Association between persistent high costs and chronic physical, mental and disability-related health conditions among community-dwelling Medicare-Medicaid dually eligible enrollees
Journal Title: Archives of Community Medicine and Public Health - Year 2018, Vol 4, Issue 2
Abstract
Background: The 11.4 million Americans who receive both Medicare and Medicaid benefits constitute one of the nation’s most vulnerable and costly populations. Objectives: We examine the relationship between persistently high costs (PHC) and physical, mental, and disability-related conditions among community-dwelling dully eligible enrollees. Research Design: Retrospective longitudinal study. Subjects: Community-dwelling beneficiaries who were continuously enrolled in Medicare and Medicaid fee-for-service 2007 through 2009. Measures: Beneficiaries in the top 10% of spending in all three study years were defined as having PHC. Chronic conditions were identified via CMS Chronic Condition Warehouse pre-defined variables. Results: Medicare and Medicaid collectively paid $77.7 billion for 1.46 million beneficiaries in the study from 2007 through 2009. Of these total expenditures, 39.3% were attributable to the 6.9% of dually eligible enrollees who were PHC. Medicaid accounted for 44.5% of total spending. Of the total Medicaid spending on dual enrollees, 67.9% was incurred by those individuals identified as PHC. An overwhelming 83.8% of PHC dually eligible enrollees were younger than 65 years. Beneficiaries with at least one disability-related condition were more likely to be PHC. In particular, beneficiaries with “intellectual disabilities and related conditions” were found to be 17 times more likely to be PHC compared to those without this condition, though this cost may be attributable to other concomitant health issues. Conclusion: Individuals with certain chronic conditions, especially disability-related conditions, tend to have persistently high costs over time. They may be particularly suitable candidates for interventions or payment models that promote more coordinated and efficient care. (250/250).
Authors and Affiliations
L Zhao, KK Anderson, G Riley
Keywords
Related Articles
- EP ID EP529318
- DOI 10.17352/2455-5479.000043
- Views 64
- Downloads 0
Injection Safety: Knowledge and Practices among Nursing Personnel in Tertiary Care Teaching Hospital of Marathwada Region of Maharashtra, India
Background: Unsafe injection practices put patients and healthcare providers at risk of infectious and non-infectious adverse events, sound knowledge and skillful practices of nurses are vital to breaks the chain of bloo...
How to induce, generate and control Immunological Anomalies in humans?
This review unravels the details of the immunological properties underlying the inducement, generation and control of immunological errors, the antigenic changes in the cells themselves, and the extent and activities of...
Palliative Care for Cancer: A Public Health Challenge in India
Palliative care is an emerging discipline worldwide which focuses on improving the quality of life of patients with chronic life threatening condition like cancer. Globally, palliative care is sparsely distributed in dev...
Necrotizing Fasciitis caused by Streptococcus pyogenes: A case report and literature review of disease diagnosis and management
Background: A 55-year-old male presented to the emergency room at a local hospital complaining of chest discomfort and severe left elbow pain. Case Presentation: Erythema and symptoms of peripheral neuropathy were evide...
Factors Associated with Medication Adherence among hypertensive Patients in a Tertiary Health Center: A Cross-Sectional Study
Introduction: Medication non-adherence is a major hindrance in the treatment of hypertension in Sub Saharan Africa. It is a major modifiable contributor to poor blood pressure control and complications of the disorder. A...