Understanding Medicaid Utilization for Children in New York State

Authors: Lee Kennedy-Shaffer, Chad Shearer 

See the related press release.

Medicaid in New York is a vital safety net for many low-income children and adolescents. The program covered more than 2 million members under the age of 21 as of July 2014, a full 43.5 percent of the total estimated population of children and adolescents in New York State. Despite their typically lower costs and utilization, children are an important focus for Medicaid. They make up 37 percent of enrollees in any given month, and they face a disproportionate burden of certain risks and diseases compared to their non-Medicaid counterparts.

To support emerging State efforts around value-based payment for child and adolescent populations, this brief highlights key findings on current Medicaid spending and utilization for children. The analysis compares children and adults, and then identifies multiple subpopulations of children with higher levels of need. Accompanying the brief is a chartbook that depicts in more detail the underlying data analysis. Information on Medicaid expenditures and utilization (including emergency department visits, other hospital inpatient visits, and length of stay) is broken out by numerous factors, including characteristics of the Medicaid enrollees (age, race/ethnicity, and diagnosis).

The brief and chartbook are part of a larger body of work at UHF focused on children's health and health care services.

Funded by the New York State Department of Health.