Medicaid PMPM Medical Spending Higher For Beneficiaries Without Social Supports

Medicaid member per month (PMPM) medical spending was higher among adult beneficiaries in the Medicaid expansion population who said they had trouble securing food, clothing, or housing, or had other problems considered "addressable social determinants of health." Within a group of 7,762 adult Medicaid expansion beneficiaries enrolled in a health plan in Chicago, Illinois, the average PMPM for medical and pharmacy, based on 12 months of utilization, was $387. Among a sub-group of these beneficiaries who on enrollment had reported low prior emergency department (ED) and inpatient utilization, the total PMPM averaged $217 for those who reported no . . .