A study of medical costs associated with selected genetic disorders in Texas.
We estimated that the payments associated with the 11 selected diseases during 1987 in Texas included $88.2 million from Medicaid and $10.6 million from CIDC for a total of $98.8 million. Patients with these diseases represented 0.83% of Medicaid claims, but 4.68% of Medicaid payments. Medicaid payments for genetic services for patients with these 11 selected disorders in Texas during a nine-month period in 1987 were $10,122, or 0.02% of the total Medicaid payments for these claimants. We conclude that our estimate of the Medicaid payments for these disorders in 1987 of nearly $100 million represents a low estimate of the true medical costs for the care of these patients. This study also indicates that these 11 disorders represent a disproportionate share of Medicaid payments; i.e., these patients show a high ratio of payment per claim. We also conclude from these data that CIDC is a significant source of support for the medical care of these patients in Texas. And, finally, this study suggests that referral for genetic services represents a significant barrier for individuals in need of these services.
McCabe
E R
ER
Patterson
P J
PJ
Botsonis
H
H
Day
D W
DW
Lockhart
L
L
Martinec
J D
JD
Weber
B
B
Godbout
R
R
Malitz
D
D
D002648:Child; D016208:Databases, Factual / Q000592:standards / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D005817:Genetic Counseling / Q000191:economics*; D030342:Genetic Diseases, Inborn / Q000145:classification / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D008484:Medicaid / Q000191:economics*; D008489:Medical Indigency; D006278:Medicare / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics; D013781:Texas; D014481:United States