Clarifying Multimorbidity Patterns to Improve Targeting and Delivery of Clinical Services for Medicaid Populations

To inform the delivery of targeted care for the highest-need beneficiaries, this resource examines comorbidity patterns among Medicaid beneficiaries under 65 years old with disabilities. Key findings include:

• Among this population, people who have the highest hospitalization rates and receive the most avoidable, costly care also frequently have multiple conditions.
• For beneficiaries with one of five common chronic physical conditions — asthma/chronic obstructive pulmonary disease, congestive heart failure, coronary heart disease, diabetes, or hypertension — the presence of mental illness as well as drug and alcohol disorders significantly increases per capita costs and number of hospitalizations.
• Beneficiaries who have a mental illness in addition to common chronic physical conditions have health care costs that are 60 to 75 percent higher than those without a mental illness.
• Evidence-based models for addressing multimorbidity share common elements that can inform Medicaid care management approaches.
• Greater integration and care management strategies are needed to meet the needs of beneficiaries with multiple conditions.