Joslyn R Tijerina MPH Study Population December 2015 snapshot of all individuals with an IO Waiver 19371 What is the Individual Options IO Waiver Medicaid waiver for people who have developmental disabilities ID: 651982
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Cost of Serving People on an Individual Options (I/O) Waiver
Joslyn R. Tijerina, MPHSlide2
Study Population
December 2015 snapshot of all individuals with an I/O Waiver
19,371Slide3
What is the Individual Options (I/O) Waiver?
Medicaid waiver for people who have developmental disabilities
Allows eligible people to receive the services and supports in their homes, rather than live in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
A more comprehensive waiver, as it has a higher funding limit and was developed to meet individualized needsSlide4
Demographics of I/O Waiver Individuals
Age
Count
2 to 4
1
5 to 13
228
14 to 18
72319 to 2046521 to 448,86945 to 595,58960 to 641,39865 to 741,40175 to 8433385+62
*2 individuals with unknown ageSlide5
Medical Expenses of Those on I/O Waivers
In CY 2015, $1.5 billion was spent by Medicaid on the I/O Waiver participants
Average Cost Per Person: $78,218.20Slide6
What Do We Mean by Dual-Diagnosis in this Study?
Medicaid Data Warehouse (QDSS) has 9 Mental Health Clinical Conditions groups pre-identified as behavioral health diagnoses
Dual-Diagnosis
Person has an I/O Waiver
Person has at least one pre-identified behavioral health diagnosisSlide7
What are the Clinical Condition Groups?
Clinical Condition
Example Diagnoses
Mental
Hlth
-Antisocial
Behav
Antisocial personality disorder, Pyromania, Homicidal ideation, Socialized conduct disorder
Mental Hlth-Anxiety DisorderGeneralized anxiety disorder, Panic disorderMental Hlth-Bipolar DisorderBipolar disorder, Manic disorderMental Hlth-DepressionMajor depressive disorder, Adjustment disorderMental Hlth-Neuroses, NECSocial phobia, Personality Disorder, Gender Identity disorder, Pica, Insomnia, ADD/ADHD, Developmental delayMental Hlth-Obsess-CompulsivObsessive-compulsive disorder, Fluency disorderMental Hlth-Psychoses, NECDelirium, Dementia, Paranoid state, Psychosis, Pervasive developmental disorderMental Hlth-SchizophreniaSchizophreniasMental Hlth-Substance Abuse
Alcohol and/or drug withdrawal, addiction, dependence, poisoning, and/or abuse, Alcoholic cirrhosisSlide8
Behavioral Health Diagnosis: Yes or No?
*9 people excludedSlide9
Total Medicaid Costs for I/O Waiver IndividualsSlide10
Average Medicaid Costs Per Person
$78,218.20Slide11
Number of Individuals with each Behavioral Health DiagnosesSlide12
Total Medicaid Cost Compared to Average Per Person by Behavioral Health DiagnosesSlide13
Average Medicaid Cost Per Person by Behavioral Health Diagnoses
$78,218.20Slide14
Conclusion
Developmentally disabled individuals on an I/O waiver with at least one behavioral health diagnoses have higher average Medicaid costs
I/O Waiver individuals with Neuroses (NEC), Psychoses, and Depression had the highest total Medicaid costs
The average cost per person was highest for Antisocial Personality Disorder, Schizophrenia, and BipolarSlide15
Limitations
Data is representative only of Ohio DODD population with Medicaid
Data may look different in other states or within counties or regions of Ohio
Clinical conditions were defined by Medicaid and are very broadSlide16
Future Analyses
In the future, it would be beneficial to repeat this analysis and compare outcomes based on:
Age
Ohio Region/County
Other States Slide17
Thank You!
Questions? Contact us!
Hope
McGonigle
:
hope.mcgonigle@dodd.ohio.gov
Joslyn Tijerina:
joslyn.tijerina@dodd.ohio.gov
Arati Sharma: arati.sharma@dodd.ohio.gov