title: Comparing methods for identifying future high-cost mental health cases in Medicaid.
abstract: OBJECTIVE
  This article examines methods for identifying future high-cost cases of Medicaid-covered mental health care services.
  
  
  METHODS
  Florida Medicaid claims data are used to compare methods based on prior cost, and concurrent and prospective diagnosis-based models. Individuals with prior year expenditures in the top decile or with predicted expenditures in the top decile from the diagnosis-based models were expected to be high-cost individuals.
  
  
  RESULTS
  Individuals in the top decile of prior year costs averaged $13,684 (U.S. dollars) in costs in the following year with 50% remaining in the top decile of spending. Individuals classified as high cost by diagnosis-based models averaged $10,935 to $10,974, with 34% meeting the criteria for a high-cost case in the following year.
  
  
  CONCLUSIONS
  In contrast to research on high-costs cases for physical health care, prior cost was superior to diagnosis-based models at identifying future high cases for mental health care.
authors.affiliation: Department of Mental Health Law and Policy, Florida Mental Health Institute, University of South Florida, Tampa, FL 33612, USA. jrobst@fmhi.usf.edu
authors.forename: John
authors.initials: J
authors.lastname: Robst
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005431:Florida; D006801:Humans; D007223:Infant; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics*; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D044469:Racial Groups; D012737:Sex Factors; D014481:United States