Missouri Medicaid Chartbook. Missouri Charts Medicaid Work Group, University of Missouri--Columbia

Missouri Medicaid Chartbook Missouri Charts ©2005 Medicaid Work Group, University of Missouri--Columbia 1 Missouri Percentage of Enrollment Group...
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Missouri Medicaid Chartbook

Missouri Charts

©2005 Medicaid Work Group, University of Missouri--Columbia

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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