OBJECTIVES: This study compared home healthcare use and expenditures among elderly Medicare beneficiaries with and without Parkinson’s disease (PD) and analyzed the extent to which individual-level factors contribute to the excess home healthcare use and expenditures among individuals with PD. METHODS: A retrospective, observational, cohort study was conducted using Medicare 5% sample claims database with baseline (year 2006) and follow-up (year 2007) period. The study sample included elderly (age > 65 years) fee-for-service Medicare beneficiaries continuously enrolled in Medicare Part A and B for 2006 and 2007. Elderly Medicare beneficiaries with PD were identified based on the ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes of 332.xx during baseline. All the independent variables were measured during baseline. The dependent variables (home healthcare use and expenditures) were measured in 2007. Logistic regressions and Ordinary Least Square regressions were used to assess the association of PD with home health use and expenditures respectively. Post regression non-linear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. RESULTS: Elderly Medicare beneficiaries with PD had 13.3 percentage point higher home healthcare use, of which 27.5% were explained by differences in characteristics between the two groups. Among home healthcare users, those with PD had greater expenditures ($6,792) compared to those without PD ($4,965). Only 18% of the difference in home healthcare expenditures were explained by differences in characteristics between the two groups. Baseline resource use and comorbidities explained majority of the differences in home healthcare use and expenditures. CONCLUSIONS: These findings underscore the importance of developing interventions such as using appropriate evidence based co-management of multiple chronic conditions and need of interdisciplinary team collaboration to provide better care.