Disproportionate Medicaid Expenditures: Select Analyses

Cassie Pavesi (Editor)

Series: Health Care in Transition
BISAC: POL019000



Volume 10

Issue 1

Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick


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Medicaid is an important source of health coverage for millions of low-income individuals. Research on Medicaid has demonstrated that a small percentage of beneficiaries account for a disproportionately large share of Medicaid expenditures. Understanding states’ expenditures for high-expenditure populations—both those dually eligible for Medicare and Medicaid, and those who are Medicaid-only—could enhance efforts to manage Medicaid expenditures.

This book examines high-expenditure Medicaid-only beneficiaries, considering states’ spending on them compared with all other Medicaid beneficiaries; their key characteristics; and their service usage compared with all other Medicaid-only beneficiaries. This book also provides an overview of Medicaid disproportionate share hospital (DSH). It includes a description of the rules delineating how state DSH allotments are calculated and the exceptions to the rules, how DSH hospitals are defined, and how DSH payments are calculated. (Imprint: Novinka )


Chapter 1 - Medicaid: Demographics and Service Usage of Certain High-Expenditure Beneficiaries (pp. 1-46)
United States Government Accountability Office

Chapter 2 - Medicaid Disproportionate Share Hospital Payments (pp. 47-96)
Alison Mitchell


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