Medicare Spending Growth Slows Down for Duals


It’s long been known that Medicare beneficiaries who also qualify for full Medicaid coverage — the so-called dual-eligible beneficiaries, or duals — use more health care and incur much higher costs than those enrolled in Medicare only. But a Commonwealth Fund–supported study in Health Affairs suggests that the spending gap between duals and Medicare-only beneficiaries does not appear to be widening.

Researchers led by Laura M. Keohane of Vanderbilt University Medical Center report average annual spending growth from 2007 to 2015 of 0.1 percent for duals, versus 0.2 percent for Medicare-only beneficiaries.

Still, there was a greater decline in inpatient hospital spending for Medicare-only beneficiaries than for duals, raising questions about whether Medicare’s recent reforms to provider payment are enough to control costs for duals. The authors say additional reforms may need to focus on long-term nursing home patients, who had both high levels of spending and high spending growth.

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