Children with noncomplex chronic diseases use one-third of annual Medicaid pediatric spending

Thirty-six percent of children enrolled in Medicaid have noncomplex chronic diseases (NC-CDs), such as asthma, diabetes, or depression, accounting for a third of Medicaid pediatric expenditures, according to a retrospective, cross-sectional analysis.

Generalizing to the 35 million children on Medicaid nationally, the NC-CD population accounts for $35 billion in annual Medicaid spending (Pediatrics. 2017. doi: 10.1542/peds.2017-0492).

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“An improved understanding of children with NC-CDs and their associated health care expenditures is needed to improve health care delivery for this population and may provide opportunities for health policy interventions to reduce costs of care,” they said.

The per member per year (PMPY) expenditures for children with NC-CDs was significantly less than that of children with complex chronic disease (C-CDs), but the annual aggregate expenditure for the NC-CD group represents a substantial cost because of the high prevalence of these conditions. The annual expenditures for the entire group was $7,226,354,620 over the study period, or $3,037 PMPY. The total PMPY expenditure for children with NC-CDs ($2,801) was significantly greater than children without chronic disease ($1,151) and lower than children with C-CDs ($12,569).

Children with NC-CDs accounted for 36% of the study population and 33% of the annualized aggregate expenditure. Children without chronic disease accounted for 53% of the study population and 20% of annualized aggregate expenditure. Children with C-CDs accounted for 11% of the study population and 47% of the annualized aggregate expenditure.

mkalaycio@frontinemedcom.com