5 Percent of Medicaid Enrollees Accounted for Half of Program’s Spending

A small-but-expensive fraction of Medicaid recipients accounted for nearly half of all spending for the program each year from 2009 to 2011, according to a new government report that studied people who do not also receive Medicare.

“Studies on healthcare spending generally find that a small percentage of individuals account for a large proportion of expenditures, and Medicaid — a federal-state health financing program for low-income and medically needy individuals — is no exception,” the Government Accountability Office said Friday in a report to Congress.

Medicaid had roughly 72 million enrollees and spending about $460 billion in fiscal 2013, although some also receive Medicare, a separate government-sponsored program. These “dual eligibles” accounted for about 13 percent of the Medicaid population and were excluded from the GAO study.

The most expensive 1 percent of Medicaid-only enrollees accounted for about a quarter of spending among that population, and the priciest 5 percent accounted for nearly half, the GAO found.