GAO report: 5 percent of Medicaid-only children account for nearly half of Medicaid-only spending

Health InsuranceFrom Press Release


A new report from the Government Accountability Office finds that for the period studied, the most expensive 5 percent of Medicaid-only enrollees accounted for almost half of the expenditures for all Medicaid-only enrollees.

U.S. Sen. Chuck Grassley (R-IA) was one of the requesters of the report.  Grassley is also one of the lead sponsors of bipartisan legislation, introduced in January, to help coordinate care and improve health outcomes for children with medically complex conditions in Medicaid.  Grassley made the following comment on the report.

“Since a small number of enrollees account for a major cost of providing care, and Medicaid spending increases are a concern, the state and federal governments should consider creative models to lower the costs of treating these high cost populations.  An example of legislation that would help is the Advancing Care for Exceptional Kids Act of 2015.  This bill is a creative idea to provide high quality, more efficient care for really sick kids through networks of providers who are willing to take responsibility for coordinating their care.  Sustaining Medicaid for the people who need it requires new ideas.”

The GAO report is available here.  More information on the Advancing Care for Exceptional Kids Act of 2015 is available here.