Per capita Med­i­caid spend­ing varies widely: GAO

Modern Healthcare - - NEWS - By Paul Demko

Per capita spend­ing on Med­i­caid ben­e­fi­cia­ries var­ied widely across the coun­try in fis­cal 2008, ac­cord­ing to an anal­y­sis by the Govern­ment Ac­count­abil­ity Of­fice.

In eight states, in­clud­ing New York, ben­e­fi­cia­ries cost an aver­age of at least $10,500. In con­trast, in six states in­clud­ing Cal­i­for­nia and Illi­nois, the per-en­rollee cost was less than $6,000. The cost in 35 states and the District of Columbia fell be­tween those two groups. Be­cause of faulty data, Mas­sachusetts was not in­cluded in the cal­cu­la­tions.

Cal­i­for­nia’s pro­gram was the most fru­gal, spend­ing roughly $3,800 per Med­i­caid en­rollee. At the other end of the spec­trum was Rhode Is­land, which spent $11,700. But the GAO noted that be­cause of im­per­fect data, the num­bers should be viewed with cau­tion.

The anal­y­sis was re­quested by Sen. Or­rin Hatch (R-Utah) and Rep. Fred Up­ton (R-Mich.). Grow­ing out of his op­po­si­tion to the Med­i­caid ex­pan­sion un­der the Pa­tient Pro­tec­tion and Af­ford­able Care Act, Hatch called for additional scru­tiny of the spend­ing dis­crep­an­cies.

There were wide dis­par­i­ties be­tween the states even for the same types of ben­e­fi­cia­ries. Dis­abled en­rollees, for in­stance, cost an aver­age of $9,000 in Alabama com­pared with $32,000 in New York. Ver­mont spent more than three times as much as Cal­i­for­nia on each child en­rollee. Care pat­terns also var­ied sig­nif­i­cantly be­tween states. For in­stance, the per­cent­age of el­derly en­rollees re­ceiv­ing longterm-care ser­vices var­ied from 18.4% in Florida to 65.6% in Iowa.

The over­all dif­fer­ences in spend­ing can be partly ex­plained by vari­a­tions in the makeup of each state’s Med­i­caid pop­u­la­tion. West Vir­ginia, for ex­am­ple, had the high­est rates of el­derly and dis­abled ben­e­fi­cia­ries, who gen­er­ally are more ex­pen­sive to cover.

Last year, the federal govern­ment spent $267 bil­lion for its con­tri­bu­tion to the federal-state Med­i­caid pro­gram for low-in­come and dis­abled Amer­i­cans. That num­ber is ex­pected to rise to nearly $600 bil­lion by 2024, ac­cord­ing to the Con­gres­sional Budget Of­fice.

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