by age group and payment source, 1998/99 and 2002 

Age group Source Percentage share of payments 

 1998/99c 2002 

All ages Total private 17.6 15.8 

Total governmenta 82.4 84.2 

 Medicare 29.1 30.6 

 Medicaid 30.6 44.8 

 State and local 21.7 7.7 

Under 65 Total private 20.9 11.3 

Total governmenta 79.0 88.7 

 Medicare 12.5 6.5 

 Medicaid 34.2 73.4 

 State and local 31.4 7.7 

65 and over Total private 15.4 18.6 

Total governmenta 84.6 81.4 

 Medicare 39.9 45.7 

 Medicaid 28.4 27.1 

 State and local 15.5 7.7 

a

 Total government is the sum of Medicare, Medicaid, Department of Veteran's Affairs, Indian Health Services, other federal 

sources, Worker's compensation, other state and local government, other public sources, and unclassified source funds. 

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Household Component of the 

Medical Expenditure Panel Survey, 1998, 1999, and 2002.