Rutgers report urges high-quality interventions for Medicaid high utilizers
According to a new report released in January 2016 from Rutgers Center for State Health Policy, small groups of high-cost Medicaid recipients in New Jersey – the majority of them with a mental health or and/or substance abuse problem —account for disproportionately large shares of total spending. In 2013, Medicaid spent approximately $9.4 billion in direct patient care for approximately 1.6 millionNew Jersey recipients. Individuals in the top 1% of the spending distribution account for 28% of total statewide spending, and those in the top 10% account for approximately 75% of statewide spending.
The prevalence of behavioral health issues in the highest spending individuals is one of the most striking features of the report, and highlights the urgency of providing adequate access to services. In Camden, as in many parts of New Jersey, the need for behavioral health services far outstrips the available supply.
Other high-priority recommendations from the report include integration of behavioral and physical health, identifying and developing interventions for populations with persistently high costs, and coordinating social service and public health, especially through the full implementation of the ACO demonstration project of which the Camden Coalition of Healthcare Providers is a part, and assessment of learning from the ACO operations.