Trends In Medicare Fee-For-Service Spending Growth For Dual-Eligible Beneficiaries, 2007-15

Health Aff (Millwood). 2018 Aug;37(8):1265-1273. doi: 10.1377/hlthaff.2018.0143.

Abstract

Cost containment for dual-eligible beneficiaries (those enrolled in Medicare and Medicaid) is a key policy goal, but few studies have examined spending trends for this population. We contrasted growth in Medicare fee-for-service per beneficiary spending for those with and without Medicaid in the period 2007-15. Relative to Medicare-only enrollees, dual-eligible beneficiaries consistently had higher overall Medicare spending levels; however, they experienced steeper declines in spending growth over the study period. These trends varied across populations of interest. For instance, dual-eligible beneficiaries ages sixty-five and older went from having annual spending growth rates that were 1.8 percentage points higher than Medicare-only beneficiaries in 2008 to rates that were 1.1 percentage points lower in 2015. Across population groups, long-term users of nursing home care had some of the highest spending growth rates, averaging 1.7-4.1 percent annually depending on age group and Medicaid participation. These findings have implications for value-based payment and other Medicare policies aimed at controlling spending for dual-eligible beneficiaries.

Keywords: Financing Health Care; Health Spending; Medicaid; Medicare; Special Populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Eligibility Determination*
  • Fee-for-Service Plans*
  • Female
  • Health Expenditures / trends*
  • Humans
  • Male
  • Medicare / economics*
  • Middle Aged
  • United States