Clarifying Multimorbidity Patterns to Improve Targeting and Delivery of Clinical Services for Medicaid Populations

Key Questions Answered
  • What are the patterns of comorbidity among Medicaid beneficiaries?
  • How can a better understanding of these patterns lead to better care and lower costs?
Key Themes and Takeaways

To inform the delivery of targeted care for the highest-need beneficiaries, this resource examines comorbidity patterns among Medicaid beneficiaries under 65 years old with disabilities. Key findings include:

  • Among this population, people who have the highest hospitalization rates and receive the most avoidable, costly care also frequently have multiple conditions.
  • For beneficiaries with one of five common chronic physical conditions — asthma/chronic obstructive pulmonary disease, congestive heart failure, coronary heart disease, diabetes, or hypertension — the presence of mental illness as well as drug and alcohol disorders significantly increases per capita costs and number of hospitalizations.
  • Beneficiaries who have a mental illness in addition to common chronic physical conditions have health care costs that are 60 to 75 percent higher than those without a mental illness.
  • Evidence-based models for addressing multimorbidity share common elements that can inform Medicaid care management approaches.
  • Greater integration and care management strategies are needed to meet the needs of beneficiaries with multiple conditions.
Cynthia Boyd
Bruce Leff
Carlos Weiss
Jennifer Wolff
Allison Hamblin
Lorie Martin
Population Addressed
Adults Under 65 with Disabilities
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Rigorous Observational Study; Moderate Evidence
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