Thursday, March 6, 2014

GAO Delves into Issues with High Cost Medicaid Beneficiaries

GAO Delves into Issues with High Cost Medicaid Beneficiaries
On February 19th, the Government Accountability Office (GAO) published a report on high-cost Medicaid beneficiaries. In FFY 2009, the GAO found that 31.6 percent of all Medicaid expenditures were spent on the most expensive Medicaid-only beneficiaries, who were 4.3 percent of total Medicaid beneficiaries. Conversely, states spent another third (33.1 percent) on all other Medicaid-only beneficiaries, who represented 81.2 percent of total Medicaid beneficiaries. The report found that dual eligibles followed a similar pattern.
Overall, the GAO found that the likelihood of being a high-expenditure Medicaid-only beneficiary was based on certain characteristics, including:
  • 24.4 percent for those residing in a long-term care facility;
  • 20.8 percent for those with HIV/AIDS;
  • 18.3 percent for those with disabilities; and,
  • 13.3 percent for new mothers or infants

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