McKnight's January 17, 2025
Before Medicaid came on the scene in 1965, everyone paid out of pocket for long-term care (LTC). Operators received a market rate for the services they provided. There was no special rate below the cost of care for public welfare recipients. Nor was there a special, higher private-pay rate to shift uncompensated costs to private payers. Those were the days!
Then came Medicaid. After five years, in 1970, out-of-pocket nursing home expenditures (call them OOPs) had fallen to less than half (49.2%) of total annual spending. By 2000, OOPs were under a third (31.6%) and by 2011, they were only a hair over one-quarter (25.3%). OOPs have since rebounded all the way to 26.1% as of the latest 2023 National...
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