The slowing of Medicaid spending and enrollment growth reflects less reimbursement for healthcare providers, a report released Thursday suggests.

Medicaid enrollment growth fell to 3.2% in 2012, compared to 4.4% in 2011. Government spending growth on Medicaid slowed to 2% in 2012. By comparison, Medicaid spending last year increased by almost 10%, according to results of a survey conducted by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

While the researchers said the current numbers reflect a better economy, it also was due to less payment for providers. Forty-five states restricted provider payment rates in 2012 and 42 states plan to do the same in 2013. Medicaid pays for the vast majority of nursing home care.

Twenty states also reported expanded use of managed care, which is believed to hold opportunities for skilled nursing facilities.

According to the Kaiser report, states are continuing to work on programs that change how long-term care is delivered through a number of Affordable Care Act programs.

“Cost pressure and cost containment were still dominant themes, but states were also able to consider program changes, payment and delivery system reforms and continue efforts to re-orient long-term care programs to community-based care models,” the report states.

Click here to read the executive summary, and here to read the full report.