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[Title Page]

Contents

I. Introduction 11

1. Medicaid: Overview 12

II. Medicaid Benefit Structure: Present Problems 17

1. Medicaid spending and benefit structure today 17

2. Increasing use of medical services and care by Medicaid beneficiaries 20

A. Number of medical services or treatments provided: Total and per beneficiary 22

B. Number of hospitalization days and outpatient visits: Total and per beneficiary 24

C. Number of patients visiting doctors' offices 27

3. Amount of medical expenses per capita for each age group 27

4. Problems with the current Medicaid spending structure 30

III. Medical Spending Forecasts 34

1. Medicaid spending forecast model 34

2. Forecasts on the number of Medicaid beneficiaries 36

A. Forecasts on the number of Medicaid beneficiaries: Based on the minimum cost of living(MCL) 36

B. Forecasts on the number of Medicaid beneficiaries: Based on the median income 41

C. Forecasts on the number of Medicaid beneficiaries by age group 46

3. Model for forecasting Medicaid spending per capita 51

A. Forecasts on Medicaid spending per capita 51

B. Forecasts on Medicaid costs per capita for each age group 55

4. Forecasts on Medicaid spending 57

A. MCL model 57

B. Median income(MI) model 59

C. Age group model 61

IV. Conclusion 63

Bibliography 66

List of Tables

〈Table I-1〉 Medicaid Reform: Overview 16

〈Table II-1〉 Trends in the NBLSP and Medicaid Budgets 18

〈Table II-2〉 Composition of Medicaid Beneficiaries Aged 65 or Older 21

〈Table II-3〉 Medical Spending per Capita and Age Group(2000-2012) 28

〈Table III-1〉 Ratios of NBLSP-Supported Households in Different-Sized... 37

〈Table III-2〉 Estimates on the Numbers of Different-Sized Households 38

〈Table III-3〉 Estimates on the Number of Other-Type Medicaid Beneficiaries 39

〈Table III-4〉 Estimates on the Number of Medicaid Beneficiaries(Based on the... 40

〈Table III-5〉 Distribution of 40%-MI Households of Different Sizes 43

〈Table III-6〉 Estimated Ratios of 40%-MI Households of Different Sizes... 44

〈Table III-7〉 Estimated Number of Medicaid Beneficiaries for Each Scenario... 45

〈Table III-8〉 Age Distribution of Medicaid Beneficiaries(2000-2012) 48

〈Table III-9〉 Yearly Forecasts on the Age Distribution of Medicaid... 49

〈Table III-10〉 Yearly Forecasts on the Age Distribution of Medicaid... 50

〈Table III-11〉 Time-Series Model Forecasts on Medicaid Costs per Capita 53

〈Table III-12〉 Forecasts on Medicaid Costs per Capita by Year and Type 54

〈Table III-13〉 Average Ratios of Medical Costs per Capita for Each Age Group 55

〈Table III-14〉 Forecasts on Total Medical Costs per Capita for Each Age Group 56

〈Table III-15〉 Medicaid Spending Forecasts for Each Scenario(MCL Model) 57

〈Table III-16〉 Medicaid Spending-to-GDP Ratio Forecasts for Each Scenario(MCL... 58

〈Table III-17〉 Medicaid Spending Forecasts for Each Scenario(MI Model) 59

〈Table III-18〉 Medicaid Spending-to-GDP Ratio Forecasts for Each Scenario(MI... 60

〈Table III-19〉 Medicaid Spending Forecasts for Each Scenario(Age Group Moel) 61

〈Table III-20〉 Medicaid Spending-to-GDP Ratio Forecasts for Each Scenario... 62

List of Figures

[Figure II-1] Trends in Medicaid Spending for Different Classes of Beneficiaries 19

[Figure II-2] Trends in Different Types of Medicaid Expenses 20

[Figure II-3] Composition of Medicaid Beneficiaries 21

[Figure II-4] Trends in the Number of Medical Services and Treatments Provided... 22

[Figure II-5] Trends in the Number of Medical Services and Treatments Provided... 23

[Figure II-6] Trends in the Ratios of Medicaid Beneficiaries Seeking Medical... 24

[Figure II-7] Trends in the Number of Hospitalization Days and Outpatient Visits... 25

[Figure II-8] Trends in the Number of Hospitalization Days and Outpatient Visits... 25

[Figure II-9] Trends in the Number of Hospitalization Days and Outpatient Visits... 26

[Figure II-10] Trends in the Number of Hospitalization Days and Outpatient Visits... 26

[Figure II-11] Trends in Medical Spending Per Capita and Age Group(2000-2012) 30

[Figure II-12] Comparison of Total Spending per Capita: NHI vs. Medicaid 31

[Figure II-13] Comparison of Benefits per Capita: NHI vs. Medicaid 31

[Figure II-14] Comparison of the Number of Hospitalization Days and Outpatient... 32

[Figure III-1] Medicaid Spending Forecast Model 35

[Figure III-2] Forecasts on the Total Number of Medicaid Beneficiaries(Based... 41

[Figure III-3] Household Income Distribution: Median Income and Average Income... 42

[Figure III-4] Trends in Median Income and Average Income(Based on Market... 42

[Figure III-5] Forecasts on the Number of Medicaid Beneficiaries(40%-MI... 46

[Figure III-6] Trends in the Age Distribution of Medicaid Beneficiaries(2000-2012) 47

[Figure III-7] Yearly Forecasts on the Number of Beneficiaries in Each Scenario 47

[Figure III-8] Yearly Trends in Medical Spending per Capita(2000-2012) 51

[Figure III-9] Monthly Trends in Medicaid Spending per Capita(January... 52

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