Intellectual or developmental disabilities, such as Down syndrome, are conditions that are present from childhood that may result in difficulties with learning, problem solving, and using everyday life skills. Medicaid home-and community- based services (HCBS) programs provide a range of services that can help individuals with these disabilities with daily activities, such as eating and bathing.
Reviewing Medicaid data for six selected states, GAO found that over 45 percent of beneficiaries with intellectual or developmental disabilities enrolled in HCBS programs had an additional health condition in 2019. Health conditions included behavioral health conditions, such as anxiety disorders, and chronic physical conditions, such as high blood pressure. Among beneficiaries enrolled in comprehensive HCBS programs, which cover round-the-clock care, the prevalence of behavioral health conditions was higher than in the overall Medicaid population.
GAO’s analysis found that average per-beneficiary Medicaid expenditures in 2019 for beneficiaries with intellectual or developmental disabilities in selected states ranged from about $51,000 to $70,000. This is two to five times higher than the average expenditure for all Medicaid beneficiaries with disabilities.