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New Study Details Complex Health Care Needs of Medicaid's Highest-Need, Highest-Cost Populations
Date:10/20/2009

lowing are highlighted findings resulting from the addition of pharmacy data:

  • The proportion of Medicaid beneficiaries with disabilities who are diagnosed with three or more chronic conditions increases from 35 percent to 45 percent.
  • The frequency of psychiatric illness among Medicaid beneficiaries with disabilities increases from 29 percent to 49 percent. Similarly, the prevalence of cardiovascular disease increases from 32 percent to 44 percent.
  • Costs for Medicaid-only beneficiaries with three or more chronic conditions increases from 66 percent to 75 percent of total spending for beneficiaries with disabilities.

Pharmacy data was particularly valuable in illustrating the prevalence of psychiatric illness in high-cost Medicaid beneficiaries. Examining diagnostic and pharmacy data together, psychiatric illness is represented in three of the top five most common pairs of diseases among the highest-cost 5 percent of Medicaid-only beneficiaries with disabilities. This was not apparent using diagnostic data alone.

"These patients account for much of the cost and use of services in Medicaid, and require special attention, considerable resources and an intensive approach to care management," said Raymond J. Baxter, PhD, senior vice president, Community Benefit, Research and Health Policy, Kaiser Permanente. "This report contributes significantly to the body of information about how to understand and improve the care of patients with complex, chronic conditions."

The Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions is the third edition in CHCS' Faces of Medicaid series. It is available for download at www.chcs.org.

The Center for Health Care Strategies (CHCS) is a nonprofit policy resource center dedicated to improving health care quality fo
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SOURCE Kaiser Permanente
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