GAO Report: Demographics and Service Usage of Certain High-Expenditure Beneficiaries

Posted by Alexandra Kielty - On February 24, 2014 (EST)

The General Accountability Office (GAO) issued GAO-14-176: "Demographics and Service Usage of Certain High-Expenditure Beneficiaries" on Feb 19, 2014. GAO found that in fiscal year 2009, states spent nearly a third (31.6 percent) of all Medicaid expenditures on the most expensive Medicaid-only beneficiaries, who were 4.3 percent of total Medicaid beneficiaries. States spent another third (33.1 percent) on all other Medicaid-only beneficiaries, who represented 81.2 percent of total Medicaid beneficiaries. Among dual eligible beneficiaries, a similar pattern existed, with a small proportion of the population accounting for a disproportionate share of expenditures.

Certain characteristics significantly increased the probability of being a high-expenditure Medicaid-only beneficiary. Specifically, the results of GAO's analyses indicate that the probability of being a high-expenditure Medicaid-only beneficiary was:

•24.4 percent for those residing in a long-term care facility,
•20.8 percent for those with human immunodeficiency virus/acquired immunodeficiency syndrome,
•18.3 percent for those with disabilities, and
•13.3 percent for new mothers or infants.

Highlights of the report are at: http://www.gao.gov/assets/670/661010.pdf

A PDF version of the full report is at: http://www.gao.gov/assets/670/661011.pdf



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