Medicaid chemical dependency patients in a commercial health plan

A cohort of 197 Medicaid-insured patients presenting for treatment in Kaiser Permanente's out-patient chemical dependency treatment program were observed the year prior to their program intake visit and followed for 3 years afterwards, to compare their medical costs and utilization to demographically matched commercially insured patients entering the same programs. The Medicaid-insured patients on average incurred medical costs 60% higher than non-Medicaid patients during the 12-month preintake period ($5402 vs $3277). During the 3 years subsequently, however, both groups of chemical dependency patients displayed significant declines in medical costs, averaging 30% from the baseline period to the third year of follow-up. Cost trends reflected declines in use of hospital days, emergency department visits, and nonemergent outpatient visits. These results may help address concerns among Medicaid managed care providers and payers by giving a more realistic account of the long-term costs of this group of high-utilizing enrollees.

对197名参加凯撒医疗集团门诊药物依赖治疗项目且享受医疗补助保险的患者进行了观察，观察时间为他们参加项目前一年，并在之后随访3年，以便将他们的医疗费用和医疗资源利用情况与参加相同项目且人口统计学特征匹配的商业保险患者进行比较。在参加项目前的12个月期间，享受医疗补助保险的患者平均产生的医疗费用比非医疗补助患者高60%（5402美元对3277美元）。然而，在随后的3年中，两组药物依赖患者的医疗费用都显著下降，从基线期到随访的第三年平均下降30%。费用趋势反映了住院天数、急诊就诊次数和非急诊门诊就诊次数的减少。这些结果通过更真实地说明这组高利用率参保人的长期费用，可能有助于解决医疗补助管理式医疗服务提供者和支付者的担忧。