Preventing Tomorrow's High-Cost Claims: The Rising-Risk Patient Opportunity in Medicaid

This commentary notes the superiority of targeting rising-risk patients rather than high-cost claimants for Medicaid cost containment based on analysis of 13.1 million beneficiaries across 15 states. In 2019, spending for rising-risk patients increased by 98.5% whereas spending for high-cost claimants decreased by 41.6%. Significantly, 54% of…