Genetic services for underserved populations. C. Finance/insurance issues

A study of medical costs associated with selected genetic disorders in Texas

E. R B McCabe, P. J. Patterson, H. Botsonis, D. W. Day, Lillian Lockhart, J. D. Martinec, B. Weber, R. Godbout, D. Malitz

Research output: Contribution to journalArticle

Abstract

We estimated that the payments associated with the 11 selected diseases during 1987 in Texas included $88.2 million from Medicaid and $10.6 million from CIDC for a total of $98.8 million. Patients with these diseases represented 0.83% of Medicaid claims, but 4.68% of Medicaid payments. Medicaid payments for genetic services for patients with these 11 selected disorders in Texas during a nine-month period in 1987 were $10,122, or 0.02% of the total Medicaid payments for these claimants. We conclude that our estimate of the Medicaid payments for these disorders in 1987 of nearly $100 million represents a low estimate of the true medical costs for the care of these patients. This study also indicates that these 11 disorders represent a disproportionate share of Medicaid payments; i.e., these patients show a high ratio of payment per claim. We also conclude from these data that CIDC is a significant source of support for the medical care of these patients in Texas. And, finally, this study suggests that referral for genetic services represents a significant barrier for individuals in need of these services.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalBirth Defects: Original Article Series
Volume26
Issue number2
StatePublished - 1990
Externally publishedYes

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Genetic Services
Inborn Genetic Diseases
Medicaid
Vulnerable Populations
Insurance
Costs and Cost Analysis
Health Care Costs
Patient Care
Referral and Consultation

ASJC Scopus subject areas

  • Genetics(clinical)
  • Developmental Biology

Cite this

Genetic services for underserved populations. C. Finance/insurance issues : A study of medical costs associated with selected genetic disorders in Texas. / McCabe, E. R B; Patterson, P. J.; Botsonis, H.; Day, D. W.; Lockhart, Lillian; Martinec, J. D.; Weber, B.; Godbout, R.; Malitz, D.

In: Birth Defects: Original Article Series, Vol. 26, No. 2, 1990, p. 132-138.

Research output: Contribution to journalArticle

McCabe, ERB, Patterson, PJ, Botsonis, H, Day, DW, Lockhart, L, Martinec, JD, Weber, B, Godbout, R & Malitz, D 1990, 'Genetic services for underserved populations. C. Finance/insurance issues: A study of medical costs associated with selected genetic disorders in Texas', Birth Defects: Original Article Series, vol. 26, no. 2, pp. 132-138.
McCabe, E. R B ; Patterson, P. J. ; Botsonis, H. ; Day, D. W. ; Lockhart, Lillian ; Martinec, J. D. ; Weber, B. ; Godbout, R. ; Malitz, D. / Genetic services for underserved populations. C. Finance/insurance issues : A study of medical costs associated with selected genetic disorders in Texas. In: Birth Defects: Original Article Series. 1990 ; Vol. 26, No. 2. pp. 132-138.
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