Missouri Medicaid Chartbook
Missouri Charts
©2005 Medicaid Work Group, University of Missouri--Columbia
1
Missouri Percentage of Enrollment Groups by Sex and Race, Feb 2005
Missouri Medicaid Chartbook MISSOURI CHARTS
Female, 52.7% Male, 47.3%
Blind/Disabled
3.4%
21.3% 75.3% Female, 71.7% Male, 28.3%
Elderly
4.6% 17.2% 78.2% Female, 67.3% Male, 32.7%
Adult
5.1% 22.7% 72.2%
Medicaid enrollment reflects the characteristics of Missouri’s poor
Female, 49.8% Male, 50.2%
Child
4.3% 29.2% 66.6%
W hite
Black
Other/Unknown
Source: DHSS, MICA; USDC, Bureau of the Census.
©2005 Medicaid Work Group, University of Missouri--Columbia
2
Missouri Medicaid Expenditures by Enrollment Group, FY2005 Total Enrollees 992,622
Missouri Medicaid Chartbook MISSOURI CHARTS
Total Expenditures $5,557,804,149
Children accounted for 55% of enrollees, but only 20% of expenditures
Note: Other includes Medicaid Assistance to Pregnant Women and the Breast or Cervical Cancer Program. Source: MoDSS Summary Table 5, FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
3
Medicaid Enrollees by Enrollment Group, FY1998 – FY2005 1,200,000 1,000,000 800,000 600,000 400,000
Missouri Medicaid Chartbook
The number of Medicaid enrollees increased to nearly one million Missourians in 2005
200,000 0 1998
1999
Adult
2000
Child
2001
2002
2003
Blind & Disabled
©2005 Medicaid Work Group, University of Missouri--Columbia
2004
Elderly
2005
Other
T otal
4
Medicaid Enrollees by Enrollment Group, FY1998 – FY2005 3%
3%
3%
100% 90%
29%
28%
25%
80% 1%
1%
70%
1%
2%
2%
2%
2%
2%
23%
22%
22%
21%
22%
1%
1%
2%
2%
2%
55%
55%
56%
19%
20%
19%
60% 56%
50%
55% 58%
58%
40%
55%
30% 20% 10%
11%
10%
17%
19%
Missouri Medicaid Chartbook
Between 2000 and 2005, there was little change in the relative mix of Missouri Medicaid enrollees by eligibility category
19%
0% 1998
1999
Adult
2000
Child
2001
2002
Blind & Disabled
2003
Elderly
©2005 Medicaid Work Group, University of Missouri--Columbia
2004
2005
Other
5
National Health & State Medicaid Expenditure Trends 1998 - 2005
Missouri Medicaid Chartbook MISSOURI CHARTS
National health expenditures were $6,423 per person (over $1.9 trillion) and Missouri Medicaid expenditures were $5,599 per enrollee 2005
2004
2003
2002
2001
2000
1999
1998
$7,000 $6,500 $6,000 $5,500 $5,000 $4,500 $4,000 $3,500 $3,000 $2,500 $2,000
National Health Expenditures Per Capita Missouri Medicaid Expenditures Per Enrollee
Source: Centers for Medicare & Medicaid Services, Office of the Actuary and MoDSS Summary Table 5, FY98-05, US Census.
©2005 Medicaid Work Group, University of Missouri--Columbia
6
Missouri Medicaid Expenditures by Type of Service, FY2005
Missouri Medicaid Chartbook MISSOURI CHARTS
(in billions of $)
Pharmacy is the largest category of costs to Missouri Medicaid
Note: All other includes rehabilitation & specialty care, EPSDT, buy-in premiums, and dental services. Source: MoDSS Summary Table 5, FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
7
Percentage of Missouri Medicaid Expenditures by Type of Service, FY2005 Managed Care 15%
Mental Health 7%
Physician 6% In-Home 6%
Nursing Facilities 15%
Hospitals 16%
All Other 12%
State Institutions 5%
Rehab & Specialty Services 3% EPSDT 3%
Pharmacy 22%
Missouri Medicaid Chartbook MISSOURI CHARTS
Managed care includes payments to hospitals, physicians, and additional health services
Buy-In 2% Dental 1%
Source: MoDSS Summary Table 5, FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
8
Annual Medicaid Expenditures by Service Type, FY1998 – FY2005
Missouri Medicaid Chartbook MISSOURI CHARTS
$1,400,000,000
$1,200,000,000
$1,000,000,000 Pharmacy Hospitals Nursing Facilities Managed Care
$800,000,000
Mental Health Physician In-Home All Other
$600,000,000
Pharmacy expenditures increased 232% between 1998 and 2005
$400,000,000
$200,000,000
$0 1998
1999
2000
2001
2002
2003
2004
2005
Source: MoDSS Summary Table 5, FY1998 - FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
9
Missouri Medicaid Chartbook
Average Monthly Recipients by Service Type, FY1998–FY2005
MISSOURI CHARTS
The increase in managed care reflects a shift from fee-for-service
Source: MoDSS Summary Table 5, FY1998 - 2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
10
Top Medicaid Expenditures by Service Type and Enrollment Group, FY 2005 Other 5.8% Physician 11.1% Pharmacy 13.6%
Hospitals 19.8%
Other 18.7%
Other 27.3%
Other 12.4% Rehab 4.3%
MISSOURI CHARTS
Other 3.5% Physician 23.4%
In-Home 12.3%
EPSDT 9.7% Pharmacy 9.1%
Mental Health 13.7%
Hospitals 18.0%
Physician 6.9%
Pharmacy 6.5%
Nursing Facilities 49.2%
Hospitals, 45.0%
Pharmacy 21.9%
Managed Care 21.6%
Pharmacy 31.7% Managed Care 49.8%
Missouri Medicaid Chartbook
Managed Care 44.6% Hospitals 20.4%
Adults
Children
Blind/Disabled
Elderly
$536,438,883
$1,170,751,020
$2,386,441,894
$1,369,283,388
The mix of service expenditures differs by enrollment group
Other $94,888,964
Source: MoDSS Summary Table 5, FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
11
Average Monthly Cost per Service Recipient by Service Type, 1998-2005
Missouri Medicaid Chartbook MISSOURI CHARTS
$3,000
$2,500 NURSING FACILITIES HOSPITALS
$2,000
DENTAL SERVICES PHARMACY PHYSICIAN RELATED
$1,500
IN-HOME SERVICES REHAB & SPECIALTY BUY-IN PREMIUMS MENTAL HEALTH SERVICES
$1,000
STATE INSTITUTIONS
Nursing facilities cost about $2,716 a month in Missouri
EPSDT SERVICES MANAGED CARE
$500
TOTAL
$0 1998
1999
2000
2001
2002
2003
2004
2005
Source: MoDSS Summary Table 5, FY1998 - FY2005.
©2005 Medicaid Work Group, University of Missouri--Columbia
12