High-cost persistence among medicaid patients receiving mental health care

Scott Wetzler, Nathaniel Counts, Bruce Schwartz, Urvashi Patel, Sarah Overholt, Samantha Holcombe, Joseph Parks

Research output: Contribution to journalArticlepeer-review


Purpose: Care management for high-cost patients is only effective if their costs persist year-to-year. Little is known about the relative persistence of high-cost patients receiving mental health care compared to random chance or a national sample of the general population. Methods: We identified Medicaid patients receiving mental health care that were in the top 20%, 10%, and 5% of costs based on claims that remained high-cost two and three years. The likelihood of two-year persistence for those in the top 10% was compared to random chance and a national sample using a 2x2 contingency table. Results: The high-cost population demonstrated two-year persistence of 64% for top 20%, 56% for top 10%, 46% for top 5%. Compared to 10% persistence from random chance and 43% persistence from a national sample, the sample persistence was significantly greater. Conclusions: High-cost Medicaid patients with mental health diagnoses demonstrate greater high-cost persistence than the general population.

Original languageEnglish (US)
JournalJournal of Health Care Finance
Issue number1
StatePublished - Jun 2021


  • Behavioral health
  • Healthcare costs
  • Mental health
  • Population health

ASJC Scopus subject areas

  • Health Policy


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