Introduction

A large share of healthcare spending in the United States goes towards care for a small subset of patients. In fact, a 2013 Centers for Medicare and Medicaid Services study found that just 1 percent of the population accounts for 22 percent of total annual healthcare expenditures (1). These “super-utilizers” of healthcare services generally have far higher rates of emergency department (ED) visits and hospital admissions than the general population (2).In 2013, the Healthy Michigan Act—Michigan’s Medicaid Expansion law—required the Michigan Department of Community Health (MDCH, now the Michigan Department of Health and Human Services) to examine the prevalence and causes of overutilization and “improper” ED use among MI Medicaid beneficiaries (3). The report, published in 2014, includes an analysis of Medicaid claims data for the years 2011-2013 as well as recommendations for decreasing high utilization of emergency services.

Author(s): Mahshid Abir, Stuart Hammond, Samantha Iovan, Paula M. Lantz