In recent years, Medi-Cal has had at least one patient whose annual medical expenses have reached between $15 million and $21 million.
The massive bills speak to the breadth of services Medi-Cal provides, as well as the staggering costs of some of those services.
They also underscore the challenges policymakers are facing with possible cuts in the federal government’s contribution to Medicaid proposed in the House and Senate Obamacare repeal bills. For patients like these, there often isn’t anywhere to reduce costs, experts say.
Medi-Cal, which is jointly funded by the federal and state governments, provides health coverage to 13.5 million Californians, or a third of state residents.
State data show that the most expensive 1% of patients in Medi-Cal account for 23% of the program’s spending. Ten percent of patients create 63% of total costs.
Some of those people may be addicted to drugs or have a mental health condition that contributes to their high healthcare expenses. They may overuse the emergency room because they don’t know how to navigate the healthcare system or find a primary care doctor.
Source: LA Times