Asthma Costs for the Medicaid Managed Care (MMC) Asthma Universe Population in New York State, 2010

Costs for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Asthma Universe Asthma-Related Cost Total Cost (Asthma-Related and Unrelated Services) Percent of Total Cost Asthma-Related Cost per Member per Year
249,350 $276,571,675 $1,929,029,077 14% $1,109

*12 months continuous enrollment


Total Cost, Average Cost per Service and Average Cost per Enrollee by Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Asthma-Related Service Total Costs Percent Total Number of Services Average Cost per Service Number of Enrollees Average Cost per Enrollee
Outpatient Visit $39,694,849 14.4% 408,517 $97 149,810 $265
ED Visit $6,732,135 2.4% 37,488 $180 26,937 $250
Hospitalization $53,295,721 19.3% 7,762 $6,866 6,149 $8,667
Pharmacy $176,848,970 63.9% 1,727,249 $102 216,556 $817

*12 months continuous enrollment


Average Asthma-Related Service Cost per Enrollee by Age Group and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Asthma-Related Service 0-4 5-11 12-50 51-64
Outpatient Visit $249 $245 $260 $355
ED Visit $238 $235 $260 $278
Hospitalization $7,404 $7,481 $9,045 $11,063
Pharmacy $498 $641 $803 $1,433

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Age Group for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

0-4 5-11 12-50 51-64 Total (0-64)
Average Asthma-Related Service Cost per Enrollee $973 $901 $1,014 $1,846 $1,109

*12 months continuous enrollment


Average Asthma-Related Service Cost per Enrollee by Gender and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Asthma-Related Service Male Female
Outpatient Visit $257 $272
ED Visit $251 $249
Hospitalization $8,257 $8,992
Pharmacy $749 $869

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Gender for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Male Female
Average Asthma-Related Service Cost per Enrollee $1,044 $1,159

*12 months continuous enrollmen


Average Asthma-Related Service Cost per Enrollee by Race and Ethnicity and Type of Asthma-Related Service for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Asthma-Related Service Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
ED Visit $248 $262 $232 $244
Hospitalization $6,948 $9,230 $8,117 $8,778
Outpatient Visit $238 $269 $231 $286
Pharmacy $845 $763 $786 $836

*12 months continuous enrollment

Average Asthma-Related Service Cost per Enrollee by Race and Ethnicity for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Non-Hispanic White Non-Hispanic Black Non-Hispanic Other Hispanic
Average Asthma-Related Service Cost per Enrollee $970 $1,187 $955 $1,182

*12 months continuous enrollment


Total Asthma-Related Service Cost and Number of Enrollees by Region for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

Service Category New York City Rest of State
Outpatient Visit $27,995,711 $11,699,139
ED Visit $4,958,698 $1,773,437
Hospitalization $44,815,220 $8,480,501
Pharmacy $127,831,649 $49,017,321

*12 months continuous enrollment

MMC Average Asthma-Related Service Cost per Enrollee by Region for the Asthma Universe* Population, New York State, 2010

New York City Rest of State
Average Asthma-Related Service Cost per Enrollee $1,191 $924

*12 months continuous enrollment

Total Asthma-Related Service Cost and Number of Enrollees by Region for the Medicaid Managed Care Asthma Universe* Population, New York State, 2010

New York City Rest of State New York State
Total Asthma-Related Service Cost $205,601,278 (74%) $70,970,398 (26%) $276,571,676
Number of Enrollees 172,567 (69%) 76,783 (31%) 249,350

*12 months continuous enrollment