medicaid benefit package, and could be much more effectively used on the pop population with disabilitiedisa. this is a slide,er we're used to seeing in every part of our health care system. there's only a few people who account for the majority of any spending. and in medicaid the top 5% really account for a substantial share of that spending and the few people there that are children and adults are relatively small but high cost. really there is largely driven by the disability population. when we think about the disabled on medicaid we have to remember they include substantial share of the population with severe mental illness and it's often when you look at who is a high cost beneficiary, it's the combination of one or another of the disabling conditions combined with mental illness. and so a diabetic, i think ken looked at this, someone with diabetes is being treated with a mental illness is at a higher cost and less likely to follow treatment protocols than someone who is just a diabetic. so that is a real challenge and especially as ken even alluded to, much of the medicaid care coord

medicaid benefit package, and could be much more effectively used on the pop population with disabilitiedisa. this is a slide,er we're used to seeing in every part of our health care system. there's only a few people who account for the majority of any spending. and in medicaid the top 5% really account for a substantial share of that spending and the few people there that are children and adults are relatively small but high cost. really there is largely driven by the disability population. when we think about the disabled on medicaid we have to remember they include substantial share of the population with severe mental illness and it's often when you look at who is a high cost beneficiary, it's the combination of one or another of the disabling conditions combined with mental illness. and so a diabetic, i think ken looked at this, someone with diabetes is being treated with a mental illness is at a higher cost and less likely to follow treatment protocols than someone who is just a diabetic. so that is a real challenge and especially as ken even alluded to, much of the medicaid care coord