Sickle Cell Disease (SCD) has a complex array of symptoms and is associated with high healthcare expenditures. A comprehensive care program may help to reduce expenditures of children with SCD. This research describes SCD comprehensive care program enrollees’ expenditure patterns by level of hospitalization risk over a three-year period and estimates whether coordination of care services reduced costs for those with different risk levels. Medicaid claims data were collected for program patients with SCD. Data from the one year prior to program enrollment categorized patients as High, Medium, or Low risk for incurring inpatient expenditures. We compared utilization risk groups on inpatient expenditures by year after program enrollment. The trends in expenditures are shown in the subgroup analyses (descriptively). 361 program enrollees ages 1 to 27y had SCD; 8.9% were categorized as High risk of utilizing hospitalization services, 47.9% were at Medium risk, and 43.2% were at Low risk. The High Utilization and Medium Utilization Risk groups showed trends of expenditure reduction, but the trends may be due to regression of extreme group costs toward the mean. The lack of a statistically significant cost benefit might be due to small sample size, low engagement in the program services, short duration of intervention, and inability to distinguish the appropriateness of healthcare utilization for SCD.