The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare
This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account for most of the group’s spending, and dual eligibles who are high cost to the Medicare program are generally not the same individuals who are high cost to the Medicaid program. The new analysis has important implications for efforts to integrate benefits and align financing for dual eligibles.
Issue Brief (.pdf)
A shorter version of this analysis was published in Health Affairs.
April 2009 (.pdf)
also of interest
- Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?
- Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations