Excess Medical Expenditures Associated with Diabetes-Related Complications among Adult Medicaid Enrollees in Eight U.S. States

The financial burden imposed by diabetes on Medicaid is substantial. While most of this burden is due to treating diabetes-related complications, little information is available on how much Medicaid paid for those complications and variability by state. Using 2008-2012 Medicaid claims data, we estimated per-capita annual medical expenditures for treating selected diabetes-related acute and chronic complications among Medicaid enrollees. Our study population included adults aged 19-64 enrolled in fee-for-service plan from eight states with adequate sample size, stratified by eligibility criteria: disability vs. non-disability enrollees. Complication conditions were identified using ICD-9 codes and selected based on sufficient sample size to derive reliable estimates. We compared expenditures between those with and without selected complications to derive excess expenditures. Diabetes-related complications consumed a substantial amount of excess Medicaid health care resources across the eight states (Table). Excess expenditure levels varied by state, condition, and eligibility criteria, with ischemic heart disease and renal disease having the largest variation. Implementing effective diabetes prevention and control measures could reduce expenditures on complications.