Abstract

BackgroundThis paper studies the temporal consistency of health care expenditures in a large state Medicaid program. Predictive machine learning models were used to forecast the expenditures, especially for the high-cost, high-need (HCHN) patients.ResultsWe systematically tests temporal correlation of patient-level health care expenditures in both the short and long terms. The results suggest that medical expenditures are significantly correlated over multiple periods. Our work demonstrates a prevalent and strong temporal correlation and shows promise for predicting future health care expenditures using machine learning. Temporal correlation is stronger in HCHN patients and their expenditures can be better predicted. Including more past periods is beneficial for better predictive performance.ConclusionsThis study shows that there is significant temporal correlation in health care expenditures. Machine learning models can help to accurately forecast the expenditures. These results could advance the field toward precise preventive care to lower overall health care costs and deliver care more efficiently.

Highlights

  • This paper studies the temporal consistency of health care expenditures in a large state Medicaid program

  • Chronic condition cohorts We examined the temporal correlation of health expenditures among entire study population as well as four chronic disease cohorts

  • We first present the temporal correlation of expenditures for the adult population, HCHN, and patients with chronic conditions

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Summary

Introduction

This paper studies the temporal consistency of health care expenditures in a large state Medicaid program. Predictive machine learning models were used to forecast the expenditures, especially for the high-cost, high-need (HCHN) patients. Machine learning models can help to accurately forecast the expenditures These results could advance the field toward precise preventive care to lower overall health care costs and deliver care more efficiently. In the United States, the Centers for Medicare & Medicaid Services (CMS) reported that in 2014, health care accounted for 17.5% of the national GDP [1] This amount is expected to increase over the several years. Resources, in terms of expenditures, are disproportionately consumed by a relatively small proportion of the health care utilizing population [2] As a result, this group of health care utilizers has been termed high-cost, high-need (HCHN) patients

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