Asthma Costs for the Medicaid Managed Care (MMC) Asthma Universe Population in New York State, 2013

Costs for the Medicaid Managed Care Asthma Universe* Population, New York State, 2013

Asthma Universe Asthma-Related Cost Total Cost (Asthma-Related and Unrelated Services) Percent of Total Cost Asthma-Related Cost per Member per Year
314,473 $295,622,614 $2,495,426,808 12% $940

*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, 2013

Asthma-Related Service Total Costs Percent Total Number of Services Average Cost per Service Number of Enrollees Average Cost per Enrollee
Outpatient Visit $50,139,935 17.0% 483,930 $104 169,349 $296
ED Visit $11,128,615 3.8% 49,320 $226 34,615 $321
Hospitalization $60,804,526 20.6% 8,655 $7,025 6,832 $8,900
Pharmacy $173,549,539 58.7% 1,724,630 $101 228,965 $758

*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, 2013

Asthma-Related Service 0-4 5-11 12-50 51-64
Outpatient Visit $283 $292 $274 $394
ED Visit $304 $293 $338 $368
Hospitalization $7,491 $7,357 $9,705 $11,552
Pharmacy $279 $422 $726 $1,402

*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, 2013

0-4 5-11 12-50 51-64 Total (0-64)
Average Asthma-Related Service Cost per Enrollee $717 $668 $873 $1,676 $940

*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, 2013

Asthma-Related Service Male Female
Outpatient Visit $285 $305
ED Visit $320 $323
Hospitalization $8,377 $9,338
Pharmacy $679 $815

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Gender for the Medicaid Managed Care Asthma Universe* Population, New York State, 2013

Male Female
Average Asthma-Related Service Cost per Enrollee $861 $1,001

*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, 2013

Asthma-Related Service Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
ED Visit $340 $354 $294 $301
Hospitalization $7,515 $9,242 $8,176 $9,186
Outpatient Visit $257 $305 $271 $323
Pharmacy $843 $709 $724 $758

*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, 2013

Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
Average Asthma-Related Service Cost per Enrollee $875 $1,042 $813 $973

*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, 2013

Service Category New York City Rest of State
Outpatient Visit $33,646,059 $16,493,876
ED Visit $7,439,479 $3,689,137
Hospitalization $49,380,291 $11,424,235
Pharmacy $111,354,294 $62,195,245

*12 months continuous enrollment

MMC Average Asthma-Related Service Cost per Enrollee by Region for the Asthma Universe* Population, New York State, 2013

New York City Rest of State
Average Asthma-Related Service Cost per Enrollee $1,016 $810

*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, 2013

New York City Rest of State New York State
Total Asthma-Related Service Cost $201,820,122 (68%) $93,802,492 (32%) $295,622,614
Number of Enrollees 198,704 (63%) 115,769 (37%) 314,473

*12 months continuous enrollment