by Karen Stevenson Brown, CPA, CMA
How has the source of payment for nursing home services changed over the years? I've collected statistics which show the increasing role of Medicaid (now covering 48% of all costs) and Medicare (covering 12%), and the resulting decline in the portion paid out of pocket from 1960 to 1997. The percentage paid by insurance is creeping up, but is still only 5%. Don't relax just yet, though. Over 30% of the cost is still paid out-of-pocket!
Aggregate Nursing Home Expenditures
by Karen Stevenson Brown, CPA, CMA
How has the source of payment for nursing home services changed over the years? I've collected statistics which show the increasing role of Medicaid (now covering 48% of all costs) and Medicare (covering 12%), and the resulting decline in the portion paid out of pocket from 1960 to 1997. The percentage paid by insurance is creeping up, but is still only 5%. Don't relax just yet, though. Over 30% of the cost is still paid out-of-pocket!
Aggregate Nursing Home Expenditures
(Millions of Dollars)
| Out of | Health Insurance | Other Private | Medicare | Medicaid | Other Public | Total | |
| 1997 | 25,741 | 4,02 | 1,562 | 10,150 | 39,439 | 1,860 | 82,774 |
| 1996 | 26,712 | 3,731 | 1,498 | 8,034 | 37,617 | 1,793 | 79,385 |
| 1995 | 26,624 | 3,395 | 1,420 | 6,734 | 35,575 | 1,719 | 75,467 |
| 1994 | 25,284 | 3,025 | 1,335 | 5,513 | 34,264 | 1,672 | 71,093 |
| 1993 | 24,529 | 2,814 | 1,209 | 3,946 | 32,449 | 1,501 | 66,448 |
| 1992 | 24,091 | 2,646 | 1,157 | 2,872 | 30,215 | 1,320 | 62,301 |
| 1991 | 23,085 | 2,386 | 1,056 | 1,935 | 27,480 | 1,222 | 57,164 |
| 1990 | 21,936 | 2,102 | 942 | 1,732 | 23,107 | 1,110 | 50,929 |
| 1989 | 18,806 | 1,784 | 831 | 2,492 | 20,032 | 991 | 44,936 |
| 1988 | 17,449 | 1,527 | 736 | 719 | 18,353 | 990 | 39,774 |
| 1987 | 15,707 | 1,285 | 674 | 482 | 17,251 | 931 | 36,330 |
| 1986 | 14,790 | 1,033 | 618 | 450 | 15,750 | 866 | 33,507 |
| 1985 | 13,601 | 813 | 565 | 452 | 14,494 | 753 | 30,678 |
| 1984 | 12,222 | 629 | 565 | 426 | 13,379 | 698 | 27,919 |
| 1983 | 11,058 | 491 | 568 | 393 | 12,377 | 589 | 25,476 |
| 1982 | 9,784 | 376 | 562 | 367 | 11,171 | 525 | 22,785 |
| 1981 | 8,237 | 274 | 550 | 337 | 10,355 | 448 | 20,201 |
| 1980 | 7,370 | 212 | 533 | 307 | 8,830 | 397 | 17,649 |
| 1979 | 6,263 | 157 | 512 | 282 | 7,753 | 337 | 15,304 |
| 1978 | 5,724 | 124 | 500 | 268 | 6,516 | 307 | 13,439 |
| 1977 | 4,983 | 94 | 478 | 267 | 5,408 | 270 | 11,500 |
| 1976 | 4,315 | 74 | 461 | 260 | 4,569 | 228 | 9,907 |
| 1975 | 3,691 | 65 | 415 | 220 | 4,086 | 191 | 8,668 |
| 1974 | 3,314 | 51 | 363 | 201 | 3,298 | 166 | 7,393 |
| 1973 | 3,242 | 37 | 321 | 165 | 2,442 | 145 | 6,352 |
| 1972 | 2,829 | 25 | 273 | 120 | 2,146 | 123 | 5,516 |
| 1971 | 2,428 | 21 | 236 | 120 | 1,367 | 590 | 4,762 |
| 1970 | 2,256 | 16 | 207 | 142 | 940 | 654 | 4,215 |
| 1969 | 2,012 | 12 | 174 | 215 | 771 | 383 | 3,567 |
| 1968 | 1,663 | 8 | 150 | 243 | 706 | 213 | 2,983 |
| 1967 | 1,199 | 8 | 123 | 190 | 628 | 190 | 2,338 |
| 1966 | 1,160 | 3 | 99 | 0 | 204 | 346 | 1,812 |
| 1965 | 884 | 2 | 84 | 0 | 0 | 502 | 1,472 |
| 1964 | 743 | 0 | 77 | 0 | 0 | 403 | 1,223 |
| 1963 | 660 | 0 | 66 | 0 | 0 | 330 | 1,056 |
| 1962 | 586 | 0 | 58 | 0 | 0 | 273 | 917 |
| 1961 | 636 | 0 | 56 | 0 | 0 | 188 | 880 |
| 1960 | 661 | 0 | 54 | 0 | 0 | 133 | 848 |
Source: Health Care Financing Administration, Office of the Actuary: National Health Statistics Group
See the supporting data at http://www.hcfa.gov/stats/nhe-oact/nhe.htm