R-2, Measurement of Economic Utility: Development of Tools To Identify and Measure Disability Population Segments

Analyzing Medicaid Healthcare Claims for People with Disabilities

What's the Bottom Line?

People with physical disabilities or cognitive limitations have higher prevalence rates for chronic diseases and are less likely to receive preventive services than persons with no disabilities. This study presents some policy strategies to improve the health and reduce costs for adults with physical disabilities or cognitive limitations.

What We've Learned

Disease Rates

  • Adults with physical disabilities or cognitive limitations have an increased risk of developing seven major chronic conditions (arthritis, asthma, cardiovascular disease, diabetes, high blood pressure, high cholesterol, and stroke).
  • More than 70% of those with physical disabilities are either overweight or obese compared to 62.7% of the cognitive disabilities group and 59.7% of the no disability group.

Associated Costs

  • Individuals with cognitive limitations ($11,487/year) had expenditures 4.8 times higher than those with no disabilities ($2,375/year).
  • Individuals with physical disabilities ($10,288/year) had average expenditures 4.3 times higher than those with no disabilities ($2,375/year).
  • Much of this cost resulted from preventable conditions that required additional outpatient and hospital care.

How Policy Change Can Help

Public health interventions and disease management programs must be designed to address the unique characteristics of adults with disabilities.

When programming incorporates the specific needs of individuals with disabilities, it will result in better use of health care expenditures and improved quality of life.

A three-pronged approach is needed to implement appropriate interventions:

  1. To increase the physical accessibility of medical facilities, legal and regulatory reform is needed and could start with implementation of the Americans with Disabilities Act Accessibility Guidelines (ADAAG) at the community level.
  2. To improve the appropriateness of care received, we must ensure that health providers receive sufficient training regarding proper disability etiquette and the unique health needs of those with disabilities.
  3. To improve health behaviors of people with disabilities, especially those related to weight loss, physical activity and disease management, we must increase appropriate physical supports. This includes the development of physically accessible exercise facilities and integration with acute care systems to fully incorporate behavioral health strategies into disease management programming.

People with disabilities can be healthy if barriers to health promotion and disease prevention programming are addressed.

For more information, contact Amanda Reichard, Ph.D., principal investigator, reichard@ku.edu or the Research and Training Center on Measurement and Interdependence in Community Living at the RTC/IL, 4089 Dole, 1000 Sunnyside Avenue, Lawrence, KS 66045

Phone: 785-864-4095 (voice), 785-864-0706 (TTY)


Using Research Findings for Advocacy (PDF) - Presentation by Amanda Reichard, PhD

Using Research Findings for Advocacy (YouTube) - Presentation by Audrey Schremmer-Philip, Executive Director of Three Rivers Center for Independent Living

Fact Sheets: 

Ways to Improve Health and Reduce Costs for Adults with Physical Disabilities or Cognitive Limitations (PDF available upon request)

Preventive Screening Improvements Needed for People with Physical Disabilities

Comparing Diabetes Rates among Adults with Cognitive Limitations to Adults with No Disabilities in the U.S. 

The Intersection of Disability and Chronic Disease


A Model Assessment for Surveillance of Disease Prevalence and Monitoring Cost Utility and Health Outcomes of Individuals with Physical Disabilities Served by HCBS Waivers (PDF)

Diabetes among Adults with Cognitive Limitations Compared to Individuals with No Disabilities in the United States (PDF available upon request)

National Institute on Disability and Rehabilitation Research grant H133B060018