Children accounted for 36.5 percent of Medicaid enrollees in 2021, which was the largest share of all enrollment groups. The elderly and persons with disabilities had the smallest shares, but together they accounted for more than half of all Medicaid expenditure.

Medicaid expenditures per enrollee Medicaid is a joint federal and state health care program in the United States. The program provides medical coverage to millions of Americans and supports a variety of enrollment groups, particularly senior citizens and individuals with disabilities. Medicaid per enrollee spending is significantly higher for these two groups because they require more frequent and costly long-term care in the community and nursing homes. In 2022 of the total U.S. health expenditure on home health care, Medicaid paid one-third.

Millions of Americans are uninsured The United States has a multi-payer health care system, meaning that some Americans will be covered by private health insurance, and others will be covered by a government program such as Medicaid. However, approximately 27.6 million people in the U.S. had no health insurance in 2021, and should they require health care, they would have to pay the full price out of their own pocket. This becomes a real problem for many because the United States has the most expensive health care system in the world.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.

Children accounted for **** percent of Medicaid enrollees in 2022, which was the largest share of all enrollment groups. The elderly and persons with disabilities had the smallest shares, but together they accounted for ************** of all Medicaid expenditure. Medicaid expenditures per enrollee Medicaid is a joint federal and state health care program in the United States. The program provides medical coverage to millions of Americans and supports a variety of enrollment groups, particularly senior citizens and individuals with disabilities. Medicaid per enrollee spending is significantly higher for these two groups because they require more frequent and costly long-term care in the community and nursing homes. In 2022 of the total U.S. health expenditure on home health care, Medicaid paid one-third. Millions of Americans are uninsured The United States has a multi-payer health care system, meaning that some Americans will be covered by private health insurance, and others will be covered by a government program such as Medicaid. However, approximately **** million people in the U.S. had no health insurance in 2021, and should they require health care, they would have to pay the full price out of their own pocket. This becomes a real problem for many because the United States has the most expensive health care system in the world.

Objective: A one third reduction of premature deaths from non-communicable diseases by 2030 is a target of the United Nations Sustainable Development Goal for Health. Unlike in other developed nations, premature mortality in the United States (US) is increasing. The state of Oklahoma suffers some of the greatest rates in the US of both all-cause mortality and overdose deaths. Medicaid opioids are associated with overdose death at the patient level, but the impact of this exposure on population all-cause mortality is unknown. The objective of this study was to look for an association between Medicaid spending, as proxy measure for Medicaid opioid exposure, and all-cause mortality rates in the 45–54-year-old American Indian/Alaska Native (AI/AN45-54) and non-Hispanic white (NHW45-54) populations.Methods: All-cause mortality rates were collected from the US Centers for Disease Control & Prevention Wonder Detailed Mortality database. Annual per capita (APC) Medicaid spending, and APC Medicare opioid claims, smoking, obesity, and poverty data were also collected from existing databases. County-level multiple linear regression (MLR) analyses were performed. American Indian mortality misclassification at death is known to be common, and sparse populations are present in certain counties; therefore, the two populations were examined as a combined population (AI/NHW45-54), with results being compared to NHW45-54 alone.Results: State-level simple linear regressions of AI/NHW45-54 mortality and APC Medicaid spending show strong, linear correlations: females, coefficient 0.168, (R2 0.956; P < 0.0001; CI95 0.15, 0.19); and males, coefficient 0.139 (R2 0.746; P < 0.0001; CI95 0.10, 0.18). County-level regression models reveal that AI/NHW45-54 mortality is strongly associated with APC Medicaid spending, adjusting for Medicare opioid claims, smoking, obesity, and poverty. In females: [R2 0.545; (F)P < 0.0001; Medicaid spending coefficient 0.137; P < 0.004; 95% CI 0.05, 0.23]. In males: [R2 0.719; (F)P < 0.0001; Medicaid spending coefficient 0.330; P < 0.001; 95% CI 0.21, 0.45].Conclusions: In Oklahoma, per capita Medicaid spending is a very strong risk factor for all-cause mortality in the combined AI/NHW45-54 population, after controlling for Medicare opioid claims, smoking, obesity, and poverty.

