More than 55 percent of Medicaid spending is incurred by just five percent of the program’s beneficiaries, including many adults with physical disabilities; individuals with mental illness and substance use disorders; frail elders; children in the child welfare system; and many others with chronic conditions.
Since 2000, CHCS’ Faces of Medicaid series has shed light on the prevalence of specific conditions among Medicaid beneficiaries, patterns of service use, and costs. By better understanding the Medicaid population, states and health plans can identify new opportunities to improve care, enhance health outcomes, and control spending.
CHCS thanks the many funders that have supported the series including the Robert Wood Johnson Foundation, Kaiser Permanente Community Benefit, The Annie E. Casey Foundation, the Substance Abuse and Mental Health Services Administration, The Commonwealth Fund, and the DentaQuest Foundation.
Faces of Medicaid Publications
- Examining Oral Health Care Utilization and Expenditures for Low-Income Adults (November 2017) This analysis explores dental service use and cost data for non-elderly Medicaid-enrolled adults by a number of individual-, community-, and state-level factors. Its findings can help policymakers, Medicaid agencies, public health departments, health/dental plans, and other oral health stakeholders identify opportunities to improve access to care and outcomes.
- Examining Children’s Behavioral Health Service Utilization and Expenditures (2013-2017) These analyses explore behavioral health service use and expense for children enrolled in Medicaid. They highlight opportunities to improve the quality, equitable access to, and cost-effectiveness of care for children in Medicaid. The series also provides analysis on psychotropic medication prescribing patters and the disproportionate use of behavioral services by children in foster care.
- Clarifying Multimorbidity Patterns to Improve Targeting and Delivery of Clinical Services for Medicaid Populations (December 2010) This analysis examines multimorbidity patterns among adult Medicaid beneficiaries with disabilities and explores the implications of specific patterns on hospitalization and cost. It uncovers significant opportunities for prioritizing clinical interventions, including the need to integrate physical and behavioral health services.
- Hospital Readmission among Medicaid Beneficiaries with Disabilities: Identifying Targets of Opportunity (December 2010) Preventing unnecessary hospital readmissions among Medicaid beneficiaries offers tremendous potential for states to improve health care quality and control spending. This analysis examines readmission rates among Medicaid beneficiaries with disabilities and identifies opportunities to reduce recurring hospitalizations.
- Refining the Portrait of People with Multiple Chronic Conditions (October 2009) This report examines five years of Medicaid diagnostic data as well as pharmacy claims in order to further refine the picture of Medicaid beneficiaries with multiple chronic conditions. The insights gained through the analysis may help states and health plans to better prioritize high-opportunity beneficiary groups for targeted interventions that can better meet their needs.
- Recognizing the Care Needs of People with Multiple Chronic Conditions (October 2007) This report highlights findings from an analysis of the prevalence and patterns of chronic conditions among Medicaid beneficiaries. The findings can help Medicaid stakeholders rethink care management approaches for high-need, high-cost beneficiaries with multimorbidity.
- The Complexities of Caring for People with Chronic Illnesses and Disabilities (November 2000) This first Faces of Medicaid analysis of high-need, high-cost Medicaid beneficiaries identifies populations with special needs and highlights the clinical and fiscal implications for states and health plans enrolling people with chronic illnesses and disabilities in managed care.