Asthma Costs for the Medicaid Managed Care (MMC) Asthma Universe Population in New York State, 2011

Costs for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Asthma Universe Asthma-Related Cost Total Cost (Asthma-Related and Unrelated Services) Percent of Total Cost Asthma-Related Cost per Member per Year
267,581 $312,169,066 $2,156,091,590 14% $1,167

*12 months continuous enrollment


Total Cost, Average Cost per Service and Average Cost per Enrollee by Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Asthma-Related Service Total Costs Percent Total Number of Services Average Cost per Service Number of Enrollees Average Cost per Enrollee
Outpatient Visit $46,068,717 14.8% 350,546 $131 158,934 $290
ED Visit $8,481,564 2.7% 39,187 $216 28,368 $299
Hospitalization $53,150,430 17.0% 7,717 $6,887 6,132 $8,668
Pharmacy $204,468,354 65.5% 1,851,618 $110 233,370 $876

*12 months continuous enrollment


Average Asthma-Related Service Cost per Enrollee by Age Group and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Asthma-Related Service 0-4 5-11 12-50 51-64
Outpatient Visit $269 $268 $287 $395
ED Visit $286 $264 $321 $339
Hospitalization $7,212 $7,464 $9,175 $11,625
Pharmacy $550 $673 $890 $1,571

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Age Group for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

0-4 5-11 12-50 51-64 Total (0-64)
Average Asthma-Related Service Cost per Enrollee $997 $925 $1,097 $1,985 $1,167

*12 months continuous enrollment


Average Asthma-Related Service Cost per Enrollee by Gender and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Asthma-Related Service Male Female
Outpatient Visit $283 $296
ED Visit $300 $299
Hospitalization $8,101 $9,119
Pharmacy $800 $935

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Gender for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Male Female
Average Asthma-Related Service Cost per Enrollee $1,092 $1,225

*12 months continuous enrollmen


Average Asthma-Related Service Cost per Enrollee by Race and Ethnicity and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Asthma-Related Service Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
ED Visit $340 $324 $266 $277
Hospitalization $7,237 $9,278 $7,690 $8,752
Outpatient Visit $248 $298 $258 $315
Pharmacy $905 $821 $842 $896

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Race and Ethnicity for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
Average Asthma-Related Service Cost per Enrollee $1,025 $1,252 $1,017 $1,239

*12 months continuous enrollment


Total Asthma-Related Service Cost and Number of Enrollees by Region for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

Service Category New York City Rest of State
Outpatient Visit $32,786,710 $13,282,008
ED Visit $5,515,757 $2,965,808
Hospitalization $43,112,504 10,037,927
Pharmacy $145,499,764 $58,968,590

*12 months continuous enrollment

MMC Average Asthma-Related Service Cost per Enrollee by Region for the Asthma Universe* Population, New York State, 2011

New York City Rest of State
Average Asthma-Related Service Cost per Enrollee $1,246 $998

*12 months continuous enrollment

Total Asthma-Related Service Cost and Number of Enrollees by Region for the Medicaid Managed Care Asthma Universe* Population, New York State, 2011

New York City Rest of State New York State
Total Asthma-Related Service Cost $226,914,733 (73%) $85,254,332 (27%) $312,169,065
Number of Enrollees 182,125 (68%) 85,456 (32%) 267,581

*12 months continuous enrollment