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Concentration of Costs
The top 5 percent of Medicaid beneficiaries account for more than half of Medicaid spending. In contrast, the bottom half of Medicaid spending accounts for 5 percent of the costs.
The top 10 percent account for 68 percent of spending
Costs persist over time with many remaining in highest spending levels
State Example:
$82 M $61 M
47%
90%
$19 M
3%
97%
$500$999
53%
41%
$50,000- $100,000 $99,999
10%
$1,000$4,999 $5,000$9,999 $30,000$49,999
25
Integrate mental and physical health services (Massachusetts' Child Psychiatry Access Project) Address costs in long-term care beneficiaries with programs that prevent or delay long-term care, integrate long-term and regular care, and provide low-cost community based options (GRACE) Manage transitions between care providers and physicians
Tools Needed
Risk stratification and predictive modeling to target patients for whom intervention holds promise Best practices collaboration between states Develop technology to identify hot spots Timely feedback to providers to facilitate delivery system reforms
Policy Implications
Policy environment that supports innovation and lowering costs rather than cost-shifting
Facilitate collaboration of public-private partnerships, and at the state and federal levels