Pilot Program Seeks Better Care, Lower Costs for Medicaid "Super Utilizers"

The budget for Missouri’s Medicaid program grew to over $9 billion last year, crowding out funding for other vital programs and once again demonstrating the need for reforms to reduce costs without jeopardizing care.

US healthcare expenses are higher per person than in any other developed nation, but almost one-fourth of our country’s healthcare costs are generated by only 1% of the population. Many of these “Super Utilizers” suffer from chronic conditions that are not properly managed, and their physical ailments are often exacerbated by mental illness or addiction. These individuals generally bounce between emergency rooms where they receive expensive but fragmented care. Such uncoordinated medical services cannot deliver long-term improvements to their health and wellbeing.

This year the Missouri legislature proposed, and the governor signed, a care management pilot program to better serve the Super Utilizers in Missouri’s Medicaid system. Coordinating medical services for Missouri’s most expensive patients will help them access the right care at the right time and reduce the state’s healthcare costs.

In the St. Louis Post-Dispatch, Dr. Randall Jotte, an emergency medicine physician in St. Louis, wrote about his experiences treating Super Utilizers. You can read the full article here.