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

Cynthia Boyd
Bruce Leff
Carlos Weiss
Jennifer Wolff
Allison Hamblin
Lorie Martin
December 2010

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.
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