December 16, 2009

The Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions

This article was written by Richard G. Kronick, PhD, University of California, San Diego, Melanie Bella, Center for Health Care Strategies, Todd P. Gilmer, PhD, University of California, San Diego. It writes that in Medicaid, the elderly and adults with disabilities make up only 25 percent of beneficiaries, but account for a majority of program spending. Within this population, fewer than 5% of beneficiaries account for more than 50% of overall Medicaid costs. Most of these high-cost beneficiaries receive care within an unmanaged fee-for-service delivery system, and the majority of them would benefit greatly from more integrated systems of care. By better understanding the specific health conditions of these beneficiaries, states can make more informed decisions about how to best manage care, thereby improving health outcomes, increasing quality of life, and controlling program costs.