CHP: While NYS Medicaid Enrollment Booms, Per Enrollee Cost Drops by 32%

Medicaid Growth Is Outside NYC Borders
Crain’s Health Pulse October 23, 2013

The New York City Independent Budget Office released a detailed dissection of the state's Medicaid program yesterday, and some of the trends it identified are surprising. Since 2008, with the onset of the economic downturn, most of the enrollment growth in Medicaid has been outside New York City.

Between 2008 and 2012, only 44% of overall enrollment growth was in the city, compared with 35.2% upstate and 20.7% in downstate suburbs. Since 2000, total Medicaid enrollment grew by 75% in the city, 87.4% upstate and 131.6% in downstate suburbs.

There also was a demographic shift in coverage. In 2000, children made up 44% of those on Medicaid, the largest share statewide, while adults made up the smallest percentage, 23% of enrollees. By 2012, adults were the largest group, at 38.3%. (Other enrollees are seniors and the disabled.)

What isn't a surprise finding of the report is that Medicaid enrollment in the state has grown. In the 12 years since 2000, Medicaid enrollment shot up 83.3%, to nearly 5 million New Yorkers in 2012, from around 2.7 million in 2000.

But the data suggest good news for the state's efforts, through the Medicaid Redesign Team, to curb Medicaid costs. While enrollment in Medicaid skyrocketed, the inflation-adjusted cost-per-enrollee fell. The IBO report said the real annual cost per enrollee decreased by 31.7% during the period, to $8,900 from $13,100. While Medicaid spending rose to $44.5 billion in 2012 from $22.7 billion in 2000—up 96% in nominal terms and 25% in real (inflation-adjusted) terms—enrollment was much higher by 2012.

The report is online here.