Online Program

Utilizing Massachusetts Medicaid data to inform health service utilization, expenditures, and prevalence of comorbid conditions for people with intellectual disabilities

Sunday, November 1, 2015

Emily Lauer, MPH, Center for Developmental Disabilities Evaluation and Research, E.K. Shriver Center, University of Massachusetts Medical School, Worcester, MA
Georgia Simpson May, MSW, Massachusetts Department of Public Health, Boston, MA
Monika Mitra, PhD, Lurie Institute for Disability Policy, Heller School of Social Policy and Management, Brandeis University, Waltham, MA
Information on health service utilization, insurance coverage, and health status of people with intellectual disabilities (ID) is limited and incomplete. Existing evidence suggests per capita health care expenditures for people with ID served by Medicare and Medicaid are at least $50,000 and at minimum 5 times higher than for people without ID. The absence of complete information for this population is a critical gap in the literature and hinders the ability to target and track the progress of public health initiatives for this high utilizing group.

In an effort to address this issue, Massachusetts is one of five pilot states working with the Association of University Centers on Disabilities and the Center for Disease Control and Prevention on a pilot project to identify people with ID using Medicaid data. The purpose of the pilot project is to test the performance of an algorithm to identify people with ID, and to analyze patterns of health service utilization, cost of care and prevalence of comorbid chronic conditions. 

Experiences with the algorithm in Massachusetts Medicaid data will be discussed, as well as state-specific findings of the demographics, prevalence of chronic health conditions and service utilization and expenditures for this population. Findings will be compared with what is known from other sources about the demographics of state-service recipients in order to inform validity of methods.  Findings from Massachusetts’ experience will likely have relevance for other states with similar expanded Medicaid coverage under the Affordable Care Act, and similar Medicaid data structure.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Describe health service utilization for Massachusetts Medicaid recipients with intellectual and developmental disabilities.

Keyword(s): Disabilities, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-investigator on a number of grants and projects related to health service utilization for people with intellectual and developmental disabilities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.