The services offered by psychiatric hospitals are extensive, covering specialized facilities like detox centers, mental health hospitals providing comprehensive care and addiction hospitals focusing on substance use disorders. Some facilities are equipped to offer integrated services for individuals with multiple diagnoses. This growth indicates both rising demand and increased public awareness of mental health and substance use issues. However, geographic disparities, especially in the West, where uneven population distribution creates service provision challenges. The financial stability of these hospitals heavily depends on payor distribution. Medicare and Medicaid contribute about a quarter of the revenue, while third-party insurers provide nearly two-thirds. Economic conditions impact these payors differently, influencing hospital revenue, operational costs and profitability. During economic downturns, cuts in government funding may reduce revenue and changes in private insurance markets can influence patient volumes. Despite initial challenges from the health crisis, government and public insurance coverage have stimulated growth. Industry revenue will climb at a CAGR of 1.1% through 2025, reaching $35.3 billion, with a 3.0% increase in 2025 alone. Innovation and consolidation are transforming hospital services and organizational structures. Artificial intelligence, teletherapy and virtual reality enhance service offerings and patient outcomes. AI aids diagnosis and personalizes treatment, while teletherapy improves access, especially in underserved areas. Virtual reality introduces novel treatment options, appealing to patients seeking advanced therapies. Also, mergers and acquisitions and an increase in the number of hospital affiliations with chains promote financial stability and competitive strength. Larger organizations leverage resources to invest in infrastructure and negotiate favorable terms with insurers, helping them stay competitive despite rising staffing costs. Future federal policy might influence consumer demand and access to psychiatric services. The reorganization under the Administration for a Healthy America (AHA) may involve budget, staff and reimbursement cuts, potentially reducing service demand and access to grants and support. State-specific reductions in Medicaid funding could destabilize hospitals reliant on these reimbursements. Even so, economic factors are expected to drive overall growth. Increases in per capita disposable income, an increase in the number of privately insured individuals and growing health expenditures will bolster funding for hospital services. Industry revenue is projected to grow at a CAGR of 2.4%, reaching $39.7 billion by 2030, with profit revenue share remaining constant.

Abstract (en): This is the fourth round of the physician survey component of the Community Tracking Study (CTS). The first round was conducted in 1996-1997 (ICPSR 2597), the second round in 1998-1999 (ICPSR 3267), and the third in 2000-2001 (ICPSR 3820). Sponsored by the Robert Wood Johnson Foundation, the CTS is a large-scale investigation of changes in the American health care system and their effects on people. As in the previous rounds, physicians were sampled in the 60 CTS sites: 51 metropolitan and 9 nonmetropolitan areas that were randomly selected to form the core of the CTS and to be representative of the nation as a whole. However, the fourth round lacks an independent supplemental national sample of physicians, which augmented the CTS site sample in the previous rounds. Information collected by the survey includes net income from the practice of medicine, year of birth, sex, race, Hispanic origin, year of graduation from medical school, specialty, board certification status, compensation model, patient mix (e.g., race/Hispanic origin of patients and percent with chronic conditions), career satisfaction, practice type, size, and ownership, percent of practice revenue from Medicare, Medicaid, or managed care, acceptance of new Medicaid and Medicare patients and, if applicable, reasons for not accepting them, use of information technology for care management, number of patient visits and hours worked in medically related activities during the last complete week of work, and the number of hours spent providing charity care in the last month. In addition, the survey elicited views on a number of issues such as patient-physician interactions, competition among practices, the influence of financial incentives on the quantity of services provided to patients, trends in the amount and quality of nursing support, one's ability to provide quality care and obtain needed services for patients, and the importance of various factors that may limit the quality of care. Part 3, the Site and County Crosswalk Data File, identifies the counties that constitute each CTS site. Part 4, Physician Survey Summary File, contains site-level estimates and standard errors for selected physician characteristics, e.g., the average age of physicians, the average percentage of patients with a formulary, and the percentage of physicians who said medical errors in hospitals are a minor problem. Physicians practicing in the contiguous United States who provided direct patient care for at least 20 hours per week. The survey excluded federal employees, specialists in fields in which the primary focus was not direct patient care, graduates of foreign medical schools who were only temporarily licensed to practice in the United States, physicians who had not completed their medical training (residents, interns, and fellows), and physicians who requested of the American Medical Association (AMA) that their names not be released to outsiders. Based on a sampling frame derived from the AMA Masterfile (which includes non-AMA members) and the American Osteopathic Association membership file, the sample design involved randomly selecting both physicians who were interviewed by the third round of the CTS Physician Survey and physicians who were not included in earlier rounds of the survey. Among the 6,628 physicians who were interviewed in round four, 4,428 also responded to round three. Only those physicians whose mailing address fell within the boundary of one of the 60 sites were selected for the survey. 2008-05-14 Stata setups were added to the collection. In addition, a missing value label for variable AP1 was added to the SPSS setup for the Restricted-Use Version of the Main Data File. Funding insitution(s): Robert Wood Johnson Foundation. computer-assisted telephone interview (CATI) Additional information about this study can be found at the Web site of the Center for Studying Health System Change.