Trends in Medicare Spending: an Analysis on the Dual-Eligible Population


Although it is well documented that health care spending by Medicare–Medicaid dual eligibles is disproportionately high compared with spending by Medicare-only beneficiaries, long-term trends in spending growth for the dual-eligible population are less clearly understood. As Medicare shifts toward value-based, risk-adjusted payment systems, there may be opportunities to provide more efficient services to this population. Access to care could be jeopardized, however, if payment methods do not accurately reflect health care costs. The project team will build on prior Commonwealth Fund–supported work showing that most of the recent slowdown in Medicare spending is concentrated among the costliest 25 percent of beneficiaries. The researchers will examine factors, such as use of institutional long-term care, that drove per-beneficiary spending by dual eligibles from 2007 to 2014. They will examine these results for key subsets of the dual-eligible population, including beneficiaries only partially covered by Medicaid or those residing in nursing homes. In addition, the researchers will analyze how changes in the characteristics of dual eligibles across states influence spending trends, and whether these trends change when states see disproportionate growth in their dual-eligible population relative to growth in their low-income elderly population.

Grant Details

Grantee Organization:
Vanderbilt University Medical Center
Principal Investigator:
Melinda Buntin, Ph.D.
Award Amount:
Approval Date:
April 12, 2016

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