Medicare Benefit Design and Long-Term Services and Supports: Gaps, Opportunities, and Implications for Beneficiaries


As members of the baby boom generation experience increasing physical and cognitive limitations, the adequacy of Medicare's benefits related to such conditions — both acute care and long-term services and supports (LTSS) — will become a central policy issue. To address these issues, policymakers require timely information on beneficiaries' care utilization, costs, and needs. This project will update analyses conducted by Johns Hopkins under a current Commonwealth Fund grant to understand beneficiaries' financial burdens and unmet needs and conduct new analyses related to LTSS. This project has two principal aims: 1) inform Medicare policy options for restructuring Medicare benefits and cost-sharing and 2) inform understanding of how an aging population affects LTSS access, use, and cost. The Johns Hopkins team will first use data from the Medicare Current Beneficiary Survey (2010 and 2015) to update evidence on the financial burden of health care expenses and premiums for beneficiaries, with a focus on low-income adults, services not covered by Medicare, and prescription drugs. The team will then use National Health and Aging Trends Study (2011–2015) data to describe use, access, unmet need, and financial burden for complex patients with acute care as well as LTSS needs. This analysis will also explore how unmet need for LTSS, and the financial burden associated with these services, may lead to beneficiary enrollment in Medicaid or to more Medicare hospitalizations and postacute admissions. Results from these analyses will enrich federal policymakers' and health system leaders' understanding of the health care needs and financial burdens that people with Medicare coverage face. In anticipation of an aging and increasingly high-need Medicare population, the project will also inform policy discussion surrounding need for and use of long-terms services and supports.

Grant Details

Grantee Organization:
Johns Hopkins University
Principal Investigator:
Amber Willink, Ph.D., and Karen Davis, Ph.D.
Award Amount:
Approval Date:
July 11, 2017

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