Association of Healthcare Use and Expenditure Based on Dual Eligibility and Enrollment in Managed Care
2024

Healthcare Use and Spending for Dual Eligible Individuals

publication

Author Information

Author(s): Toseef Mohammad Usama, Dharia Aastha, Homayouni Ramin, Tarraf Wassim

Primary Institution: Corewell Health, Royal Oak, Michigan, United States

Hypothesis

Does enrollment in managed care affect healthcare use and expenditures for individuals with dual eligibility in Medicaid and Medicare?

Conclusion

Dual eligible individuals use more inpatient and emergency room services than non-duals, but managed care does not significantly change their expenditures.

Supporting Evidence

  • Dual eligible individuals have higher inpatient and emergency room usage compared to non-duals.
  • Non-duals in managed care have lower outpatient and emergency room visits than those not in managed care.
  • No significant differences were found for dual eligibles based on managed care status.

Takeaway

People who have both Medicaid and Medicare go to the hospital and emergency room more often than those who only have one type of insurance, but being in a managed care plan doesn't change how much they spend.

Methodology

The study used the 2020-2021 Medical Expenditure Panel Survey and applied Poisson regressions and generalized linear models to analyze healthcare use and expenditures.

Limitations

More research and years of data are needed to determine the impact of managed care on dual eligibles.

Participant Demographics

Individuals enrolled in both Medicaid and Medicare.

Digital Object Identifier (DOI)

10.1093/geroni/igae098.4387

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