The most expensive 5% of Medicaid beneficiaries nationally accounted for nearly half of program spending from 2009 to 2011, the Government Accountability Office reports.
The new GAO study did not include people who are dually eligible for Medicaid and Medicare, who are some of the most expensive patients in the program. The study shows that there is another group of very expensive Medicaid patients besides dual eligibles.
“Studies on healthcare spending generally find that a small percentage of individuals account for a large proportion of expenditures, and Medicaid…is no exception,” the report said.
The most expensive 1% of Medicaid-only enrollees accounted for about one-quarter of the expenditures for Medicaid-only enrollees. The most expensive 5% accounted for almost half of the expenditures. The most expensive 25% accounted for more than three quarters of the expenditures.
On the opposite end, the least expensive 50% accounted for less than 8% of the expenditures. About 12% had no expenditures.